ABSTRACT
DBT applies contingency-management procedures when skilful behaviour has been either punished or not reinforced or maladaptive behaviour has been reinforced. DBT increases skilful behaviour by eliciting internally reinforcing skilful behaviours (e.g. emotion-regulation skills reduce emotional distress, mindfulness reduces paranoid ideation), by helping the client to elicit or arrange effective reinforcement in the natural environment (e.g. interpersonal skills lead to husband decreasing unwanted sexual demands, family agrees to allow an adolescent more freedom if he returns to school) and by directly applying reinforcing consequences within the therapy context (e.g. problem solving by a client who wants therapist involvement leads to a longer session with the therapist). DBT decreases problematic behaviour through extinction (e.g. the husband no longer bandages his wife's wounds when she has cut herself because she felt lonely) and the judicious utilization of punishment (e.g. continuing non-collaboration by a client who wants therapist involvement leads to a shorter session with the therapist).
