Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

27. Dialectical Behavior Therapy 621TABLE 27.2. Patient and Therapy Assumptions in Dialectical Behavior TherapyPatients1. Patients are doing the best they can.2. Patients want to improve.3. Patients need to do better, try harder, and be more motivated to change.4. Patients must solve their current problems, regardless of who caused these problems.5. Patients are living lives that are unbearable as they are currently being lived.6. Patients must learn new behaviors in all relevant contexts.Therapy1. Patients can not fail in DBT, but the therapy or therapist can fail the patient.2. Helping patients work toward their ultimate goals in life is the most caring thing atherapist can do.3. DBT therapists need support.4. The therapeutic relationship is a relationship of two equals.5. Principles of behavior are universal, affecting both patients and therapists alike.TABLE 27.3. Patient and Therapist Agreements in DialecticalBehavior TherapyPatient agreements1. Stay in therapy for a specified period of time, usually 1 year.2. Attend all therapy sessions.3. Therapy will be discontinued if four consecutive sessions are missed.4. Work toward terminating self-injurious behavior and other therapeutic targets.5. Participate in skills training.6. Abide by relevant research conditions of therapy.7. Pay agreed upon fees for service.Therapy agreements1. Maintain competence and effort.2. Provide ethical and professional treatment.3. Be available for weekly sessions and phone consultation.4. Treat patients humanely, with respect and integrity.5. Maintain confidentiality.6. Seek appropriate consultation.