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DBT

Learn how DBT can help you manage emotions, build resilience, and foster positive change in your life.

DBT Essentials: A Roadmap to Handling Borderline Personality Disorder

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 treatment method specifically designed for chronically suicidal individuals diagnosed with borderline personality disorder. 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. Here is a roadmap to guide the treatment of BPD using DBT:

  1. Assessment and Diagnosis:
    1. Thorough Assessment: Conduct a comprehensive assessment to understand the individual’s history, symptoms, and challenges.
    2. Collaborative Diagnosis: Work collaboratively with the individual to establish a diagnosis of borderline personality disorder.
  2. Building a Therapeutic Alliance:
    1. Establish Trust: Recognize the importance of trust in the therapeutic relationship. Validate the individual’s emotions and experiences.
    2. Commitment to Treatment: Ensure commitment from both the therapist and the individual to engage in the therapeutic process.
  3. Orientation to DBT:
    1. Educate about DBT: Provide a clear understanding of what DBT is, its goals, and how it can help in managing emotions and behaviors.
    2. Highlight Dialectics: Emphasize the dialectical nature of DBT – balancing acceptance and change.
  4. Individual Therapy:
    1. Target Identification: Collaboratively identify and prioritize specific target behaviors and problems to address in therapy.
    2. Skills Training: Begin teaching skills in distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness.
  5. Group Skills Training:
    1. Structured Modules: Conduct weekly group sessions to teach and practice DBT skills, focusing on the four modules mentioned above.
    2. Homework Assignments: Encourage individuals to practice skills between sessions and discuss their experiences in the group.
  6. Phone Coaching:
    1. Availability: Establish clear guidelines for when and how individuals can contact the therapist for phone coaching between sessions.
    2. Crisis Intervention: Provide guidance and support during moments of crisis, reinforcing the application of DBT skills.
  7. Mindfulness Practice:
    1. Integration: Integrate mindfulness techniques into both individual and group sessions to enhance awareness and reduce impulsivity.
    2. Regular Practice: Encourage regular mindfulness practice as a key component of emotional regulation.
  8. Therapist Consultation Team (TCT):
    1. Supervision: Therapists involved in DBT should meet regularly to discuss cases and receive consultation to ensure adherence to the DBT model.
    2. Problem Solving: Use the TCT for problem-solving challenging cases and maintaining therapist motivation and commitment.
  9. Assessment of Suicidal and High-Risk Behaviors:
    1. Safety Planning: Develop and regularly update a safety plan to address suicidal and self-harming behaviors.
    2. Collaboration with Other Professionals: Coordinate with other healthcare providers involved in the individual’s care to ensure a comprehensive approach.
  10. Termination and Aftercare:
    1. Gradual Termination: Plan a gradual termination process to allow for a smooth transition from therapy.
    2. Aftercare Planning: Develop an aftercare plan that includes ongoing support, continued skill practice, and resources for maintaining progress.
  11. Ongoing Monitoring and Evaluation:
    1. Regular Assessments: Continuously assess progress, adapting treatment goals as needed.
    2. Feedback and Adjustments: Solicit feedback from the individual regarding their experience in therapy and make necessary adjustments to enhance effectiveness.

Implementing DBT for borderline personality disorder requires commitment, patience, and flexibility. Regular supervision and ongoing education for therapists are crucial for maintaining fidelity to the DBT model.

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.

 

 

DBT Skills for Emotional Regulation in BPD

DBT Skills

Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. BPD is characterized by a “pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses, which is a core feature of borderline personality disorder.

DBT Basics

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 treatment method specifically designed for chronically suicidal individuals diagnosed with borderline personality disorder. 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. DBT is carried out in three therapeutic settings: weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. This allows participants to engage in individualized and collective treatment while focusing on the four modules of DBT, which are core mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

Emotion Regulation Skills

Emotion regulation is defined as “the process by which individuals influence which emotions they have, when they have them, and how they experience and express their feelings. Emotional regulation can be automatic or controlled, conscious or unconscious, and may have effects at one or more points in the emotion producing process.” The DBT emotion regulation module focuses on skills that are aimed to help individuals learn to experience strong emotions while simultaneously reducing the intensity of the emotions, without acting impulsively on them. This module provides education regarding the function of emotions as well as teaches an array of important skills surrounding emotion regulation, such as:

  • Opposite action skill: As the name suggests, individuals are taught to act the opposite of how they feel. First, identify how you are feeling and do the opposite (e.g., if you are feeling sad and want to withdraw from loved ones, make plans to spend time with them instead).
  • Cope ahead skill: This skill is intended encourage individuals to consider how they might be prepared in some way to reduce stress ahead of the time. Come up with a plan that prepares you to skillfully navigate and cope with emotional situations.
  • Positive self-talk skill: Positive self-talk encourages self-confidence, effective coping, achievement, and a general feeling of well-being. Select a few affirmations, or positive statements, that speak to you and then repeat them regularly.
  • STOP skills: STOP is an acronym for Stop, Take a step back, Observe, and Proceed mindfully, which can help an individual avoid engaging in impulsive behavior.
  • PLEASE skills: Are guidelines to remind people to prioritize physical health, because physical health is closely tied to mental health.

The goals of this module are threefold: to understand one’s emotions, reduce emotional vulnerability, and decrease emotional suffering.

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 Is The Main Focus Of The Dialectical Approach?

dialectical approach

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that is founded on the principles of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspect of treatment. The term “dialectical” derives from the idea that combining two opposites in therapy (acceptance and change) yields better results than either would on its own. The philosophical perspective of dialectics greatly influences and informs dialectical behavior therapy.

Psychologist Marsha M. Linehan developed dialectical behavior therapy in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). The Merck Manual explains that BPD is “characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses, which is a core feature of borderline personality disorder. The focus of DBT is to improve patients’ quality of life by reducing “ineffective action tendencies associated with dysregulated emotions.” Dialectical behavior therapy allow participants to engage in individualized and collective treatment by focusing on the four modules of DBT, which are: core mindfulness (focusing skills), distress tolerance (crisis survival skills), emotion regulation (de-escalation skills), and interpersonal effectiveness (social/ relationship skills). The primary goal of DBT, according to Psychology Today, is to “transform negative thinking patterns and destructive behaviors into positive outcomes.” Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD and has since been deemed an effective method of treatment for many other mental health conditions.

What Is Dialectical Thinking?

Dialectical thinking is defined as “a form of analytical reasoning that pursues knowledge and truth as long as there are questions and conflicts.” In the 1800s, German philosopher Georg Hegel, developed a new form of thinking and logic that he called “speculative reason.” The concept of dialectical thinking, which is included in speculative reason, was established after grappling with the limitations of both common sense and of traditional philosophy at grasping philosophical problems and the relation between thought and reality. A dialectic is rooted in the notion that everything is made up of opposites, and a dialogue between the opposing ends ignites change. Dialectical thinking enables an individual to hold two seemingly opposite perspectives simultaneously. This, in turn, promotes balance and minimizes the tendencies to think in absolutes. Dialectical thinking fosters an inclusive worldview (both- and) instead of an exclusive (either- or) outlook on life. Dialectical thinking is a cornerstone of the DBT process.

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.

Does DBT Change The Brain?

Does DBT Change The Brain

Dialectical behavior therapy (DBT) is an evidence-based psychotherapeutic modality that combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices. It was developed in the late 1980s by Marsha M. Linehan as a therapeutic approach specifically geared to treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal thoughts and/ or attempts. 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. The Mayo Clinic refers to the brain as the most complex organ in the human body. As indicated below, research suggests that DBT can change the brain:

  • Studies using brain imaging techniques have shown that individuals who have undergone DBT demonstrate changes in brain activity in regions involved in emotion regulation, such as the prefrontal cortex and amygdala.
  • Individuals who have received DBT show decreased activation in brain areas associated with emotional reactivity, suggesting that the therapy may help modulate emotional responses.
  • Research indicates that DBT can enhance cognitive control processes, such as inhibitory control and attentional flexibility, which are associated with specific brain regions involved in executive functions.
  • One study concluded that mindfulness practices, which are a fundamental component of DBT, are directly correlated to “changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”

