Episode 46: Dylan Zambrano, MSW
Dylan Zambrano, MSW: There's mindfulness that's really embedded here in this journaling practice to really acknowledge what's being experienced, where our successes are, things that we're grateful for, and our accomplishments in the day, um, so that we can really sense into that experience and not let that go unnoticed.
Jessica Fowler: Welcome back to What Your Therapist Is Reading. I'm your host, Jessica Fowler. On today's episode, we are speaking with Dylan Zambrano, MSW, about his book, DBT Skills Daily Journal. Dylan is the founder and clinical director of DBT Virtual, an online dialectical behavioral therapy practice serving multiple Canadian provinces. He has several years of experience working on a DBT team within an outpatient mental health hospital setting, and provides DBT training, consultation, and supervision to mental health therapist organizations. Dylan also teaches courses in mindfulness and compassion meditation at the University of Toronto.
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Welcome back listeners. Today, we're speaking with Dylan Zambrano, MSW, welcome.
Dylan Zambrano, MSW: Hi there. Thanks for having me.
Jessica Fowler: So as we've talked, I wanted to ask this question. Can you share about a memory of how reading has impacted you?
Dylan Zambrano, MSW: Absolutely. So these days, what I find myself reading most is DBT related books. Um, I focus most of my practice on DBTand, uh, find myself, uh, really wanting to expand, uh, my, the, the, the work that I'm doing with clients.Um, and, and really adhering very closely to. Uh, manualize it here in DBT delivery. Um, but one of the books that really stands out was actually written by. The forward writer of the dbt skills daily journal. Her name is Sherry Van Dyke, um, who has published many DBT workbooks and DBT books, uh, but what really inspired me was her book DBT Made Simple, which I was introduced to quite early on in my career. And it really paved the path, uh, for my, that my specialty and my focus in, in, in DBT work. Um, but what, what I really, uh, took away from, from DBT Made Simple was, was the way that Sherry really made the book, uh, very tangible for mental health professionals who are wanting to integrate DBT into their practice. That was really important to me at the time, because I mean, DBT is a very complex treatment. There's lots of working parts to it. There's lots of different interventions, different modes of, of treatment. And it was a way that really simplified how to do DBT, how to integrate some of its core components, um, and really make the treatment more accessible to mental health professionals. And, um, and, and I think that really, It really translated into the, the, the book that I wrote, the DBT skills daily journal. Um, as I was really thinking about ways to, to integrate DBT skills for those who are participating in DBT or have completed DBT treatment, uh, and really trying to find a way to, to make it, uh, uh, tangible to, to make it, uh, to simplify the, the skills that are introduced and ways to actually uh, integrate them into one's daily life. Um, and so that is, is something that, uh, the journal, uh, really, uh, allows for us is being able to, to learn and apply the skills in a very tangible way.
Jessica Fowler: So, we're saying DBT a lot. Can we slow down for the people who don't know what DBT is? And can you share a little bit about what form of therapy that is, what DBT stands for, for those who don't know?
Dylan Zambrano, MSW: So, DBT stands for Dialectical Behavior Therapy. This is a, quite a comprehensive treatment that was initially designed for people with borderline personality disorder, and it's now being used across many different populations, as well as, uh, being, uh, offered to, to those who may not actually meet, uh, the criteria for any particular mental health diagnosis, but are wanting to, to learn how to regulate their emotions better, to improve their relationships. And DBT has a lot of, as I mentioned, working parts to it. It's a complex treatment. We have these different modes of the therapy that include individual therapy. What we call skills groups. We have phone coaching, which is out of session skills coaching. And then there's also a core component to it. That is the support, uh, that the, the DBT therapists get amongst the DBT team. So, the skills group is where much of the, the skills training happens. And so, this is where clients who are participating in DBT. Are being trained on the coping skills that we deliver in this treatment. So, the coping skills were organized into these four different categories, and that includes mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. And so largely these skills, these skills really are intended to support people with experiencing, expressing, and managing emotions better. Being able to manage, uh, negative thoughts, impulsive urges, improving the way that people handle crisis, crises or distressing moments and, really enhancing relationships, teaching people how to, to communicate in ways that are effective, that allow them to obtain what they, uh, need out of interactions and relationships, while balancing the relationship itself with their own self-respect. And so, with many of these skills targeted at improving emotions and relationships, I will often suggest that these s kills aren't only for people who are going through therapy, but not only for people who may need it. have a mental health diagnosis, that these are life skills that we're teaching that just allow us to, to manage our emotions better, to be able to control our attention and our thoughts, to make more intentional decisions when strong emotions are here and, and, and to be able to navigate relationships, navigate the conflicts that can sometimes come up in our relationships, as we integrate these skills into these moments.
