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DBT Intake Questionnaire Overview

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322 views3 pages

DBT Intake Questionnaire Overview

Uploaded by

yasmeensburner
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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  • DBT Intake Questionnaire

DBT INTAKE QUESTIONNAIRE

Please answer all questions. You can use the back of these pages if you need more space. I
know that filling out this questionnaire will take time and effort. I appreciate your
willingness to really examine what you want to accomplish in DBT and what will help you
achieve your goals. Thoughtfully completing these questions is an effective first step toward
getting to where you want to go and identifying and meeting your goals. We will discuss
your answers during your intake process and use them in helping us figure out how you can
best benefit from DBT.

1. One major purpose of DBT is to help people manage negative


emotions. Please identify the main reasons you want to learn to
manage your emotions.

2. Many people come to DBT because they are engaging in behaviors that
are problematic to them and interfere with their daily life and reaching
their long term goals. Please identify 5 specific behaviors that you
want to decrease and indicate how each interferes with your daily life.
Some examples of behaviors that people want to decrease are: self-
harm or impulsive behaviors (cutting, drinking too much, impulsive
sex, road rage, suicide attempts, ending relationships prematurely)
and avoidance behaviors (avoiding friends, sleeping too much, not
completing tasks.)
3. Please identify 5 behaviors that you want to increase and indicate how
each change can help you. Some examples of behaviors that people
want to increase include: setting healthy limits, dealing with conflict,
tolerating emotions without exploding, learning how to calm down
when upset, engaging in pleasurable experiences.

4. Learning new skills requires repetition and practice. Are there things
you know about yourself that might get in the way of practicing skills?
Examples of some things that may get in the way of learning new skills
include: skipping or being late to sessions, not paying attention,
forgetting to practice, a chaotic life style, substance abuse, being
overwhelmed. Identifying these challenges now will help us in figuring
out how you can most effectively overcome them so that you can
practice your skills and get the most out of your therapy.
5. How might you prepare yourself in order to prevent some of your old
habits from getting in the way of learning new skills? Some ideas
include: setting a regular time for practice, having a friend call to wake
you up/remind you of session times, setting a reminder on your smart
phone, planning to arrive early to enjoy a cup of tea or hot chocolate
in the waiting area, examining how much you have planned and
prioritizing.

6. Is this the right time in your life to participate in DBT? Do you have
the motivation and desire to make changes at this time? Please
explain.

Common questions

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People wish to increase behaviors such as setting healthy limits, dealing with conflict, tolerating emotions without reacting negatively, calming down, and engaging in pleasurable experiences. These changes help improve emotional regulation, interpersonal effectiveness, and overall life satisfaction .

A detailed examination of emotional management goals allows individuals to pinpoint specific emotional triggers and corresponding behaviors needing regulation. This clarity enables personalized strategy development, contributing to more targeted and effective therapeutic interventions .

Problematic behaviors in DBT, such as self-harm, impulsive actions, or avoidance, interfere with daily life by preventing individuals from reaching their long-term goals, engaging in self-destructive patterns, and hindering their ability to maintain healthy relationships and functional daily routines .

Specifying behaviors needing decrease helps identify patterns that disrupt daily life and sustainability of long-term goals. This focus facilitates the creation of targeted interventions and behavioral modifications crucial for therapeutic progress .

Participants in DBT aim primarily to manage negative emotions and decrease problematic behaviors that interfere with daily life and long-term goals. They also aim to increase adaptive behaviors that promote healthy coping and emotional regulation .

The 'right time' for DBT participation is when an individual possesses the motivation and desire to make changes. This is crucial for engagement and commitment to the therapy process, as noted in the need to explain personal readiness on the questionnaire .

Repetition and practice are crucial in DBT because they reinforce skill acquisition and facilitate the transition from learned behavior to automatic response. This suggests that consistent practice is key to transforming therapeutic learnings into habitual actions .

Engaging in DBT amidst a chaotic lifestyle implies additional challenges such as inconsistent attendance and limited focus. Overcoming these requires structured planning, such as using reminders and prioritizing tasks, to ensure commitment and benefit from therapy .

Completing the DBT intake questionnaire helps participants self-examine their goals and challenges, which fosters a deeper understanding of personal barriers and areas needing improvement. It also aids therapists in tailoring the DBT process to address specific client needs effectively .

Challenges in practicing new skills in DBT include irregular attendance, distraction, forgetting to practice, chaotic lifestyles, and substance abuse. Individuals can prepare by establishing regular practice schedules, using reminders, and prioritizing activities to mitigate these barriers .

DBT INTAKE QUESTIONNAIRE Please answer all questions. You can use the back of these pages if you need more space. I know tha
3. Please identify 5 behaviors that you want to increase and indicate how each change can help you. Some examples of behavior
5. How might you prepare yourself in order to prevent some of your old habits from getting in the way of learning new skills?

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