Dialectical Behavioral Therapy (DBT) is a model of therapy that uses skills training and the therapeutic relationship to manage strong emotions and behavioral dyscontrol. It was originally created to treat symptoms of Borderline Personality Disorder, primarily suicide and self-harm. DBT uses group work, individual therapy, and self-monitoring to change target behaviors. Multiple studies have found DBT to be an effective evidence-based practice for reducing suicidal behaviors, self-injury, and psychiatric hospitalization compared to treatment as usual. However, DBT requires strict adherence to the treatment manual and all four components of individual therapy, skills training group, phone coaching, and therapist consultation in order to achieve these results. There is ongoing research into adapting
DBT in a concise form. This presentation covers the basics of DBT, the core strategies and the treatment strategies in DBT. Also highlights why DBT was preferred to CBT in patients with borderline personality disorders.
DBT in a concise form. This presentation covers the basics of DBT, the core strategies and the treatment strategies in DBT. Also highlights why DBT was preferred to CBT in patients with borderline personality disorders.
As research into the applications of mindfulness progresses, both in the medical field for problems like pain and chronic illness management, and in the mental health field through therapies such as Dialectical Behavior Therapy, Acceptance & Commitment Therapy, and Mindfulness-Based Cognitive Therapy continue to increase the empirical support for the efficacy of this approach in a variety of conditions, it behooves us to learn more about this and apply it in our own lives and practices.
Kevin Drab
This is a presentation regarding Albert Ellis' REBT. Ellis' model teaches us to dispute irrational beliefs and replace them with rational ones to experience effective change.
MENTAL HEALTH MUST BE BROADLY DEFINED IN TERMS THAT ARE CULTURALLY SENSITIVE AND INCLUSIVE.
THE CRITERIA FOR MENTAL HEALTH MUST BE EMPIRICALLY AND LONGITUDINALLY VALIDATED.
VALIDATION MEANS PAYING SPECIAL ATTENTION TO CROSS-CULTURAL STUDIES.
How to Control Your Anger: Anger Management Techniques for BeginnersJoan Mullally
Discover what anger management is and how you can use it to prevent your anger from running away with you and causing problems in your career and personal life.
As research into the applications of mindfulness progresses, both in the medical field for problems like pain and chronic illness management, and in the mental health field through therapies such as Dialectical Behavior Therapy, Acceptance & Commitment Therapy, and Mindfulness-Based Cognitive Therapy continue to increase the empirical support for the efficacy of this approach in a variety of conditions, it behooves us to learn more about this and apply it in our own lives and practices.
Kevin Drab
This is a presentation regarding Albert Ellis' REBT. Ellis' model teaches us to dispute irrational beliefs and replace them with rational ones to experience effective change.
MENTAL HEALTH MUST BE BROADLY DEFINED IN TERMS THAT ARE CULTURALLY SENSITIVE AND INCLUSIVE.
THE CRITERIA FOR MENTAL HEALTH MUST BE EMPIRICALLY AND LONGITUDINALLY VALIDATED.
VALIDATION MEANS PAYING SPECIAL ATTENTION TO CROSS-CULTURAL STUDIES.
How to Control Your Anger: Anger Management Techniques for BeginnersJoan Mullally
Discover what anger management is and how you can use it to prevent your anger from running away with you and causing problems in your career and personal life.
Treating Co-Occurring Mood & Anxiety Disorders with Substance Use DisordersGlenn Duncan
Evidence Based Treatment in the consideration of treating anxiety and depressive disorders in the substance using populations. Introduction into these disorders, DSM-5 preview with changes to substance use disorders, certain anxiety and mood disorders. Cultural and best practices treatment considerations (Mindfulness, DBT, MI, Cognitive Behavioral Therapy are in focus with mentions on other best practices such as EMDR). Issues of duty to warn and protect are covered also.
