Radically Open Dialectical Behavior Therapy by Thomas R. Lynch

Author:Thomas R. Lynch
Language: eng
Format: epub
Tags: PSY007000 Psychology / Clinical Psychology, PSY023000 Psychology / Personality, MED105000 Medical / Psychiatry / General, PSY045070 Psychology / Movements / Cognitive Behavioral Therapy (cbt)
Publisher: New Harbinger Publications

Targeting Problematic Social Signaling in Session: A Step-by-Step Protocol

Broadly speaking, whether identified from in-session behavior or derived from clients’ self-reports of behavior occurring outside of session, the most important question to keep in mind when targeting social signaling is How might my client’s social signaling impact social connectedness? The core idea is for the therapist to use her personal success in establishing close social bonds as a template to evaluate the potential effectiveness of her client’s social signaling (this presumes, of course, that the therapist has had some success herself in forming long-term intimate bonds). To put it another way, the essence of this evaluation boils down to the following question: If this person were not my client, would I enjoy spending time with him? Or, to be even more colloquial, Is this the type of person I would like to go have a beer with? If not, why not? Or, more specifically, What is it about my client’s social signaling that might make people less likely to desire to affiliate with him? However, there are some unique features associated with in-session social signaling targeting that, once mastered, can be iteratively integrated into targeting social signals outside of session (that is, social signals that are never seen directly by a therapist but only heard about via clients’ self-reports). Thus I chose to begin with in-session behaviors.

The entire protocol (which I affectionately call the “yawning protocol”) is summarized in detail by the clinical example presented in appendix 5. It includes not only detailed descriptions of the client’s nonverbal social signaling, which can be used to determine whether a client is engaged or nonengaged in treatment, but also detailed accounts of how the therapist uses his own social signaling behavior to influence the client, without ever saying a word.

It is important not to become demoralized by the amount of detail or the number of steps in the protocol (there are fifteen in all), because in many ways this one clinical example contains the entire essence of RO DBT when it comes to treatment targeting; indeed, it makes this chapter almost superfluous. Plus, to go even stronger (let’s be bold), when the clinical example in appendix 5 is combined with a thorough knowledge of the skills training manual, the therapist is basically equipped with the core principles of what to target and how to target (these principles are found in appendix 5) as well as how to intervene (these principles are found in the skills training manual). Another advantage of appendix 5 is that it illustrates just how much social signaling is happening in session that oftentimes we don’t notice, or ignore, or believe to be irrelevant, or have no idea what to do with.53

The clinical example in appendix 5 should not be mistaken as relevant only to clients who yawn. It is also intended to be used as a template for applying the targeting principles to other potential problematic social signals. To do so, simply replace the word “yawn” and its variants

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