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Copyright: 2012 Australian Institute of Professional Counsellors

Welcome to Edition 133 of Institute Inbrief. In this edition we overview Dialectical Behaviour Therapy (DBT) a cognitive behavioural therapy developed as a treatment for self harming.
Also in this edition:
-      Self-Disclosure – Concepts and Applications
-      Professional Development news
-      Blog and Twitter updates
-      Upcoming seminar dates
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The Institute's Diploma of Counselling is an Industry Recognised Qualification, Allowing You to Practice as a Qualified Counsellor.
The nationally recognised Diploma of Counselling is recognised by the Australian Counselling Association (ACA), Australia's largest Member Association for Counsellors.
As part of its charter, ACA recognises courses that meet its training standards. These standards cover a broad range of areas, encompassing core organisational, staffing and educational competencies, as well as ensuring AIPC as a training body maintains an exceptionally high professional standard.
When you graduate, you are automatically eligible to become a Qualified Member of the Australian Counselling Association. You will be able to get professional indemnity insurance (preferred rates), and your qualification and Membership will be accepted and regarded in the industry.
And while you're studying with the Institute...
Simply put, AIPC sets the benchmark in education support. Even if you decide to study entirely at home or online, you'll never be alone in your studies. We have specialised in external education for over 19 years and have the most highly qualified, professional support team in the industry. Help is only ever a phone call or email away. Our enormous pool of educational resources means you have access to:
-      An Education team of over 65 degree qualified counselling professionals, all with extensive industry experience and teaching and assessing qualifications.
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Want to find out more? Visit
Learn How You Can Gain Specialty Expertise And A Graduate Qualification With A Vocational Graduate Certificate Or Vocational Graduate Diploma In Counselling...
...In Only 6 to 12 Months.
More and more Counsellors are gaining advanced specialist skills with a Vocational Graduate qualification. Vocational Graduate qualifications provide a higher level, vocational alternative to traditional Post Graduate courses offered by Universities.
It's time and cost effective, meaning you can gain a formal graduate qualification in 6 to 12 months in your specialist area. Here's how a graduate qualification can advance your career:
-      Develop a deeper understanding of your area of interest and achieve more optimal outcomes with your clients.
-      A graduate qualification will assist you move up the corporate ladder from practitioner to manager/supervisor.
-      Make the shift from being a generalist practitioner to a specialist.
-      Gain greater professional recognition from your peers.
-      Increase client referrals from allied health professionals.
-      Maximise job opportunities in your preferred specialty area.
-      Formalise years of specialist experience with a respected qualification.
Save Over $6,000 (67% Discount to Market)
A Vocational Graduate Diploma at a university costs between $10,000 and $38,000. BUT, you don't have to pay these exorbitant amounts for an equally high quality qualification. You can do your qualification with the Institute and save a massive $6,000+ on the cost of doing a similar course at university.
To learn more, please visit Alternatively, call your nearest Institute branch on the FreeCall numbers shown below:
Sydney: 1800 677 697
Melbourne: 1800 622 489
Perth: 1800 353 643
Brisbane: 1800 246 324
Adelaide: 1800 246 381
Regional NSW: 1800 625 329
Regional QLD: 1800 359 565
Gold Coast: 1800 625 359
Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT) is a cognitive behavioural therapy developed as a treatment for self harming, particularly in borderline personality disorder (Low et al., 2001). Underpinning ideas of DBT suggest that invalidating environments that may have occurred during upbringing can inhibit the effective development of coping methods to deal with sudden intense surges of emotion (Linehan, 2003). 
The primary treatment goal of DBT is to reduce self harming behaviour by helping clients develop new coping skills and addressing obstacles that may prohibit the client from using those skills. This is achieved by implementing a hierarchical stage model that provides a guiding structure for the therapy using a number of treatment modalities including individual sessions, group therapy and coaching (Swales, Heard & Williams, 2000). Treatment consists of weekly individual psychotherapy combined with group behavioural skills training. The skills taught include emotional regulation, distress tolerance and problem solving (Low et al.2001).
