for delegates preparing for DBT intensive training part II

1. C H R I S T I N E D U N K L E Y
DBT Case Presentation Template
for part II

2. (intro)
 This side gives very basic info – gender, age, whether
she’s in-patent or out patient, how long she’s been in
DBT, single/lives with partner, number of kids etc
 Around 6-8 bullet points, no historical info on this
slide.

3. (history)
 Here you start to demonstrate your skill – people
who haven’t grasped that this is a BEHAVIOURAL
treatment give loads of irrelevant info here.
 This slide should only take up 2 mins of your
presentation, we don’t care that her sister died when
she was 3. Tell us if she was raped or in prison or a
drug dealer, just the big ticket items. No more than
6-8 bullets.

4. 1st Target hierarchy slide: life threatening
behaviours
 Remember DBT brings ALL the dysfunctional things the
client does into one long line and puts them in order,
with the most serious at the top.
 This slide is for “Suicidal, parasuicidal ,homicidal, or
otherwise imminently life threatening behaviours” that
could KILL YOUR CLIENT BEFORE YOU SEE THEM
NEXT WEEK. (so not smoking or having an eating
disorder)
 The only exception is that you also include here low level
DELIBERATE self harm such as scratching self with a
paperclip. This is because INTENT to harm self with
accompanying action is so highly correlate with suicide.
 Also include URGES to do any of these things

5. 2. Target hierarchy: Therapy interfering
behaviours
 This is for any behaviours that prevent the client
getting therapy from you because they:
 Physically remove the client
 Seriously block you doing the therapy (e.g. running
round the room, saying I don’t know, I don’t know,
not bringing diary card)
 Demotivate the therapist (e.g. making repeated
complaints)

6. 3. Target Hierarchy: Quality of Life Interfering
Behaviours
 This is the hardest slide because the QOLIBs are not well defined in
the book. These are serious, destabilising behaviours that would
constitute a referral to your service or another government agency
in their own right.
 To see if it goes here, ask yourself; if the client was referred with this
problem, and no other, would we accept them onto our books, or
refer them to another government body (e.g. eating disorder,
depression, unemployment, panic disorder, school refusal)
 If it is a condition that you are treating here, then present the
disorder with some example target BEHAVIOURS in brackets, like
this:
 Anorexia (1.missing meals, 2. pretending to eat whilst concealing food)
 Depression (1. staying in bed past 11:00am, 2. not answering phone)
 Unemployment (1.not reading job ads on Thursdays, 2.not applying for 3 jobs per
week)

7. Chain and solution analysis
 It’s fine to do this on a separate page and hand it out.
Do NOT do a bubble diagram. Do a table with the
chain of events down one side, and the solutions that
you provided for each link. See separate sheet.