It is possible for DBT to change one’s brain because of its neuroplasticity. Frontiers In Psychology defines neuroplasticity as “a general umbrella term that refers to the brain’s ability to modify, change, and adapt both structure and function throughout life and in response to experience.” Hence, the brain is a continuously evolving, highly adaptable organ. Neural pathways are developed through synaptic connections that occur in one’s brain, directly resulting from a person’s habits and behaviors. These connections create a map of a myriad of circuits within one’s brain which enable the brain to process various experiences and are essential in how the brain retains and accesses information. Neural pathways strengthen with repetition and can similarly become obsolete without repetition. The nature of DBT and the integration and repetition of certain DBT techniques can potentially reshape neural pathways and strengthen healthier patterns of thinking and behavior. Nevertheless, further research is required to fully understand the neural mechanisms underlying the effects of DBT on the brain.

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 DBT Distress Tolerance Skills?

DBT Distress

Dialectical behavior therapy (DBT) was developed by psychologist Marsha M. Linehan in the late 1980s and was originally intended as a treatment method for borderline personality disorder (BPD). It is a rigidly structured, evidence-based psychotherapy that combines standard cognitive behavioral therapy (CBT) techniques for emotional regulation and reality testing with concepts derived from Eastern meditative practice (e.g., awareness, mindfulness and attentiveness to current situations and emotional experiences) to emphasize the psychosocial aspects of treatment. DBT is a multifaceted approach that is carried out in three therapeutic settings, which include: weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. This format allows participants to engage in individualized and collective treatment to focus on the four modules of DBT which are core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Distress Tolerance Skills

Distress tolerance is explained by experts as “the perceived capacity to withstand negative emotional and/ or other aversive states (e.g., physical discomfort), and the behavioral act of withstanding distressing internal states elicited by some type of stressor.” Distress tolerance skills, also known as crisis survival skills, include a variety of short-term coping strategies. The skills taught in this module are intended to help individuals learn tools and techniques to get through challenging situations when emotions are heightened and avoid destructive behavior. The DBT distress tolerance module focuses on teaching an array of crisis survival skills, some of which include:

  • TIPP skills: TIPP is an acronym for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. TIPP skills quickly calm the limbic system and lower the state of emotional arousal.
  • Square breathing: This is a guided breathing exercise that can be used by anyone to manage stress and anxiety, as it has been shown to relax the nervous system. Try it out by following these simple directions:
    • Inhale to a count of 4.
    • Hold your breath to a count of 4.
    • Exhale to a count of 4.
    • Hold it for a count of 4.
  • Weigh the pros and cons: Noting the pros and cons can encourage an individual to pause and take a moment to think about a situation and the most appropriate subsequent steps.
  • STOP skill: STOP is an acronym for Stop, Take a step back, Observe, and Proceed mindfully, which can help assuage impulsivity.
  • Radical acceptance: This skill entails making a conscious choice to accept the state of things as they are, without working to change them. 
  • Distraction: In moments of intense overwhelm, temporary distractions (e.g., calling a friend, reading a book, watching TV, etc.) can provide brief relief from the distressing situation.
  • IMPROVE skills: IMPROVE is an acronym for Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, and Encouragement, all of which can help with improving the moment.
  • Failing forward: Failing forward eliminates the fear of failure by recognizing and celebrating it as an opportunity for growth. It allows an individual to see that failure does not imply that they have failed as a person, and simultaneously reinforces the notion that growth is always possible.

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 Four Modules Of Dialectical Behavioral Therapy?

Dialectical Behavioral Therapy Module

Dialectical behavior therapy (DBT) 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. It is a rigidly structured, evidence-based psychotherapy that emphasizes the psychosocial aspect of treatment. It is comprised of three distinct therapeutic settings, which include: weekly individual psychotherapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. 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. Dialectical behavior therapy focuses on teaching skills in four primary areas, also known as the four modules of DBT. Each module highlights specific skills that build upon each other and are individually and collectively integral to the success of DBT.

Module One: Core Mindfulness

The Oxford English Dictionary defines mindfulness as “a mental state achieved by focusing one’s awareness on the present moment, while calmly acknowledging and accepting one’s feelings, thoughts, and bodily sensations.” There have been studies that indicate that the tranquility effects of practicing mindfulness can be directly correlated to a reduction in one’s stress levels, which can subsequently have a positive effect on one’s immune system. Skills during this module help individuals learn to slow down and focus on mindfully acknowledging and experiencing emotions without reacting impulsively and/ or destructively. It teaches skills to help individuals avoid taking things personally, garner a better understanding of their emotions, become active listeners, and learn to sit with emotions instead of trying to ignore, expel, or dismiss them.