Psychotherapy sessions focus on the problem behaviour and events that occurred that may have triggered the client to self-harm. The therapist explores alternative solutions that the client could use in times of crises and investigates what prohibited the client from using those adaptive solutions during crises in the first place.
The role of the therapist adopting a DBT approach is to teach and reinforce adaptive behaviours. The emphasis is on teaching clients how to manage emotional trauma rather than reduce crises (Swales, Heard & Williams, 2000; Muehlenkamp, 2006). An overview of the DBT approach is outlined below.
The Pre-Treatment Stage
This preliminary stage or area of focus involves building rapport and the therapeutic alliance with the client. This is something that, once established, must continue to be monitored and upheld.
Stage 1
The first stage focuses on reducing self harming behaviours, reducing distress and maintaining the client’s therapy compliance. This is achieved by employing strategies such as:
1) Validation of the client’s experience
This is achieved mainly through empathetic reflection from the counsellor. For example:
Client: “it’s not something that I’ve ever questioned. The moment I feel things becoming unbearable around him or even just thinking about him, I start to feel like I can’t escape this strong feeling of anxiety and anger that just wells up inside me, So I get all tense just thinking about being alone with him for any length of time and so then... to calm myself down and relax myself... I tend to cut... it seems to work ok...”
Counsellor: I can understand why you might feel so angry and anxious and uneasy to be alone with your father... He violated your trust in such a significant way. You’ve been deprived of a caring and kind father, haven’t you?”
2) Teaching alternative adaptive behaviour
This is achieved progressively whereby, as a first step, alternative behaviours may be a close mimic of the self-harming behaviour but without the enduring physical consequences. Below are example behaviours that a client could adopt as an alternative adaptive behaviour in the progression away from the self-harming behaviour.
“When feeling angry, frustrated or anxious...”
Try something physical that is not a violent act directed at a living thing. For example:
-      Punch a boxing bag.
-      Slash an empty plastic soda bottle or a piece of heavy cardboard or an old shirt or sock.
-      Make a soft cloth doll to represent the things you are angry at. Cut and tear it instead of yourself.
-      Flatten aluminium cans for recycling, seeing how fast you can go.
-      Use a pillow to hit a wall, pillow-fight style.
“When feeling depersonalised, dissociating, feeling unreal...”
Do something that creates a sharp physical sensation. For example:
-      Squeeze ice hard (putting ice on a spot you want to burn gives you a strong painful sensation and leaves a red mark afterward, kind of like burning would, it really hurts but does not have long term consequences).
-      Put a finger into a frozen food (like ice cream) for a minute.
-      Bite into a hot pepper or chew a piece of ginger root.
“Wanting to see blood...”
-      Draw on yourself with a red felt-tip pen on the areas you want to cut.
-      Paint yourself with red paint.
“Wanting to see scars or pick scabs...”
-      Get a henna tattoo kit. You put the henna on as a paste and leave it overnight; the next day you can pick it off as you would a scab and it leaves an orange-red mark behind for a period of time.
3) Behavioural skills training in mindfulness, emotional regulation, interpersonal effectiveness and distress tolerance
Distraction is simply doing other things to distract self from self-harming. Most of the techniques mentioned above are distraction techniques; whereby you bring something else in to change the feeling. Using ice, rubber bands, etc., work as a distraction from and substitute for other intense self injurious responses. Other distractions/substitutes include experiences that change the client’s current feelings.
This includes tasks (like counting the colours seen in the immediate environment) that do not require much effort but do take a great deal of concentration thereby distracting from the desire and act of self harming. Volunteer work could also play a part in distracting the client from self harming behaviours if they would otherwise be idol a lot throughout the day.
Evaluating the Pros and Cons of Tolerating Distress
This involves evaluating the benefits and costs of self-harming. The client needs to consider what the pros or benefits are and what the cons or bad things are about self harming. Sometimes writing this down can help the client come to a decision not to self-harm.