11Different types of self-harming treatment for Borderline P.docxdrennanmicah
11
Different types of self-harming treatment for Borderline Personality Disorder I would change title to something like:
Review of Interventions for Self-Harm in the context of a diagnosis of Borderline Personality Disorder
A human being’s personality is affected by surroundings and life situations experiences (eEnvironment) and , biologically inherited traits and daily life experiences. Individual personalities may develop into long term maladaptive patterns of behavior and experiences that differ significantly from what is ‘normal’ and expected by human beings toincrease the risk of give rise to vulnerability to developing different personality disorders Wetterborg (2015). The personality disorders may be develop gradually from adolescence to adulthood and may cause distress to the individual or problems in functioning. Without proper evidence based care and treatment personality disorders may affect the way of thinking about oneself and others and emotional response that will affect how an individual will relate to other people and how one controls his or her behavior. Comment by Ibrahim, Jeyda: Could you break this into two sentences? Comment by Ibrahim, Jeyda: Subtitle- Borderline personality disorder
Borderline personality disorder (BPD) is a type of personality disorder characterized by ongoing pattern of varying mood, self-image and changing behavior. (Wetterborg, 2015)
These individuals may have mood swings, and be uncertain of their place in the world and how they see themselves, hence they may have an intense and unstable pattern relationships with other people. BPD is mostly a mental disorder and is recognized by the Statistical Manual of Mental Disorders (DMS) and is thought to affect at least one percent of the population diagnosed and three quarters are women (Daubney, 2015). This may be because of how sexes deal with criticism in different ways with males tending to cast out issues while females internalize or due to different brain functions of the sexes. Comment by Ibrahim, Jeyda: I am not sure what you mean by mostly a mental disorder? Comment by Ibrahim, Jeyda: I think this needs to be a separate sentence
These people view things in extreme cognitive biases? and may quickly change individual opinionhow they feel about people and be a result of tense relationssomeone?. There are many other symptoms relating to borderline personality disorderBPD such as unstable and distorted self-image or sense of self, having dangerous and impulsive behaviors during periods of elevated moods, self-harming behaviors and procuring thoughts of suicidal behaviors among many others. Borderline personality disorderBPD is not usually diagnosed before adolescence and symptoms may improve or even disappear with time. Full range of most symptoms appear during teenage life and early child hood because diagnosis is difficult in children and some people may not have prevalent signs and symptoms until their mid to late life. AfterIf symptoms begi.
General Overview
Previously had a link to Marsha Linehan's video podcast on Mindfulness. If interested, check the reference section for a direct link for viewing.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
2. What is DBT?
DBT is Dialectical Behavioral Therapy.
A model of therapy that uses skills training and the
therapeutic relationship to manage strong emotions and
behavioral dyscontrol.
Originally created for treatment of symptoms of Borderline
Personality Disorder,
Primarily suicide and self-harm
Has been modified for a variety of treatment settings
A bio/psycho/social model that builds on traditional
behavioral approaches
Uses group work (skills training), individual therapy and self-
monitoring to change target behaviors.
Provides support for clinicians to be able to work with a
difficult population.
3. DBT as Evidence Based Practice
DBT vs TAU comparison group
DBT had higher global functioning scales
DBT had fewer parasuicidal (self-injurious) behaviors
DBT had fewer psychiatric inpatient days
Multiple Randomized Control Trials and Meta-Analyses Conducted
Two separate meta-analysis reviewed effect sizes
Evidence strongest for Suicidal Behaviors/Attempts, Self-Injury, Dropout
Conflicting evidence for Axis I conditions – depression, anxiety, bi-polar
Counterindicated for schizophrenia/psychosis, developmental delays, manic episodes
Replicated across treatment conditions and different treatment manuals
Substance Abuse (DBT-S)
Eating Disorders
Inpatient Settings, Forensics & Older Adults - not supported by RCT
Evidence for clinicians
Reduces clinician drop-out and clinician burnout
4. DBT requires fidelity
DBT is a Manualized Treatment Program requiring treatment
fidelity
Use of Linehan DBT treatment manual (others have not been tested)
Intensive training for providers
Must use all four components
Individual Therapy
Skills Training Group
24 Hour access to skills coaching
Consultation Team for providers
Can only claim to be doing DBT with all of these components
Skills training alone does not constitute DBT as an EBP
“DBT Light”
No consultation or fidelity checks required to implement program
5. What is Dialectics:
The idea that two opposite or contradictory ideas can
exist simultaneously.
