Just because you’ve decided to attend therapy sessions doesn’t mean you’re actually trying therapy. Practitioners of dialectical behavior therapy (DBT) have identified what they called TIBs. These are therapy interfering behaviors. As the name implies, such behaviors (intentional or not) get in the way of a productive therapy session.
DBT is designed to reduce such impediments to progress. For DBT therapists, of course, life-threatening behaviors would be the highest priority. After that, TIBs are paramount. The idea is to identify and address these behaviors before they fully sabotage the therapist-client relationship. Dealing with TIBs is also an excellent way to model effective communication.
What Are Some Therapy Interfering Behaviors?
Dialectical behavior therapy doesn’t label therapist-client problems as flaws in one’s personality. Instead, it’s all about recognizing behaviors and then managing them. Addressing TIBs removes a major obstacle to the client’s recovery.
It’s important to note that TIBs are not onetime situations. Anyone can have something interfere with an individual session. Rather, a therapy interfering behavior is part of an ongoing pattern. To follow are some obvious examples of TIBs:
- Showing up late to sessions
- Canceling sessions (especially last-minute cancellations)
- “Forgetting” to pay for sessions
- Not doing any of the homework assigned by the therapist
- Frequently threatening to quit therapy
More covert or subtle TIBs examples include:
- Behaviors that shut down the productivity of sessions, e.g. not answering questions or saying “I don’t know,” yelling at or criticizing the therapist, and uncontrollable sobbing
- Not acknowledging a problem or downplaying the severity of that problem
- Derailing the focus of a session — particularly to topics that are unrelated to treatment
- Not setting clear treatment goals
- Cryptically hinting at self-harm or self-destructive acts
- Only reporting negative updates while downplaying anything positive
Why Therapy Interfering Behavior is Important to Address in DBT
One expects a certain amount of confusion when attempting to heal from emotional wounds. TIBs, on the other hand, can completely sidetrack any realistic efforts at treatment. Even when the client’s intention is to cooperate, TIBs can emerge and disrupt.
An experienced DBT therapist is adept at recognizing these patterns before they can take hold. Addressing TIBs is a giant set toward both a better client-therapist relationship and making solid progress in terms of treatment. A therapist will not expect their client to initiate this process. The onus on the counselor to redirect the sessions in a productive way.
How DBT Address TIBs
Before initiating a conversation about TIBs with a client, a therapist will do some valuable prep work. This process includes:
- Analyzing the TIBs and attempting to discern a motivation
- Coming up with empathetic and non-judgmental to ask about the TIBs
- Choose the best possible time to introduce this topic
Once the discussion has been initiated, it is essential for the therapist to maintain the client’s participation. This can be done via:
- Confirmation: Make sure the client fully understands what is being said — and why. Ask the client to repeat back what they are hearing. Then, have the client clarify if they are willing to change the TIBs.
- Collaboration: Once the client understands and commits to change, this must be a collaborative effort. Both parties can work together to set goals and identify what role each of them will play.
Therapy interfering behaviors can stymie any DBT progress. They can also frustrate even the most experienced therapist. Thus, addressing TIBs is not a single conversation. It’s an ongoing joint commitment for the good of the client (and often, the therapist). This is just part of what DBT so effective. If you’d like to learn more, please reach out to set up a free consultation.