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Therapy role-play · DBT
Also written Dialectical Behavior Therapy
Marsha Linehan developed Dialectical Behaviour Therapy for clients whose emotions arrive fast and hard, and who often struggle with urges to self-harm. The therapy holds acceptance and change in the same hand. Here you practise the individual therapy: chain analysis, validation, and coaching the client in DBT skills.
Why this therapy
Some clients feel emotions faster, more strongly and for longer than most people do, and many have learned to get through them by self-harm or by acting on impulse. Push for change alone and they feel invalidated all over again; offer warmth alone and nothing moves. DBT does both at once. It validates what makes sense in the client’s experience, and it teaches concrete skills to replace the behaviours that have been doing that job.
Each protocol follows its published treatment model, and so does your feedback.
Simulated clients are a training aid. They do not replace supervised work with real clients.
Each one is reviewed in your debrief, with one concrete thing to try next time.
Walk one episode back link by link: what left the client vulnerable, what set it off, what followed. When they say “I don’t know, it just happened”, stay with the chain.
Say what makes sense about the client’s experience, and pitch it at the right level. Validation is not agreement, and it is not reassurance.
Life-threatening behaviour first, then whatever interferes with therapy, then quality of life. If a self-harm episode is on the diary card, it comes before the row with the parent, however loud that row was.
Teach mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness skills, and rehearse them in the room rather than describing them.
Move between acceptance and change without losing the client on either side. All push and they shut down; all warmth and nothing changes.
Ask for the diary card at the start, every time, and let it choose the target. “I forgot it” is itself something to work on.
The same client carries across modes. Start where you feel comfortable, then stretch.
Free examples
Worked examples from the Practice Library, built on the same published model.
Each client comes with a history, a presentation and measures. Read the referral as you would on placement, then begin.
The client responds to how you work. Make your mistakes here, where they cost nothing; hints come only if you ask for them.
A clear debrief on the core skills of your model (the CTS-R for CBT). Then take any one skill into a focused drill and work on it until it holds.
Dialectical Behaviour Therapy, spelled Dialectical Behavior Therapy in the US. It is a skills-based therapy for emotion dysregulation, which means great difficulty managing strong emotions, and it was first developed for chronic suicidality and self-harm.
Yes. Simulated clients may voice self-harm urges, but they never describe methods. You practise asking about risk and building a safety plan, and the debrief tells you how you did. Practice sessions support, and do not replace, supervised work with real clients and your service’s own risk procedures.
Yes. DBT for Adolescents (DBT-A) brings parents or carers in, through a multifamily skills group and family sessions. NICE suggests considering it for young people with significant emotional dysregulation who self-harm frequently. Radically Open DBT is a separate variant, for clients who are overcontrolled rather than impulsive.
Practise DBT with us
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