Emotions
Behaviors Thoughts
Similar to CBT and behavior modification with addition of
recognition of emotion on thoughts and behaviors (and
VALIDATION of emotion)
7. Stages of Treatment
Stage I Treatment
Stage IV Life Threatening Behavior
Incompleteness Therapy Interferring Behavior
Life Interferring Behaviors
Stage III Quiet Desperation
Problems in Living
Inhibited Grieving
Re-Learning to Experience
Stage II
Emotions
Quiet Desperation
Problems in Living
Stage I “Ordinary Unhappiness”
Life In Hell Incompleteness
Capacity for Joy (Existential)
8. Individual Treatment Strategies
Every session follows the stages of treatment:
“Let’s start with your diary card.”
“Any life threatening behaviors this week?”
Diary cards
Ways to record impulses and behaviors
Rewards for using skills
Transitional Object – continues relationship outside office
Behavior Chains
Maps out rewards/consequences of certain behaviors
Focused way for therapist and client to think about behaviors
Can serve as negative reinforcement…
Skills Review and in-session practice for life situations
Role play skills for life situations
Problem solving
Therapist as participant
Observes and addresses violations of personal boundaries
Offers opinion, disappointment, uses relationship as both reward and consequence
Allows patient to express all emotions, re-teach appropriate emotional response through relationship
Middle ground solutions to dialectical dilemmas
9. Group Skills Training
Skills Training – NOT Group therapy
In CONJUNCTION with individual therapy – the
two compliment each other.
Serves purpose of:
Skill Acquisition
Skills Strengthening
Skills Generalization
Builds relationship with skills groups leaders through therapist
modeling and reinforcement of skills.
11. DBT Group Skills
Mindfulness Skills Distress Tolerance Skills
Wise Mind Wise Mind ACCEPTS
The intersection of Emotion Improve the Moment
and Rational Mind Self-Soothe
The What and How Skills Pros/Cons
Observe Breathing Exercises
Describe Half-Smile
Participate Radical Acceptance
One mindfully Willingness vs.
Effectively Willfulness
Non-Judgementally Turning the Mind
12. DBT Group Skills
Interpersonal
Effectiveness Emotional Regulation
DEAR MAN Model for Describing
To make requests Emotions
GIVE Check the Facts
To maintain relationship
ABC Please
FAST
To maintain self-respect Mindfulness of Emotions
Intensity and Options for Opposite Action
Asking Brainstorming and
Provides Middle Ground for
when, how and if to ask
Problem solving
13. To complete the full program
For DBT fidelity, clients must:
Be able to develop “behavioral” goals
Participate in weekly individual therapy
Attend group sessions for minimum of 6 months
It is recommended that clients repeat and do two rounds for a year
of time
Complete diary cards on a daily basis
Commit to creating a “life worth living”
14. DBT for children
Appropriate for children?
DBT requires insight, impulse control and ability to notice and control one’s
thought patterns
Children under 10-12 years old have not yet developed necessary skills
No treatment manual with differing literacy levels
Modified treatment manuals (those using images rather than text) have limited
evidence as to their use
Perepletchikova, F. Axelrod, S.R., Kaufman, J., Rounsaville, B.J.,
Douglas, H., & Miller, A.L. (2011). Adapting dialectical behaviour
therapy for children: Toward a new research agenda for pediatric
suicidal and non-suicidal self-injurious behaviours. Child &
Adolescent Mental Health, 16,(2) 116-121.