Jessica Fowler: Can you share with the listeners just maybe one example of how this kind of, how this might play out in a session?
Dylan Zambrano, MSW: How the skills might play out in a session?
Jessica Fowler: Yeah.
Dylan Zambrano, MSW: Yeah, so I mean skills might be integrated into individual therapy if there's an opportunity for skills to be applied in a particular moment. Maybe we're rehearsing the skill with the client. Perhaps we are teaching the skill because the client may not at that point in time have learned that skill. But typically we're looking for opportunities where we can integrate these coping skills to help reduce the frequency of certain targets, or target behaviors that, that we're focusing on in the therapy, those that we're hoping to reduce in the therapy. And so, for example, if we have a client who is, you know, is entering a, a situation that they anticipate experiencing some emotional difficulties, we might integrate a skill that we call cope ahead, which is a skill that, uh, helps the person come up with this preemptive plan, uh, before they even enter the situation, uh, thinking about the way that the, the anticipated problem. So, what thoughts urges. Emotions, uh, behavioral urges that might come up or events that might happen. And what are the subsequent skills that, that we would hope to accompany those experiences with so that the person feels prepared so that they can rehearse this plan in advance and, uh, be able to, to navigate that difficulty with a little bit more ease or, or preparedness. So, we might integrate that into individual therapy. We might, uh, and, and we, we, we certainly integrate this into, uh, skills groups, the, the group therapy component of DBT, where the, the, you know, the main purpose of that mode of DBT treatment is to train our clients on, uh, these, these particular coping strategies.
Jessica Fowler: So, I'm not trained in DBT, but I, you know, I'm a therapist. We all have exposure to things and colleagues who are trained in it. And it always just, to me, seems like the skills are so good, really for like anyone to get to know, like, we're not always taught how to do all of these things and to have a place to, you know, just be taught the skills of how to interact and how to deal with situations how to regulate our emotions I mean, I think obviously there's a push to do that starting from a young age now, which is great. So, all of that kind of tied into one from an evidence based therapy model is great.
Dylan Zambrano, MSW: Absolutely. And what, what is unfortunate is that DBT can be quite inaccessible for, for many people. I mean, we, we experience long wait times in the, the hospital system, um, in the private practice worlds, uh, the world. fees for DBT can be quite high. And so, uh, I, I think some of the work around teaching some of these skills through, through workbooks, through different, through making these accessible, these skills accessible to those who may not be able to access DBT, I think is really important because, you know, there, there is so much value that we can get out of these skills. You know, I mentioned that I, I truly see these skills as life skills and, you know, it's great that we're starting to see these being integrated early, uh, earlier on in, in clients' lives to, to really allow them to, to be able to manage their emotions and relationships better. And so, uh, when we can get these skills integrated into therapy, um, even if we're teaching these skills and maybe not, um, doing uh, DBT that's adherence to the manualized therapy, we can provide these effective tools that can support people with emotion regulation and their interpersonal functioning.
Jessica Fowler: Which brings us to your journal. Can you share about your journal?
Dylan Zambrano, MSW: So, the DBT skills daily journal was, was really this came out of this idea, uh, to make guided journaling more DBT informed. This came really came out of my experience with many previous clients who would often use journaling as a coping strategy would use it as a way a practice of self-inquiry of self-awareness and self-reflection but often didn't have, um, a structure to it and would, would often ask me, do you have any suggestions for how I can journal, um, and exploring what was existing in the, uh, literature that, uh, there, there didn't seem to be a DBT skills informed guided journal. And so, what we know from research on journaling. We know that it can be an effective coping strategy to help process emotions to help change one's attitude or mindsets to be more positively oriented. It can help to enhance our resilience. And I think that that's when the journal, the journaling practice is actually being done in an effective way. So, the DBT skills daily journal is really intended to provide daily prompts that create an opportunity for reflection on one's emotions and the causes or the reasons as to why that emotion might be there. There's also reflection on one's goals for that particular day, along with the challenges that might come up for that individual and inviting an opportunity for some reflection on the skills that might be, that could be applied, uh, to, to meet those challenges. So really the book is intended to support the work that people are either doing in DBT, Um, or if they've completed DBT and are looking to, to really hold themselves accountable to practicing these skills. Otherwise, I did write the book in a way with an introduction and a summary of some of the foundational DBT skills, so that really anyone could pick this up and understand some of the DBT skills to start putting into practice right away. There in each. day of journaling there's also an evening reflection where the reader is invited to reflect on a new prompt for each day that is informed by a DBT skill and so we'll see skills or an influence of skills that come from mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness throughout the entire book, as well as an opportunity to, to reflect on one's accomplishments, any lessons that were learned from that day, anything that, that they were grateful for that they had experienced that day. And then a section on a, a section to write down the skills that they were able to practice that day. So, ultimately, the point of this book is, is to really help with this behavioral change towards more skills practice, because, you know, it's one thing to know the skills or to, to learn the skills. It's a whole other thing to, to actually be putting them into practice.