An example list of pros and cons is presented below.
-      Makes me feel high
-      Releases my frustrations
-      I like to see my own blood
-      I can communicate my distress
-      I cope with physical pain better than emotional pain
-      Upsets people who love and care for me
-      My family would be devastated if I die
-      There are better ways of dealing with my problems
-      I’m permanently scarring my body
-      I feel ashamed and, embarrassed
This, like distraction, is a distress tolerance technique. It's quite straightforward. The client is encouraged to use things that are pleasing to their senses to soothe themselves. Some people find that active distraction works better for violent angry feelings and self-soothing is more effective for soft, sad feelings.
Reducing Vulnerability to Negative Emotion
This involves the client employing ongoing global self-care strategies in order to minimize the times when the urge to self-harm occurs. For example, balanced eating, sleeping, and exercise can help in the management of overwhelming emotion thus helping to reduce the motivation to self-harm.
Interpersonal Effectiveness
This involves helping the client become clear on what they want and how to communicate these priorities effectively in an interaction with others. Effective expressions like using “I” statements to state feelings play an important part in this process to help the client identify and express their thoughts, feelings, preferred actions and choices
Stage 2
At this stage, the therapist addresses ways of processing and dealing with traumatic experiences and invalidating environments. Some practical tools which may be used to aid the trauma sufferer in terms of processing such events include:
Writing about trauma
Writing may often provide the client with a cathartic release as it is one practical means of getting all the chaotic thoughts resulting from a traumatic experience out of one's mind and on to paper. Through expressing in words exactly how they felt leading up to, during and after, a traumatic experience it may help the client gain a better understanding of why it is so painful and why they need time to make sense of it all and process everything constructively (Smyth, True & Souto, 2001).
Painting or drawing the trauma
While some people are able to express themselves more easily using the written word, others are far more comfortable with using art to get their feelings out and on to paper. Colours may be used to symbolise pain and a whole host of emotions resulting from the trauma such as fear, anger, guilt, shame, despair and anxiety (Smyth, True & Souto, 2001). Ultimately the goals are the same as when writing in words about the trauma.
A significant outcome for this stage of therapy is a reduction in the level of emotional distress experienced by the client (Swales, Heard and Williams, 2000).This stage only takes place when the client has developed sufficient skills to cope with the intensity of emotions that can be resurfaced when remembering and processing traumatic events. This is achieved by revisiting and reinforcing the skills that were implemented at stage 1.
Stage 3
This stage focuses on increasing the client’s self-respect and achieving relevant goals. The therapist aims to help the client learn to; trust themselves, validate their own thoughts, opinions and emotions and to learn self-respect. Some of the strategies used in this stage include goal setting and problem solving. A problem-solving approach is suitable for self-harm, provided the client’s problems can be specified, the goals seem realistic, and there is an absence of severe acute psychiatric illness that would impede the therapeutic process.
The first step is to draw up a list of problems with the client. Each problem should be clearly defined. The therapist may have to ask the client to describe each problem in great detail in order to obtain a clear account of each difficulty. In some cases, it may not be possible to identify a specific problem, and so the client may be asked to keep a diary over 1 or 2 weeks, and record times when he or she feels upset or anxious. Key problem areas may then be identified (Guthrie, 2003).
Problem-solving attempts to harness the client’s own resources and skills to overcome difficulties. Self-harm clients often have poor levels of social support, and may be socially isolated or estranged from their families. Assessment of the client’s personal assets and strengths and the degree of support he or she has from friends, family and other professionals is important. How the client has coped in the past with problems, particularly those similar to current difficulties will provide some indication of how he or she may react or cope in the future.
Key aspects of problem-solving treatments in self-harm are:
-      Exploration of the meaning placed on self-harm episodes
-      Clarification and identification of specific problems
-      Generation of problem solutions
-      Exploration of alternative strategies to self-harm
-      Agreement about goals of treatment
-      Assessment of support and the client’s personal strengths and assets
(Guthrie, 2003)
-       Guthrie, E. (2003). Psychological treatment for deliberate self harm. Psychiatry: The Medicine Publishing Company. Retrieved on the 18th of August 2010 from World Wide Web
-       Linehan M (1993) Cognitive-Behavior Therapy for Borderline Personality Disorder. New York: Guilford Press.
