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Treating persons with severe emotional dysregulation can be a turbulent ride. Individual clients and individual sessions vary greatly. The therapist often must juggle so many urgent priorities that it is hard to know where to begin or how to proceed. Moreover, clients and therapists alike often get in the way of effective therapy. In the case vignette, Miranda’s arriving intoxicated and having strong urges to quit therapy reflect what we call therapy-interfering behaviors. Somehow, the therapist must deftly juggle various treatment targets and goals, move therapy along consistently, and help clients learn how to build lives they experience as worth living.
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