The therapist models many of the skills and validates the valid thoughts, wants, and emotional responses of each family member along the way or coaches family members to do this, thus demonstrating or facilitating skillful responses and alternatives for the clients and cheerleading their new steps (Fruzzetti & Ruork, 2018).
Much like the process of individual chain analysis (e.g., Rizvi & Ritschel, 2014), a double chain analysis is an opportunity for both assessment and intervention. The goal is to understand the antecedents and consequences of a problematic behavior in order to facilitate the generation of possible solutions. Typically, in individual chain analysis the therapist and client will discuss the client’s behavioral chain (vulnerabilities, thoughts/judgments, emotions, sensations, actions) and then identify and practice possible solutions to “break the chain.” All events are understood primarily from the perspective of the client. In a double chain analysis, each individual’s chain is described, including points in which their chains intersect and affect each other. These “public” links are shaded in Fig. 1, and only one occurs at any given moment, highlighting actions or verbal behaviors that are relevant to both people. In contrast, the “open” links are drawn for each person simultaneously. A double chain thus can illuminate a great deal about the transaction between one individual’s overt behavior and the other’s dysregulated emotion (and vice-versa), allowing for the selection of specific targets to treat, ultimately replacing problematic reactions and other behaviors with new emotional or relationship skills, as well as mutual understanding.
To begin a double chain analysis, the therapist (with input from the individual client and the family) selects a specific instance (specific day, time, and place) of a problem or conflict. Each family member then goes though the links on the chain, including vulnerabilities, thoughts, urges, emotions, and actions (verbal or other). As shown in Fig. 1, the shaded links represent the public events and the nonshaded links represent private experiences (thoughts, emotions, desires, etc.), that can only be understood once described in an accurate way. Each individual has the opportunity to disclose his or her experiences and validate the other’s experiences. With this greater knowledge of the chain of events, each person can discuss and practice skillful alternatives to “break the chain” and end the interaction in a completely different manner.
In the session, one or more people may be dysregulated, and conducting a double chain analysis (or any meaningful exchange) may be difficult. DBT couple and family therapists may need to utilize various session-management strategies in order to run the session effectively. These include blocking dysfunction early, inviting accurate expression, providing at least minimal validation to soothe negative emotional arousal, making sure not to show up parents or partners (instead, try to make them look good and build competence), real-time skill coaching in the session, and the therapist may even employ a “revolving door” in which more regulated and collaborative family members spend short periods of time in the waiting area while the therapist tries to understand, block, and teach or coach relevant skills to the more dysregulated family member to allow for meaningful discourse in the session together (see Fruzzetti & Payne, 2015, for more details about these strategies).