-       Low, G., Jones, D., Duggan, C., Power, M., Macleod, A. (2001). The treatment of deliberate self harm in borderline personality disorder using dialectical behaviour therapy: A pilot study in a high security hospital. Behavioral and Cognitive Psychotherapy, 29, 85-92.
-       Muehlenkamp, J. (2006). Empirically supported treatments and general therapy guidelines for non suicidal self injury. Journal of Mental Health Couselling.
-       Smyth, J., True, N & Souto, J. (2001). Effects about writing about traumatic experiences. The necessity for narrative structuring. Journal of Social and Clinical Psychology, 20, 161-170.
-       Swales, M., Heard, H.L. & Williams, J.M.G. (2000). Linehan’s dialectical behaviour therapy for borderline personality disorder: Overview and adaption. Journal of Mental Health, 9, 7-23.
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The Institute has a list of recommended textbooks and DVDs which can add great value to your learning journey - and the good news is that you can purchase them very easily. The AIPC bookstore will give YOU:
-      Discounted prices!
-      Easy ordering method!
-      Quality guarantee!
This fortnight's feature is...
Name: Advanced Professional Counselling, 6th edition
Author: Clarke, J.
AIPC Price: $60.00
ISBN: 0-958-53034-3
The fundamentals of Human Behaviour and the theory & practicalities of counselling. This book explains the practical theory and then applies it to the issues of everyday counselling.
To order this book, simply contact your nearest Student Support Centre or the AIPC Head Office (1800 657 667).
Self-Disclosure – Concepts and Applications
Are you a very important person? Sure you are. The reason for this answer is the same for almost everyone: we like talking about ourselves, we enjoy being listened to, we praise our achievements, and we are very much into introspection. Although we are ultimately social beings, most humans are both consciously and subconsciously determined to improve themselves, and to derive meaning to their existence.
In this context, we are faced with the everyday challenge of balancing our own needs for fulfilment and recognition with the need to co-relate with others, to promote altruism and to help people in need. This paradox takes centre stage in counselling sessions in the form of self-disclosure – as a counsellor, how much of yourself should you reveal to your clients?
Click here to continue reading this article...
Other articles:
Convenient Professional Development
Hundreds of counsellors, psychologists, social workers, mental health nurses and allied health professionals already access over 100 Hours of Professional Development online, for less than $1 a day. Now it's your turn.
Mental Health Academy (MHA) is the leading provider of professional development education for the mental health industry. MHA provides the largest variety of courses and videos workshops, all conveniently delivered via the internet.
With MHA, you no longer have to worry about high costs, proximity and availability, or fitting a workshop around your lifestyle!
You can access the huge range of PD, including courses and video workshops, whenever and from wherever you want.
Whether you are looking for courses on anxiety and depression, or a video workshop discussing the intricacies of relationship counselling - Mental Health Academy is your gateway to over 100 hours of professional development content.
Take a quick look at what Mental Health Academy offers:
-      Over 70 professionally developed courses.
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Begin your journey today. Click on the link below to register for a monthly or annual unlimited membership. As an unlimited member, you can access all MHA courses for less than $1 per day, and receive discounts when purchasing any video workshops:
Have you visited Counselling Connection, the Institute's Blog yet? We continually publish new and interesting posts including case studies, profiles, success stories and much more. Make sure you too get connected (and thank you for those who have already submitted comments and suggestions).
Anorexia Nervosa - The Female Phenomenon
Discourses on anorexia nervosa have ranged from its origins in religious practices of female self-starvation, to the presently constituted female phenomenon informed by psycho-medical ideas. These discourses have created the dominant understandings and knowledge of anorexia nervosa, a milieu that males enter whilst dealing with anorexia nervosa.
