Speaker A
Here are the commitment strategies. I'm going to teach you them didactically: boom, boom, boom. Then I'm going to have a Lean Ago Gorian from Clearview come up here. We're going to do a roleplay of trying to get a commitment from her.
An overview of DBT commitment strategies with roleplay examples, focusing on client autonomy, pros and cons, and techniques like foot-in-the-door.
Key Takeaways
- Commitment strategies require understanding client perspectives deeply before encouraging change.
- Maintaining client autonomy and freedom to choose is essential, even when alternatives are limited.
- Techniques from social psychology, such as foot-in-the-door and door-in-the-face, help build commitment gradually.
- Validation and challenge must be balanced to support voluntary engagement in DBT.
- Revisiting and reinforcing prior commitments strengthens treatment adherence.
Summary
- The video explains DBT commitment strategies didactically and through roleplay.
- It emphasizes understanding the pros and cons of committing to change from the client's perspective.
- The importance of validating the client's reasons for current behaviors before exploring disadvantages is highlighted.
- Freedom to choose is a core principle, ensuring clients feel voluntary in their commitment despite limited alternatives.
- The video discusses social psychology techniques like foot-in-the-door and door-in-the-face to gain commitment.
- It stresses cultivating voluntariness even in restrictive settings like prisons or forensic programs.
- The roleplay demonstrates applying these strategies in real treatment scenarios.
- The presenter advocates for balancing challenge, validation, and client autonomy.
- Cheerleading is used to reinforce clients’ belief in their capability to commit.
- Prior commitments are revisited to strengthen ongoing engagement in treatment.
Full Transcript — Download SRT & Markdown
Speaker A
free for a certain target in treatment so I want you to see what these are so you can see them in action pros and cons what are the pros and cons of committing to give up this behavior or to do this
Speaker A
Free for a certain target in treatment. So I want you to see what these are so you can see them in action, pros and cons. What are the pros and cons of committing to give up this behavior or to do this particular thing in treatment? What are the pros and cons?
Speaker A
were in their shoes I also would cut I really that's my standard I don't want to shift over to looking at the disadvantages of cutting until I get it from the inside I almost to where I feel like no wonder
Speaker A
And so you want to get the Ayaka. I usually do the cons first, which means I want to hear the advantages of continuing to cut. I want to hear them so well that actually if I were in their shoes, I also would cut. That's my standard.
Speaker A
know it's a good place and then I shift over saying are there any disadvantages to cutting and then you hear more than if you start out there then once they get that you would cut too they say yeah
Speaker A
I don't want to shift over to looking at the disadvantages of cutting until I get it from the inside. I almost want to feel like, "No wonder you cut. Now I get it. It does so much for you, and you have so little other alternatives. Of course you cut. I would cut too if I was in that exact situation."
Speaker A
cutting bla bla bla all these things okay freedom to choose an absence of alternatives this means I keep conveying to the patient that you are making your own choice for this treatment and these parts of this treatment you're not being
Speaker A
If I get to that point, I know it's a good place. Then I shift over, saying, "Are there any disadvantages to cutting?" And then you hear more than if you start out there. Then once they get that you would cut too, they say, "Yeah, well, I don't like having scars, or I know that my boyfriend, my new boyfriend, doesn't want me to cut, and I don't want to tell him. I don't want to lie to him. Everybody just thinks I should stop cutting," bla bla bla, all these things.
Speaker A
it validate it but let them out they want to be out you know you only go so far of keeping making people do it so with any of these things you want to make sure there's a freedom to choose
Speaker A
Okay, freedom to choose, an absence of alternatives. This means I keep conveying to the patient that you are making your own choice for this treatment and these parts of this treatment. You're not being made to do it. That's just a very important position to be in.
Speaker A
don't have many alternatives but you're treating them as if they completely have the freedom to choose if you work in a prison setting this is all the more important because nobody there feels like they have the freedom to choose
Speaker A
You don't want to be in the position of dragging somebody to do DBT. They want to be out, you know? Challenge them, talk to them, understand it, validate it, but let them out. They want to be out, you know? You only go so far in keeping, making people do it.
Speaker A
this or not do this there might be consequences if you don't do this but that's the way it is in life but it really is your business whether you do this foot in the door and door in the
Speaker A
So with any of these things, you want to make sure there's a freedom to choose.
Speaker A
the door once your foots in the door then you try to expand it door in the face is the opposite it's like if you go to if you're an encyclopedia salesman and you go to the person's door and
Speaker A
The absence of alternatives. Linehan put that in there just because in a lot of cases, there actually aren't many alternatives by this point for that patient. They've been through treatments, they've been through a lot. Things are going down in their life. They really don't have many alternatives.
Speaker A
yeah sure your children have you think they're like the most up-to-date encyclopedia well we have the 1958 world book it's been was good enough for me I mean okay would you think they'd be interested in a more current thing well I suppose
Speaker A
But you're treating them as if they completely have the freedom to choose. If you work in a prison setting, this is all the more important because nobody there feels like they have the freedom to choose.
Speaker A
the door and you say how would you like to pay $100,000 for an encyclopedia britannica for your child door in the face you know you're asking for the moon how would you like to give up cutting for a year even though you cut several
Speaker A
They're put in a DBT skills group in their prison or in their forensic program, you know, and they're committed there or they're imprisoned there. So you have to cultivate voluntariness of commitment by saying, "You know, you can do this or not do this. There might be consequences if you don't do this, but that's the way it is in life. But it really is your business whether you do this."
Speaker A
in the next session because actually then you'll start to see what that's like now that you've got that actually the kind of a problem if you if we just think it's till the next session because then we're both going to know that right
Speaker A
Foot in the door and door in the face. This comes from the social psychology of salesmanship, encyclopedia salesmen, car salesmen. This is where foot-in-the-door is just saying, just asking for a little bit of commitment when really what you want is more than that, but it's just getting your foot in the door.
Speaker A
to argue okay and foot in the door in door in the face means you kind of do a back and forth between until you find the place where you can really get somebody to commit but it's going to be
Speaker A
Once your foot's in the door, then you try to expand it. Door in the face is the opposite. It's like if you go to, if you're an encyclopedia salesman and you go to the person's door and knock, knock, knock, and they open it and say, you know, my foot in the door would be to say, "Are you interested in your children's education?" "Well, yes."
Speaker A
give it a good try as problematic with commitment because giving it a good try is a thousand degrees away from I'm gonna do it you know that in your own life ask my kids will you mow the lawn
Speaker A
"Do you think it's important in an education to have reference materials, things to read?" "Yeah, sure."
Speaker A
hundred percent but way up when somebody says that so you want to get that connect present two prior commitments remind somebody what they committed before that they early and treatment agreed to something and now they're sort of fading away
Speaker A
"Your children have, you think they're like the most up-to-date encyclopedia?" "Well, we have the 1958 World Book. It was good enough for me."
Speaker A
sure they're really thinking about how hard it's gonna be you might jump ship on the other side and say well let me just ask you this why would you ever do this this is gonna be the hardest thing you've ever done in
Speaker A
"I mean, okay, would you think they'd be interested in a more current thing?" "Well, I suppose that's a good idea."
Speaker A
that's good you've just strengthened there at least their verbal statement of commitment and cheerleading is really cheerleading that they have the capability to commit even if they're sort of shaky about it you
Topics:DBT commitment strategiesDialectical Behavior Therapyclient autonomybehavior changefoot-in-the-doordoor-in-the-facetreatment engagementvalidationroleplayClearview Treatment Programs
