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COSIG CONFERENCE BROCHURE.pdf - Drexel University College ...

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<strong>COSIG</strong> Co-Occurring Disorders Conference, Hershey PA, May 15-17, 2006<br />

Essential Components of<br />

Treatment (Paris, 1993)<br />

1. Providing a stable treatment framework<br />

2. Having highly active/involving therapists<br />

3. Establishing a connection between the<br />

person’s actions (e.g. substance use) and<br />

feelings in the present<br />

4. Identifying adverse effects of self-destructive<br />

behaviors, including substance use that<br />

interferes with quality of life<br />

5. Paying careful attention to countertransference<br />

feelings<br />

6. Referring to 12 step programs<br />

31<br />

Subjective Units of Distress Scale<br />

[SUDS] For Self-Management<br />

• “On as stress scale of 0 to 10, with 0 as a<br />

neutral and 10 is the maximum emotional or<br />

physical discomfort you can imagine, where<br />

are you right now?”<br />

• 0 – 3 GREEN ZONE<br />

• 4 – 6 YELLOW ZONE<br />

• 7 – 10 RED ZONE<br />

• Can also be combined with Chain<br />

Analysis of substance use behavior<br />

32<br />

Hierarchy of Treatment<br />

Priorities (APA, 2001)<br />

• Suicidal and self-destructive<br />

behaviors<br />

• Behaviors interfering with therapy<br />

• Behaviors interfering with quality<br />

of life<br />

33<br />

Parasuicidal Behaviors<br />

(Linehan, 1993)<br />

• Nonfatal acts in which an individual deliberately<br />

causes self-injury or ingests a substance in<br />

excess of an prescribed or generally recognized<br />

dose.<br />

• ¾ of BPD individuals have committed at least<br />

one parasuicidal act.<br />

• Parasuicidal acts are never accepted as<br />

therapeutic choice.<br />

34<br />

Skill Building in Therapy with<br />

Persons with BPD<br />

Information can be offered that helps the<br />

understanding of events, feelings,<br />

behaviors etc. and validates the individual.<br />

Learning skills: interpersonal; distress<br />

tolerance; mindfulness; problem solving<br />

and social skills are helpful and can be<br />

accomplished by persons with BPD.<br />

35<br />

Effective Supervision<br />

• Since a team approach is recommended<br />

to treat persons with BPD, team<br />

supervision meetings are recommended to<br />

provide mutual support, problem solving<br />

and to renew “HOPE” for the team<br />

members<br />

• Therapists need regular consultation,and<br />

peer support to manage their own<br />

transference and intense feelings which<br />

arise<br />

36<br />

6

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