Individuals

Dialectical Behavior Treatment 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 intensively trained in DBT and have completed a full year in the DBT intensive training program of the Yale New Haven Psychiatric Hospital.

DBT Skills Group

In addition to individual psychotherapy and coaching, a central component of DBT is skills training groups aimed at teaching our clients new competencies. DBT skills groups last about 2 hours. 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 four modules in skills training:

Mindfulness: the practice of being fully aware and non-judgmentally present in the mome

Distress Tolerance: how to tolerate crises without making the moment worse

Emotion Regulation: how to regulate emotions

Interpersonal Effectiveness: how and how strongly to ask for what you want and say no while maintaining self-respect and relationships with others; how to nurture or end relationships.

CBT, ACT & CBASP

Cognitive Behavior Therapy

Cognitive Behavior Therapy (CBT) was developed by Aaron Beck in the 1960s. It is an evidence-based psychotherapy that is highly effective in addressing a wide range of internalizing and externalizing problems in children, adolescents, and adults, 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 also utilized to bring about lasting behavior change.

Acceptance & Commitment Therapy

Acceptance and Commitment Therapy (ACT) is a variation of traditional CBT. It is another evidence-based treatment with substantial empirical support for a broad range of psychological difficulties across the lifespan. 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.

Cognitive Behavioral Analysis System of Psychotherapy

Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is an integrative therapy with strong research support for treating chronically depressed adults. The treatment combines components of cognitive, behavioral, interpersonal, and psychodynamic therapies. Chronic depression is viewed as the outcome of persistent disconnectedness from the environment and interpersonal avoidance. Problem solving techniques, exploration of past traumatic relationships, identification of healthy relationships, and behavioral skills are used to help chronically depressed individuals modify maladaptive behavior, understand problematic interpersonal patterns and relationships, and start achieving desired outcomes.

DBT & PE for Trauma-related Issues

Prolonged Exposure (PE)

Prolonged Exposure (PE; Foa, Hembree, & Rothbaum, 2007) 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 (Foa, 2011).

DBT-PE

DBT-PE (Harned, Korslund, Foa, & Linehan, 2012) was developed 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. Research support for DBT-PE is mounting with studies demonstrating promising results (Harned, Korslund, & Linehan, 2014).

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT; Resick & Schnicke, 1993) 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 (Cusak et al., 2015).

Grief Treatment/ Grief Counseling

Grief is a universal human experience and it is a privilege to share the journey with those who have suffered loss. Lives are permanently changed by the experience of loss, and yet still there is the capacity to proceed with a satisfying future, and even experiences of joy, following the death of someone we are close to.

The goal of Complicated Grief Treatment (CGT) is to release people from the pain that can dominate their experience and compromise their hope for a meaningful future. CGT is a 16-session evidence-based intervention with a 70% efficacy rate in helping people to integrate their experiences of loss. The process aims to restore their ability to experience joy and satisfaction in life while accepting the finality and consequences of their loss and maintaining a connection to the person who died. This treatment is intended and effective for those who experience yearning, longing and sorrow, frequent preoccupying thoughts of the deceased, difficulty accepting the loss, and persistent intense emotional or physiological activation when experiencing reminders of the loss.

It has been said that grief is the form that love takes when someone we care about dies. Complicated Grief Treatment can be a pathway to honoring the experience of grief, and is individualized to each person’s unique circumstances of loss.