The first level of conceptualization in dialectical behavior therapy
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Pracownia Psychologii i Psychoterapii Systemowej, Klinika Psychiatrii i Psychoterapii Dzieci i Młodzieży, Katedra Psychiatrii UJ CM
Ambulatorium Terapii Rodzin, Oddział Kliniczny Psychiatrii Dorosłych, Dzieci i Młodzieży, Szpital Uniwersytecki w Krakowie
Submission date: 2022-10-31
Final revision date: 2023-05-08
Acceptance date: 2023-05-10
Publication date: 2023-08-03
Corresponding author
Bartłomiej Taurogiński   

Jagiellonian University Medical College
Psychoter 2023;204(1):15-25
The ability to build a conceptualization of a patient's problem is a key competency of effective psychotherapists. Ways of understanding the patient and his or her problems vary between approaches in psychotherapy and depend on the theoretical framework within which the therapist operates. Even within such a coherent therapeutic approach as cognitive behavioral therapy (CBT), differences are discernible in the way in which the understanding of the patient is constructed, especially by therapists of the so-called third wave. In this article, the author introduces the philosophy of working in dialectical-behavior therapy, which is one of the approaches in the cognitive-behavioral therapies. He also makes a description of how conceptualization is carried out at the so-called first level - i.e., understanding the patient's reported problem in the context of the "here and now." The author also tries to outline the similarities and differences between the classical cognitive model used in CBT conceptualization and the models used in DBT therapy, namely the emotion model and the behavioral chain. Among the many similarities, the author points out areas where DBT conceptualization seems to go beyond the classical CBT conceptualization framework (e.g., the role of impulses accompanying emotional reactions).
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