The knowledge about skills alone is, is really insufficient in creating meaningful behavioral change. And so, in, in DBT therapy as well as in this, uh, the, the DBTskills, daily journal, really the, the focus is not just learning the skills, but being able to apply them to generalize them to, to context where the skills are most needed when we're facing emotional difficulties, when we're faced with interpersonal conflicts. And so, you know, we do this in the therapy, but there's, there's elements of this in, in the journal as well, uh, where we are generating. potential solutions to future problems. We're rehearsing the application of skills and the skills coping plan. Uh, and with the journal, it's through writing and setting goals, setting intentions for how we'll integrate those skills to, to help us manage emotions and our relationships. And holding ourselves accountable in a way that really, really increases our commitment to a daily DBT skills practice.
Jessica Fowler: So, I have a couple of things that I want to follow up on that. So going back to originally what you said about how the journal is set up and I can see how if you are in DBT that this would be a useful resource that you sort of know kind of what's happening and with the skills like that language is something you're comfortable with. But it's also written in a way where it starts with explaining those skills, not in an exhaustive way where you're reading a whole book about it, but in enough that especially if you're in therapy of some sort, you could probably very much pick it up and apply. It's an easy read in that way to for application from reading to application, I guess is what I'm trying to say.
And you're very right. I've said on this podcast a lot, this idea that we can be taught something, but we need to practice when we're not upset. And that's what this does. It gives another opportunity to reflect and to practice when we're not upset because if we learn a skill and then we're upset and then we get mad at ourselves because we didn't use the skill it has to we have to practice and practice so we then can start using it when we're upset being told what to do right being told to take a deep breath when you're angry at work, and then you don't, and you get mad at yourself, right? We don't want that. It's the practicing. So, then you're like, oh yeah, that's right. I can, I can use this skill. I do. I do have this skill. Let me try it. It's really hard to do when you go from zero to 10, right? Got to practice that.
Dylan Zambrano, MSW: Yeah, absolutely. And, um, especially because for many people, emotions can go from zero to 10 really, really quickly. Um, it's, it's finding these moments to you know, practice the skills anywhere that you can to think really intentionally about sitting goals and preemptively in advance of those moments and what I often recommend to people is, is, is finding moments to, you know, the mild to moderate range moments where, where these skills can be practiced to really set ourselves up for success for when the really big emotions come up. Um, and so, you know, with this book, it really is intended to provide a bit of a snapshot of the skills that people can start to, uh, pull from, uh, even if they don't have any sort of preexisting knowledge about DBT skills, so that there's something there that can be practiced. And I mean, there are other resources or books out there that do a much deeper dive into the skills, and that just wasn't the point. Purpose of this particular book, but to give that, that summary of skills that people can, can pull from, uh, whether you have that preexisting knowledge of DBT skills or not to be able to apply those through writing, to create an opportunity for this really mindful, intentional reflection and a goal setting around what skills can be applied. So, in an attempt to, to help prevent some of these, uh, big emotions. From occurring or, or, or escalating to hopefully creating an opportunity to, to, to be able to contain those emotions more effectively.
Jessica Fowler: Yeah. And I liked the journal part where you, you have consistent questions and like you said, the different question of the application of the skill or the, how could you apply it in this situation, which I think is helpful, right? You're, you change it up and to have that reflection piece.
Dylan Zambrano, MSW: Yeah, and so some of the the recurring prompts every day are around, you know, tuning into one's emotions Anticipating challenges for the day and coming up with a plan for what skills can be applied. And then we have that recurring prompt, or sorry, new prompt that, uh, occurs on each day of journaling that, uh, all of them are informed by a DBT skill. And so I can actually just sort of read from a couple, I mean, one here is, What is a recent difficult event that I fully accepted for what it was, without resistance? What made this possible? And so that corresponds with a skill that we call radical acceptance. There's another prompt here. What is a worry I frequently have? What are all possible outcomes for this situation? How likely is it that the worry will really come true? And so, this is a prompt that, uh, corresponds with our skill, check the facts. And I'll give you one more example here. One prompt that's that says, what activities make me feel most accomplished and proud of myself? Where in my routine can I integrate more activities that give me these feelings? And so, this will correspond with the skill we call building mastery. Right. So, the language around the, or the titles of the DBT skills aren't necessarily in the prompts themselves. Um, and they're intentionally worded that way so that somebody picking up this journal who doesn't have that, that, uh, preexisting knowledge about the skills or the skills titles can actually benefit from, uh, the, the, the prompt and be able to engage in the prompt meaningfully. And inadvertently practicing the skill right there through the written rehearsal of it.
