ABSTRACT
To facilitate generalization, DBT out-patient programmes generally provide clients with the opportunity to phone their individual therapist for brief coaching interventions between individual therapy sessions. During the telephone contact, the individual therapist offers skills coaching rather than psychotherapy or general support. The skills coach helps the client to generate, select and practise the appropriate skills needed to solve the most immediate problem. The skills coach does not analyze the problem in detail or discuss the client’s longerterm problems. For example, if a client had strong urges to harm herself following an argument with her husband, she might phone the therapist for coaching on how to reduce those urges. When generating solutions, the therapist and client may consider interpersonal skills that would change how the client interacted with her husband in the immediate future. They would not discuss, however, all of the client’s longterm marital problems. Indeed, for many clients ruminating on their long-term marital problems would have been a critical link in the chain between the argument and the self-harm urges. In such cases, the skills coach would suggest using mindfulness to decrease the ruminating.
