موقعیت یابی مشتریان برای مربیگری تلفنی در رفتار درمانی دیالکتیکی

Considerable attention in the literature has been devoted to individual therapy and group skills training in dialectical behavior therapy. However, there is a relative dearth of information on telephone coaching in DBT. While several authors have addressed important issues in DBT, including studies on efficacy and therapeutic considerations, what is glaringly absent from the literature is a basic overview of how to orient new clients to DBT phone coaching. The goal of the current paper is to highlight the following six important areas and their role in orientation to DBT phone coaching: (a) orientation to the three functions of DBT telephone coaching; (b) orientation to the rationale of the 24-hour rule; (c) orientation to the logistics of contacting their therapist after hours; (d) orientation to observing the therapist’s personal limits; (e) orientation to the purpose of phone holidays; and (f) orientation to the practice of using skills prior to calling. A video is provided to further elucidate how to orient clients to DBT telephone coaching.

Many researchers and clinicians recognize the importance of orienting clients to treatment. The goal of this paper and the accompanying video was to extend this to the area of orienting clients to DBT telephone coaching. Clinicians who are new to DBT may not fully appreciate how DBT telephone coaching differs from intersession contact that they previously have had with clients. Orienting clients to the three functions of DBT telephone coaching provides the therapist and the client with the information of when and why to contact a therapist between sessions. By explaining the 24-hour rule, prior to the occurrence of any nonsuicidal self-injurious behaviors, clients are made aware of the contingencies. Similarly, orienting clients to phone holidays and the therapist’s personal limits around phone coaching allows therapists to be proactive rather than reactive when personal limits are breached. Orientation to phone coaching often occurs after an unsuccessful or problematic use of phone coaching. Because clients with BPD can be keenly sensitive, this can feel like a reprimand, and, as such, may deter some clients with BPD from using phone coaching in the future. Thus, by properly orienting clients to the contingencies present in DBT phone coaching, problematic and unskillful use of this treatment modality is diminished.