Jessica Fowler: I'll just say I love that question about something you're proud of. I've said it on this podcast before too. It's one of my favorite questions to ask people because I don't think that we ask it enough where I was giving ourselves a hard time about things and do like, oh no, I actually am proud of myself for doing this. Whether it's, you know, something like getting out of bed in the morning or saying no, or working out or whatever, it doesn't have to be something huge. It can just be something that you're proud of used to skill.
Dylan Zambrano, MSW: Right. Well, and I find that much of the time or I should say sometimes people aren't mindful of the experience, right? So they've done something that make would make them feel accomplished if they really took a moment to take a step back and acknowledge like what's just been achieved, really savoring the experience. And so I think you know, this written reflection that the guided journal allows for is, is an opportunity to, to really acknowledge the pleasant feelings that can come from doing something that, that is maybe difficult, but, but you achieved or something that would generate pride if we really pay attention to it. And so, you know, there's mindfulness that's really embedded here in this journaling practice to really acknowledge what's being experienced, where our successes are. Things that we're grateful for and our accomplishments in the day, um, so that we can really sense into that experience and, and not let that go unnoticed.
Jessica Fowler: Absolutely. I mean, isn't that why, well, this is why I love therapy, right? That reflection, but that knowledge too, that we are wired to go for the negative or the anxiety, or, you know, we can get so stuck in that we got to do, do, do, do, do, but then with the reflection and we slow down and that's mindfulness. Then we can start to notice those other feelings that actually can bring us a lot of joy, which can help balance us out a little bit and just be like, yeah, I'm proud of myself. I really did enjoy that. Or it was nice to just learn to sit and not do anything, not feel like I have to go, go, go.
Dylan Zambrano, MSW: Right.
Jessica Fowler: Oh, I could do that. I can make time for that walk, whatever it is, right? I think that's a gift of therapy, learning how to do that.
Dylan Zambrano, MSW: Absolutely.
Jessica Fowler: Anything else our listeners should know about your journal?
Dylan Zambrano, MSW: So some additional tools that are available in, in the book at the very start includes the introduction and in the summary of DBT skills, which I've mentioned, but there's also an opportunity to create a coping plan that is unique to the individual that explores, uh, potential strategies for self-soothing for distraction from the distress that might be experienced in that moment for people whom they can connect to, um, so that this becomes a resource that people can carry with them and, uh, resorts to during moments of emotional difficulties. In addition to that, we have something in the book called a skills coach, and this is a walkthrough of a different coping skills that somebody might be able to use based on the emotional intensity, based on the present situation and weather the problem in the moment can be solved, or whether somebody needs to turn to skills to make them feel better in the moment, or perhaps accept and tolerate the experience. Prior to the journaling actually beginning, there's an opportunity to set intentions, to look ahead and set one's goals for, for how they use the, the book. Anticipate challenges that might get in the way of keeping up with a regular a journaling practice using this book, as well as a list of emotions to, to help with accurately labeling their emotions, because that is such a, an important and essential part of emotion regulation is to be able to identify and understand those emotions. And so we have that emotion list in there as well. That, um, can, can really help with that, uh, emotional awareness.
Jessica Fowler: Oh, wonderful. Thank you for sharing that. So, this was such a lovely conversation talking about DBT. Where can our listeners connect with you?
Dylan Zambrano, MSW: So, people can connect with me at DBT virtual, uh, on our Instagram, Facebook, LinkedIn, uh, pages, or our website, DBTvirtual.com. I always like to connect with those, uh, who. You know, want to reach out and ask questions about the book or ask questions about DBT. And so I'm more than happy to, to connect with anyone who's listened in and has a question about anything DBT related to any questions about DBT skills. I'm happy to connect and support in any way that I can.
Jessica Fowler: Wonderful. Well, thank you so much for coming on the show today.
Dylan Zambrano, MSW: Thanks for having me.
Jessica Fowler: Thank you for listening to this week's episode of What Your Therapist Is Reading. Make sure you head on over to the website or social media to find out about the latest giveaway. The information provided in this program is for educational and informational purposes only, and although I'm a social worker licensed in the state of New York, this program is not intended to provide mental health treatment and does not constitute a patient therapist relationship.