The Analysis of Behavioral Chains in DBT (2020) – Review of the book by Shireen L. Rizvi
The analysis of behavioral chains in DBT presents and exemplifies the foundations of a neither rigid nor schematic method, which identifies the cause-effect relationships between events and behavior.
Among the third wave approaches, Dialectical Behavior Therapy (DBT) has provided numerous evidence of efficacy. The techniques used aim to improve skills, increase tolerance to suffering, increase interpersonal effectiveness, emotional regulation, ultimately the acquisition and generalization of an alternative repertoire of emotional, cognitive and behavioral responses to the aiming to reduce behavioral drowsiness. The functional analysis of behavior is the fundamental tool to move from identifying problems to building solutions.
In the volume The analysis of behavioral chains in DBT the foundations of a neither rigid nor schematic method are presented and exemplified, which identifies the cause-effect relationships between events and behavior:
Behavioral chains offer the possibility of identifying different solutions and implementing the most effective one / s, taking into due consideration the obstacles and the strategies to be adopted to overcome them.
The five components of the chain analysis are:
DBT therapists use behavioral chain analysis to gain a complete understanding of every single episode of a target behavior.
Guidelines for orienting patients to procedures and for increasing collaboration are described by Rizvi; to identify the target behavior of the analysis; to keep the therapist and patient engaged; on the process of inserting solutions in the analysis of the behavioral chain.
The therapist must often describe what he is doing and why he is doing it. Guidance is about providing the client with information about the purpose, process and requirements of a task or procedure.
Validation techniques are explicitly incorporated into the analysis and are used to balance and improve change strategies. The commitment is aimed at dialectically balancing responsive communication, warmth, reciprocity, sincerity, self disclosure and irreverent, humorous communication, which displaces and stimulates a new way of thinking.
In the fifth chapter the author provides an overview of the solutions that can be inserted in the analysis of the behavioral chain classified into four categories: (1) learning of skills, (2) cognitive modification, (3) exposure and (4) contingency management.
What if the behavior doesn’t change? Characteristic reasons why a problem does not improve are listed. The analysis is also carried out on problems concerning occult behaviors in the form of impulses and thoughts that need to be evaluated and treated. Examples of analyzes are presented when the target behavior is less clearly defined.
The last chapter of the book focuses on the analysis of the behavioral chain in therapy team meetings, skills training and telephone coaching.
A very useful reading full of examples that make the theory behind the treatment very clear and offer interesting procedures to be applied in the therapeutic setting.