Module Two: Distress Tolerance

Distress tolerance is often conceptualized as “one’s ability to tolerate and withstand negative or uncomfortable emotional states.” Distress tolerance skills, also known as crisis survival skills, are short-term coping strategies intended to help manage emotional pain to avoid destructive behavior. Distress tolerance skills help an individual learn to acknowledge, process, and integrate emotions and situations in a way that is non-evaluative and nonjudgmental. The purpose of the distress tolerance modules is to bolster one’s ability to cope with feelings that do not have an immediately known resolution.

Module Three: Emotion Regulation

Emotion regulation can be explained as “the ability to exert control over one’s own emotional state.” The goals of this module are threefold: to understand one’s emotions, reduce emotional vulnerability, and decrease emotional suffering. The emotion regulation module focuses on skills that are aimed to help an individual learn to decrease the intensity of their emotions, sit with, and experience strong unwanted emotions, without impulsively acting on them.

Module Four: Interpersonal Effectiveness

The interpersonal effectiveness module is intended to teach people skills to navigate interpersonal problem solving, improve assertiveness, hone social skills to modify aversive environments, and to realize goals in interpersonal encounters. These skills involve helping individuals identify and understand their own needs in a relationship. Interpersonal effectiveness skills also help an individual learn to cultivate, engage, and maintain healthy relationships with others that enable one’s needs to be met. This includes advocating for one’s needs and communicating in way that is non-damaging, assertive, maintains self-respect, and strengthens relationships.

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 Some Examples Of DBT Therapy?

DBT Therapy

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that is founded on the principals of cognitive behavioral therapy (CBT) and rooted in mindfulness practices based on Zen Buddhist teachings. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). The primary goal of DBT, according to Psychology Today, is to “transform negative thinking patterns and destructive behaviors into positive outcomes.” While it was originally developed and remains the gold standard method of treatment for individuals diagnosed with BPD, evidence has shown it to be a successful treatment method for individuals struggling with other mental health conditions.

DBT: A Closer Look

Dialectical behavior therapy is made up of three distinct therapeutic settings, which include weekly individual psychotherapy (one-on-one therapy) sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching to provide additional support between the weekly individual and group sessions. One-on-one therapy sessions are intended to provide personalized support for individuals with processing experiences, addressing issues, navigating challenges, and identifying successes that occurred in the previous week. The DBT skills training group therapy sessions are focused on enhancing the capabilities of each participant by teaching behavioral skills related to the four modules that make up the pillars of DBT. They include the following, provided by the Linehan Institute:

  1. Core Mindfulness (focusing skills): the practice of being fully aware and entirely present in the current moment.
  2. Distress Tolerance (crisis survival skills): learning tools and techniques to accept, find meaning through, and tolerate distress.
  3. Interpersonal Effectiveness (social skills): learning assertive communication methods that enable an individual to engage with others in a way that maintains self-respect and simultaneously strengthens relationships.
  4. Emotion Regulation (de-escalation skills): learning to recognize, label, and adjust emotions to assist in regulating emotions and subsequently changing reactions to events.

In DBT skills training group therapy sessions the clinician running the session will follow the lessons provided in the DBT curriculum, teach the pertinent skills, and facilitate activities to allow the participants to practice implementing the newly learned DBT skills. These group sessions offer participants an emotionally safe environment to begin to adopt the DBT skills alongside others working on similar issues. Group members are encouraged to share their experiences and provide mutual support, which can be invaluable to the therapeutic process. The work that occurs during the DBT skills training group therapy sessions continues, as homework assignments that correspond to the DBT skills taught or visited during each DBT skills training group therapy session are regularly assigned. DBT relies on supportive resources (e.g., handouts, diary cards, worksheets, workbooks, etc.) to help reinforce the skills taught in each DBT skills training group therapy session and to provide additional opportunities for participants to continue to practice applying the learned skills in daily life.

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.

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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