These taken-for-granted discourses have led to difficulties in diagnostic practices with males, and have consequently impacted on the reported low prevalence of males with anorexia nervosa. Furthermore, past research has drawn on the dominant positivist/empirical, quantitative approaches, and has tended to exclude males, or has included a significantly lesser number of males than females in research samples.
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Dilemma Involving Self-Harm
Chantelle is 14 and in foster care. Chantelle was removed from her parents’ care at the age of seven and has since had several foster placements. Her last care arrangement ended, one month ago, when her foster family relocated interstate. Child protection workers have found a new foster placement for Chantelle and you have been asked to counsel Chantelle through the transition into her new care arrangement. As part of the counselling process, it is also expected that you will support the carers in their new role.
In your first session, Chantelle discloses that she dislikes her child safety case worker, doesn’t feel comfortable with her new foster arrangement and dreams of being reunited with her mother. She also discloses that she sometimes feels an almost uncontrollable urge to cut herself. She has aggressively cut her arms twice in the past two months and wears long sleeves to cover the wounds.
Click here to continue reading this post...
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"Action and reaction, ebb and flow, trial and error, change - this is the rhythm of living. Out of our over-confidence, fear; out of our fear, clearer vision, fresh hope. And out of hope, progress." 
~ Bruce Barton
Many students of the Diploma of Counselling attend seminars to complete the practical requirements of their course. Seminars provide an ideal opportunity to network with other students and liaise with qualified counselling professionals in conjunction with completing compulsory coursework.
Below are some of the seminars available for the first semester of 2011. To register for a seminar, please contact your Student Support Centre.
To access the full list, visit:
Diploma of Counselling (CDA) Timetable
Northern Territory
The Counselling Process: 25/06
Communication Skills I: 26/02
Communication Skills II: 16/04
Family Therapy: 02/04
South Australia
The Counselling Process: 26/03, 28/05
Communication Skills I: 02/04, 04/06
Communication Skills II: 03/04, 05/06
Counselling Therapies I: 07-08/05
Counselling Therapies II: 26-27/02, 21-22/05
Legal & Ethical Frameworks: 01/05
Family Therapy: 29/05
Case Management: 18-19/06
The Counselling Process: 21/03, 09/04, 06/05, 28/05, 03/06, 29/06
Communication Skills I: 17/03, 14/04, 13/05, 17/06
Communication Skills II: 18/03, 15/04, 20/05, 22/06
Counselling Therapies I: 28-29/04, 15-16/06
Counselling Therapies II: 03-04/03, 30-31/05
Case Management: 24-25/03, 26-27/05
Western Australia
The Counselling Process: 19/03, 16/04, 14/05, 18/06
Communication Skills I: 12/03, 30/04, 28/05
Communication Skills II: 13/03, 01/05, 29/05
Counselling Therapies I: 09-10/04, 11-12/06
Counselling Therapies II: 26-27/02, 07-08/05
Legal & Ethical Frameworks: 19/06
Family Therapy: 17/04
Case Management: 21-22/05
The Counselling Process: 30/04
Communication Skills I: 05/03, 28/05
Communication Skills II: 02/04, 25/06
Counselling Therapies I: 26-27/03
Counselling Therapies II: 16-17/04
Legal & Ethical Frameworks: 14/05
Family Therapy: 04/06
The Counselling Process: 22/05
Communication Skills I: 27/03, 26/06
Communication Skills II: 08/05
Counselling Therapies I: 19-20/03
Counselling Therapies II: 30/04-01/05
