• Laura Richardson, Ph.D.

What is the 24 hour rule -- why do we have it?

After a client self-harms or attempts suicide, there will be no coaching or other extra contact for 24 hours. Why? Isn't this the time that a client needs their therapist the most?

The critical concept with the 24 hour rule is "reinforcement". The DBT therapist does not want to reinforce self-harm or suicide attempts. The data show that increased therapist contact after self-harm/suicide attempts can result in additional self-harm or attempts.

Instead, the therapist tries to shape the behavior of having the client call for skills coaching BEFORE they act on their urge, so that they can put their skills to use instead of acting on their urge.

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