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Dialectical Behavior Therapy
Dialectical Behavior Treatment Therapy is a cognitive behavioral treatment designed to help people learn and use new skills and strategies towards developing a life that they experience as worth living. DBT was originally developed to treat chronically suicidal individuals. With impressive outcomes, it is now recognized as the gold standard treatment for those who struggle with symptoms of borderline personality disorder (BPD). It is also effective in treating other disorders including depression, substance dependence, eating disorders, and in its prolonged exposure (PE) adaptation, post-traumatic stress disorder (PTSD).
Dialectical Behavior Therapy (DBT) is a complex treatment that requires thorough clinician training. All Families On The Line clinicians have been or are being intensively trained in DBT.
DBT Skills Group
In addition to individual psychotherapy and coaching, a central component of DBT is skills training groups aimed learning new competencies. DBT skills groups last 90 minutes. They are structured like a class where the group leaders teach skills and assign homework. The homework helps clients practice using the skills in their everyday lives.
There are 4 modules:
- Mindfulness: the practice of being fully aware and non-judgmentally present in the moment.
- Emotion Regulation: how to regulate emotions.
- Distress Tolerance: how to tolerate crises without making the moment worse.
- Interpersonal Effectiveness: how to ask for what you want and say no to what you don’t want while maintaining self-respect and relationships with others; how to nurture or end relationships.
Cognitive Behavior Therapy (CBT)
Cognitive Behavior Therapy (CBT) is an evidence-based psychotherapy that is highly effective in addressing a wide range of problems including mood disorders, anxiety and related disorders, problems of inattention, impulsivity or defiance (e.g., ADHD, oppositional defiant disorder, conduct disorder), habit disorders (e.g., trichotillomania, skin picking), procrastination, difficulties in problem solving or decision making, social skills problems, thought disorders, eating disorders, chronic pain, and interpersonal problems. Treatment is based on developing an understanding of how an individual’s current thinking patterns and belief system about themselves, others and the world influence emotions and problematic behaviors. There is a central focus on identifying, evaluating, and responding to dysfunctional thoughts and beliefs. Behavioral interventions are utilized to bring about lasting behavior change.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) is an evidence based variation of CBT. From an ACT perspective, psychological suffering is caused by attempts to control and escape painful emotions and other difficult experiences. The primary goal of ACT is to increase psychological flexibility – the ability to contact the present moment more fully as a conscious human being, and to change or persist in behavior in order to foster a values-driven life. Psychological flexibility is based in acceptance, mindfulness, and behavior change strategies.
For Trauma Related Issues
- Prolonged Exposure (PE) is an exposure-based, time-limited therapy for post-traumatic stress disorder (PTSD). It combines both in-session imaginal exposure exercises and out of session practices to increase emotional processing of the traumatic events and break the cycle of avoidance that has been theorized to underlie many of the unwanted and often debilitating symptoms of PTSD. The average number of sessions for a round of PE is 8-15, but this may vary depending on number, type, and chronicity of traumas experienced. Sessions are highly structured, range from 60-120 minutes in length, and include homework and out of session exercises. There is a strong research basis for PE, with clinical trials demonstrating its efficacy across a number of populations and conditions.
- DBT-PE was developed and is demonstrated to treat PTSD among those with a diagnosis of BPD and/or related issues (e.g., suicidality, self-harm) who are also receiving DBT. DBT-PE is intensive as it includes both weekly comprehensive DBT programming (individual + group sessions) and weekly PE sessions (as described above). DBT-PE thoughtfully and comprehensively addresses PTSD in the context of high-risk behaviors and safety concerns.
- Cognative Processing Therapy (CPT) is a time-limited, cognitive behavioral therapy treatment that operates under the premise that the modification of thoughts related to the trauma will produce improvements in emotions and behavior. Over time, the aim of treatment is to help individuals understand how their experience of the trauma affected their view of themselves, others, and the world, and then to learn new, more helpful ways of thinking. CPT sessions are 60 minutes long, highly structured, and include the assignment of out-of-session homework. The average length for a round of CPT is 6-24 sessions. Research support for CPT is strong, with a number of studies demonstrating efficacy.