Legal & Ethical Frameworks: 29/05
Family Therapy: 13/03
Case Management: 09-10/04
The Counselling Process: 27/02, 03/04, 08/05, 17/06
Communication Skills I: 27/03, 09/04, 07/05, 03/06
Communication Skills II: 26/02, 26/03, 02/04, 01/05, 10/06
Counselling Therapies I: 05-06/03, 16-17/04, 14-15/05, 18-19/06
Counselling Therapies II: 12-13/03, 23-24/04, 21-22/05, 25-26/06
Legal & Ethical Frameworks: 05/06
Family Therapy: 04/06
Case Management: 19-20/03, 28-29/05
Sunshine Coast
The Counselling Process: 16/04
Communication Skills I: 12/03, 04/06
Communication Skills II: 13/03, 05/06
Counselling Therapies I: 02-03/04
Counselling Therapies II: 21-22/05
Legal & Ethical Frameworks: 18/06
Case Management: 25-26/06
Gold Coast
The Counselling Process: 16/04
Communication Skills I: 26/02, 21/05
Communication Skills II: 19/03, 18/06
Counselling Therapies I: 25-26/03
Counselling Therapies II: 06-07/05
Legal & Ethical Frameworks: 15/04
Case Management: 01-02/04
Diploma of Professional Counselling (DPCD) Timetable
Northern Territory
Communication Skills I: 26/02
Communication Skills II: 16/04
The Counselling Process: 25/06
Counselling Therapies I: 19-20/03
Counselling Therapies II: 30/04-01/05
Advanced Counselling Techniques: 12/03, 11/06
Counselling Applications: 07/05
South Australia
Communication Skills I: 02/04, 04/06
Communication Skills II: 03/04, 05/06
The Counselling Process: 26/03, 28/05
Counselling Therapies I: 07-08/05
Counselling Therapies II: 26-27/02, 21-22/05
Case Management: 18-19/06
Counselling Applications: 27/03
Communication Skills I: 17/03, 14/04, 13/05, 17/06
Communication Skills II: 18/03, 15/04, 20/05, 22/06
The Counselling Process: 28/02, 21/03, 09/04, 06/05, 28/05, 03/06, 29/06
Counselling Therapies I: 28-29/04, 15-16/06
Counselling Therapies II: 03-04/03, 30-31/05
Case Management: 24-25/03, 26-27/05
Advanced Counselling Techniques: 31/03, 04/06
Counselling Applications: 01/04
Western Australia
Communication Skills I: 12/03, 30/04, 28/05
Communication Skills II: 13/03, 01/05, 29/05
The Counselling Process: 19/02, 19/03, 16/04, 14/05, 18/06
Counselling Therapies I: 09-10/04, 11-12/06
Counselling Therapies II: 26-27/02, 07-08/05
Case Management: 21-22/05
Advanced Counselling Techniques: 15/05
Counselling Applications: 20/03
Communication Skills I: 05/03, 28/05
Communication Skills II: 02/04, 25/06
The Counselling Process: 30/04
Counselling Therapies I: 18-19/06
Case Management: 19-20/02
Advanced Counselling Techniques: 26/02, 11/06
Counselling Applications: 12/03
Communication Skills I:  27/03, 26/06
Communication Skills II: 08/05
The Counselling Process: 22/05
Case Management: 09-10/04
Advanced Counselling Techniques: 27/02, 19/06
Counselling Applications: 03/04
Communication Skills I: 27/03, 09/04, 07/05, 03/06
Communication Skills II: 26/02, 26/03, 02/04, 01/05, 10/06
The Counselling Process: 27/02, 03/04, 08/05, 17/06
Counselling Therapies I: 05-06/03, 16-17/04, 14-15/05, 18-19/06
Counselling Therapies II: 12-13/03, 23-24/04, 21-22/05, 25-26/06
Case Management: 19-20/03, 28-29/05
Advanced Counselling Techniques: 30/04, 12/06
Counselling Applications: 10/04, 11/06
Sunshine Coast
Communication Skills I: 12/03, 04/06
Communication Skills II: 13/03, 05/06
The Counselling Process: 16/04
Counselling Therapies I: 02-03/04
Counselling Therapies II: 21-22/05
Case Management: 25-26/06
Advanced Counselling Techniques: 09/04
Counselling Applications: 28/05
Important Note: Advertising of the dates above does not guarantee availability of places in the seminar. Please check availability with the respective Student Support Centre.
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