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DBT

Is DBT Good For Complex Trauma?

Trauma

The Centers for Disease Control and Prevention (CDC), describes trauma as “an event, or series of events, that causes moderate to severe stress reactions… [that are] characterized by a sense of horror, helplessness, serious injury, or the threat of serious injury or death.” Post-traumatic stress disorder (PTSD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). It is defined by the Mayo Clinic as “a mental health condition that’s triggered by a terrifying event—either experiencing it or witnessing it.” Unlike PTSD that is caused by a single traumatic event or isolated incidents, complex trauma refers to a series of traumatic events that take place over time. Many symptoms of complex trauma overlap with symptoms of PTSD, some of which include:

  • Anxiousness
  • Flashbacks
  • Avoiding circumstances that are reminders of traumatic events
  • Distorted sense of self
  • Difficulty controlling emotions
  • Relationships challenges

Somatic symptoms (e.g., fatigue, nausea, diarrhea, constipation, joint or muscle pain, headaches, etc.) are also common with complex trauma. More than an estimated 3% of people in America meet the criteria for complex trauma. If complex trauma is left untreated, its symptoms can be pervasively disruptive and interfere with one’s ability to function in his or her daily life.

Dialectical Behavior Therapy

Psychologist Marsha M. Linehan developed dialectical behavior therapy (DBT) in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is founded on the principals of cognitive behavioral therapy (CBT), utilizing standard CBT techniques for emotional regulation and reality testing, and combines concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences.

Psychology Today emphasizes the notion that complex trauma requires multifaceted and sequenced treatment, which involves different components that target the various symptoms that present on the road to recovery. According to the U.S. Department of Veterans Affairs, due to the fact that DBT does not necessarily involve any form of trauma processing, it is not and should not be considered a stand-alone treatment for trauma. However, some studies do indicate that DBT can be used to effectively treat the symptoms of complex trauma. DBT remains the only empirically supported treatment for BPD, and current evidence also recognizes DBT as an applicable and effective treatment method for many other mental health conditions.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Type Of Behavior Is The Highest And First Priority Of DBT?

Dialectical behavior therapy

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy treatment that was originally developed by Psychologist Marsha M. Linehan, in the late 1980s, to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is founded on the principals of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspects of treatment. DBT remains the gold-standard form of treatment for individuals with BPD and according to the National Alliance on Mental Illness (NAMI), has since been recognized as an effective method of treatment for a wide range of other mental health disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), eating disorders, and more. As explained by Behavioral Tech, DBT focuses on teaching four sets or modules of behavioral skills, which include:

  • Core mindfulness: the practice of being completely present and aware in any given moment
  • Distress tolerance: increasing an individual’s tolerance of negative emotions as opposed to attempting to avoid or escape them
  • Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions
  • Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging

The therapeutic approach is comprised of three different therapy settings, including weekly individual psychotherapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching to provide additional support between the weekly individual and group sessions.

DBT Treatment Targets

DBT relies on a hierarchy of treatment targets to help the therapist determine the order in which problems should be addressed. The first and highest priority target behavior is any life-threatening behaviors, (e.g., suicide communications, suicidal ideation, and all forms of suicidal, non-suicidal self-injury, etc.). The subsequent treatment targets, in order of priority, according to the University of Washington, are:

  1. Therapy-interfering behaviors: This includes any behavior by the client and/ or therapist that interferes with the client receiving effective treatment (e.g., arriving late to sessions, cancelling appointments, etc.).
  2. Quality of life behaviors: This category includes any other type of behavior that interferes with clients having a reasonable quality of life (e.g., disorders, relationship problems, financial or housing crises, etc.).
  3. Skills acquisition: This refers to the need for clients to learn new skillful behaviors to replace ineffective behaviors and help them achieve their goals.

Clients who receive DBT typically have multiple problems that require treatment, which is why the hierarchy of treatment targets is so deeply embedded in the DBT framework.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

What Are The Limitations Of DBT?

dbt

Dialectical behavior therapy (DBT) is an evidence-based, rigidly structured form of psychotherapy. It was developed by psychologist Marsha M. Linehan in the late 1980s as a means to better treat individuals diagnosed with borderline personality disorder (BPD), suffering from chronic suicidal ideation. DBT combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. It is carried out in three therapeutic settings, including weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills training group therapy sessions, and access to twenty-four-hour support between sessions via phone coaching. Dialectical behavior therapy focuses on teaching skills in four primary areas, which are known as the four modules of DBT. Each module highlights distinct and specific skills that build upon each other and are individually and collectively integral to the success of DBT. Nevertheless, as is true with any mental health intervention, DBT has its fair share of limitations, some of which include:

  • May be ineffective in treating trauma: According to the U.S. Department of Veterans Affairs, due to the fact that DBT does not necessarily involve any form of trauma processing, it is not and should not be considered a stand-alone treatment for trauma.
  • The format and duration of DBT may be a deterrent: The different layers of treatment required for DBT including the amount of time allocated to each of the four modules, the three different therapeutic settings, etc. may be perceived by some as overwhelming and discouraging. As a result, some individuals that could benefit greatly from dialectical behavior therapy view it as overly complex to the point that they are unwilling to try the treatment.
  • DBT is religiously integrated: The foundation of DBT is rooted in mindfulness practice based on Zen Buddhist teachings, therefore some clients (e.g., conservative or orthodox Jews, Christians, Muslims, etc.) may object to certain facets of DBT that are derived from eastern religious philosophies.
  • Large-scale research is lacking: Critics argue that additional research is required to determine if DBT works for those with varied or complex mental health concerns, as most of the available research on the efficacy of DBT includes small sample sizes and focuses on a specific sector of the mental health population.
  • The availability of comprehensive training for providers is insufficient: DBT relies on a detailed manual and demands an intensive amount of training to deliver the services as designed. In many of the research studies where DBT was found to be effective, the providers implementing the DBT treatment were doctoral-level students or higher, which the minimizes the availability of providers.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

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