Wednesday, January 7, 2015

Notes From Therapy

I saw my therapist today for the first time in a couple of weeks. The appointment came at a time when, frankly, I really needed it. Trying to live one day at a time came be difficult when the future hangs in the balance.  Suffice to say, talking with my therapist shined some light onto my someone dark day.

Right now I am going through orientation with him to prep for full-DBT come February. One of the first things he explained to me is that due to his DBT caseload I will have to change therapists once I start the program. He asked me how I felt and after I told him, he said he was really impressed that I was able to stay in wise mind as well as label my emotions in a non-judgmental way. He told me that he's going to miss working with me and one of the things he really likes about me is that no matter how bad things get I'm always willing to do the work. He said that the whole time he's worked with me, I've always been 100% about the treatment and that's refreshing.

So what will full DBT look like? It will consist of the following components.
  • Individual therapy
  • Skills group
  • Coaching calls
  • Medication
  • Consults (for the therapist)
From now until I start I have to keep daily diary cards which tracks things like suicidal behaviors, drug and alcohol use (obviously not an issue for me), and if I've experienced specific emotions within a 24 hour period. The goal of the first year is to eliminate target one behavior. Target one is suicidal behavior. For me this includes actions and (as my therapist and I agreed on), suicidal speech (things like posting to Facebook, telling people I'm going to kill myself. This does not include genuinely asking a friend for help.) If I engage in target one behavior I lose access to my therapist via phone/coaching calls for 24 hours. I still have access to backups, and I can still go to any appointments that may be scheduled in that time frame.

During individual therapy my therapist will go over my diary card for the week and depending on how it's filled out, will first need to address the following three things (lower target numbers take priority. So, 1>2, 2>3)

Target 1: As talked about this is suicidal behavior (includes self-harm)
Target 2: Therapy interfering behaviors. This includes things like not showing up, not doing my homework, lying or omitting things.
Target 3: Quality of life issues (losing a job, relationships, etc). These are things that could potentially trigger target 1 and 2 behaviors.

I also talked to my therapist about the work I've been doing outside of therapy and he was very impressed, and approved of it. He liked that I was taking initiative and keeping busy.

I really needed this session.

No comments:

Post a Comment