In Dialectical Behavior Therapy (DBT), chain analysis is used to identify the chain of events, context, emotions, and reactions that lead to a specific disordered or problematic behavior.
Chain analysis naturally lends itself to treatment plan development and case formulation. One of the many behavioral change strategies in DBT, chain analysis is the modified counterpart to functional analysis/behavioral analysis in standard Cognitive Behavior Therapy (CBT).
The Chain in Chain Analysis
Through chain analysis, the client and DBT therapist work together to start changing the problem behavior by identifying the prompting event and the vulnerability factors leading to the behavior. The prompting event is the situation that led to the behavior, such as an argument with a friend that led to the client binge eating. The vulnerability factors are the conditions that added to the intensity of prompting event, such as illness, lack of sleep, hunger, or anything that affects emotional stability.
Starting from the prompting event, the client relates what happened as her DBT therapist asks about her feelings, thoughts, and actions each moment leading up to the behavior and during the behavior itself. Together, they work to find the links between each of these aspects.
The last part of the chain analysis is identifying the consequences of the behavior. These are what happened as a result of, for example, the client binge eating. It includes her actions and how they made her feel.
The Point of Chain Analysis in DBT
Chain analysis gives the DBT therapist a new view to theorize at each link alternate behaviors that might work more effectively for the client when she is triggered by a negative event.
A chain analysis also includes searching for any patterns across problem behaviors, looking for any commonalities across several chains. When done correctly, chain analysis as part of Dialectical Behavior Therapy can help clients recognize how their behaviors are triggered and learn healthier ways to cope with upsetting or triggering events.
Chain analysis can also help a DBT therapist find the controlling variables interfering with choosing alternate behavior. This is accomplished through target hierarchy, biological social theory, and behavior theories of change. The therapist applies these to links checking for skills deficits, conditioned emotional responses, problematic contingencies, and problematic cognitive processes or content.