Beginning stages of creating treatment manual
Very small sample
Found that it may be more effective as parent training strategy than for the
children themselves
15. DBT for adolescents
Miller, A.L., Rathus, J.H., Linehan, M.M., &
Swenson, C.R. (2007). Dialectical Behavioral
Therapy with suicidal adolescents. New York:
Guilford Press.
Book about possibility of implementing DBT with
adolescents
Not a treatment manual
Suggests different components to treatment
Suggests different dialectics
16. Differences from standard DBT
Treatment Manual Adolescent Dialectics
Shorter modules
Excessive
Less time in treatment Leniency
Force Normalize
How groups are conducted
Pathological
Autonomy Behavior
Implementation of a
“Graduate Group” Pathologize
Normal
Foster
Dependency
Behaviors
Involvement of the parents Authoritarian
Control
17. Issues using DBT with adolescents
No specific treatment manual
Miller book primarily theory based, not like specific steps to
treatment like Linehan model
Cannot diagnose adolescents with BPD
Personality does not stabilize until after adolescence
Most “typical” adolescent behavior could be considered BPD
Recent concerns with using group treatment methods
with adolescents
Can reinforce deviant/negative behaviors
Many providers moving to Multi-Family Group, where parents are
involved
Not evidence based
No RCT’s
18. Recent publications in DBT-A
Klein, D.A. & Miller, A.L. (2011). Dialectical behavior therapy
for suicidal adolescents. Child & Adolescent Psychiatry Clinics
of North America, 20(5), 205-216.
“Although research to date on dialectical behavior therapy (DBT) for
adolescents has its limitations, growing evidence suggests that DBT is a
promising treatment for adolescents with a range of problematic
behaviors.”
Backer, H.S., Miller, A.L., & van den Bosch, L.M. (2009).
Dialectical beahviour therapy for adolescents; a literature
review. Dutch Journal of Psychiatry, 51(1) 31-41.
“There were no rct's involving dbt in adolescents, but we did find one
quasi-experimental design and several other studies with a pre-post
treatment design. However, the studies were difficult to compare. In
some cases it was doubtful whether the treatment could still be called
dbt.”
19. Recent publications in DBT-A
Fleischhaker, et. al (2011). Dialectical Behavioral
Therapy for Adolescents (DBT-A): a clinical Trial for
patients with suicidal and self-injurious behavior
and borderline symptoms with a one-year Follow-up.
Child and Adolescent Mental Health, 28(1) 3-10.
Pre-post with improvements directly related to suicide
attempts
One year follow up with still no attempts
Only 12 participants in study, no comparison group
20. So what does this all mean?
DBT is effective in reducing suicide and self-injurious
behaviors in adults
Must have fidelity to model to say using DBT
DBT is not appropriate for children at this time
Unlikely that it will be any time soon – work is too far out and not
appropriate developmentally
It is unknown if DBT is effective with adolescent
population
A “promising practice”
Further evidence should be available in next few years, but to date,
no large scale studies done
Understanding of Dialectics. Because people with Borderline PD tend to see things in black and white, the concept of dialectics is one of the grounding theories of this treatment. While standard CBT incorporates thoughts and behaviors, DBT also accounts for the emotions. Validation that emotions are tied to thoughts and behaviors is one of the first concepts presented. With an understanding of the theory behind BPD, contradiction and validation are what make this treatment different.
DBT treatment first requires patients and therapists to define target behaviors in Stage I of treatment. Within life in hell are three areas that must be addressed in this order. By following this path, therapists are better able to control the sessions and focus on target behaviors without getting thrown off track. Stage I is currently the only stage that is well developed. Research is beginning to address treatment strategies for Stages II & III.
Refer Back to DSM Criteria
Skills can be found in DBT workbook; can use individual skills with any client – do not need full treatment to do specific skills