Coping with COVID Using DBT Skills to Help

Coping with COVID: Using DBT Skills to Help us and our Clients Manage in Times of Crisis Sheri Van Dijk, MSW, RSW sherivandijk@rogers. com ww. sherivandijk. com

Conflict of Interest No individuals who have the ability to control or influence the content of this webinar have a relevant relationship with any commercial interest, including but not limited to members of the Planning Committee, speakers, presenters, authors, and/or content reviewers. “Many of the concepts I'm presenting today are from my books. I do benefit financially from royalty payments from the sale of these products. ”

Objectives 1. Providing support to clinicians in dealing with the COVID-19 crisis 2. Reviewing DBT skills to help clinicians and clients manage through the crisis

Skills to Quickly Re-regulate TIP Skills: 1. Forward Bend (baroreceptors activate PNS) 2. “TIP” the temperature of your face with cold water (mammalian dive reflex) 3. Paced Breathing (PNS)

Dialectics: Walking the Middle Path Limiting exposure to media/social media Versus Staying informed

Dialectics: Walking the Middle Path Taking precautions and being cautious Versus Panicking!

Check the Facts Make sure you’re responding to the facts of the situation. There can be a lot of rumors and misinformation on social media regarding COVID-19. Find reputable sources for checking facts. Check out the organizations below for credible information! World Health Organization: https: //www. facebook. com/WHO @WHO Center for Disease Control: https: //www. facebook. com/CDC @CDCgov

Ø Ø Ø What is Mindfulness? Focusing on one thing at a time, in the present moment, with your full attention, and with acceptance. Step out of automatic pilot Turn your attention to what is happening NOW, within yourself or within your environment. Adopt an attitude of curiosity, acceptance, and openness toward your experience

Mindfulness Reactive Practice: how our clients often start practicing – i. e. when they feel they “need it” Proactive Practice: how we want our clients to be practicing more often; the more they practice proactively, the less often they’ll find themselves “needing” mindfulness

Radical Acceptance Ø “It is what it is” Ø “Acceptance” does NOT mean approval Ø RA reduces the amount of suffering in our lives Ø Acceptance of the past and the present, not the future

Distress Tolerance Techniques to help your client get to Radical Acceptance: 1. Breathing 2. Taking an open posture 3. Half-Smile

Stay STRONG S – Sleep T – Take meds as prescribed and treat health problems R – Resist using drugs and alcohol O – Once daily, build mastery N – Nutrition G – Get exercise In addition, helping clients stick to a routine will be helpful!

Distress Tolerance It’s important to be aware that our clients of course are at more of a risk right now of engaging in problem behaviors (due to high stress levels, as well as increased isolation, cancelation of appointments, etc. )

Distress Tolerance Distracting Skills: Activities (e. g. TV, reading, walking, Zentangle) Contribute to others (e. g. volunteer, do something kind for someone else) Comparisons (e. g. to others, to yourself) Emotions (e. g. TV, music) Pushing Away (with imagery) Thoughts (ie. Generate neutral thoughts, such as counting, singing a song, etc. ) Sensations (e. g. take a bath, elastic band, ice)

Distress Tolerance The skills of Participating emphasizes the importance of feeling connected with others/a higher power/the universe (look at Italy as a wonderful example!) “Care-Mongering”

Distress Tolerance Self-soothing with the senses: 1. Sight (e. g. flowers, clean room) 2. Hearing (another person’s voice, nature, music) 3. Touch (e. g. clean sheets, pets) 4. Taste (e. g. herbal tea, a favourite food, mint) 5. Smell (flowers, perfume, etc. ) - Helpful during a crisis, and also as general selfcare - Note that some people over-use this; others feel guilt and so tend to avoid self-soothing; the challenge with both instances is to help the client find balance.

Distress Tolerance - Have your client make a list of the distracting and self-soothing skills; keeping in mind the current limitations and possible limitations (e. g. if they were to need to self-isolate or quarantine) - Now’s a great time to get them reading about skills, watching You. Tube videos and listening to podcasts (Charlie Swenson’s “To Hell and Back” is on my list!)

TZK Seminars Live Webinars n n Cheaper More comfortable No travel Increased access to national experts Home Study Videos n n n Watch right away, no DVD’s mailed to you Recorded webinar-better than reading a pamphlet Watch in your own time New Webinars n n n Evidence-Based Psychodynamic Psychotherapy Trauma Processing ACT Trauma Focused-CBT Pain Management

Thank You!!!