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Tuesday, August 10, 2004

What Is Dialectical Behavioral Therapy?

from Qutayba Abdullatif & Nicole Bekman

Dialectical Behavioral Therapy (DBT) is a method of treatment that
was devised by Marsha Linehan, faculty at the University of
Washington in Seattle, for the treatment of borderline personality
disorder (BPD). Typically clients with BPD, as defined in DSM-IV,
are notoriously difficult to treat (Linehan 1993a). They often do
not attend regularly, frequently fail to respond to therapeutic
efforts and make considerable demands on the emotional resources of
the therapist (particularly when suicidal and parasuicidal behaviors
are prominent). The effectiveness of DBT has been demonstrated in
many controlled studies across different research groups. Because of
this success and due to similar behavior patterns, DBT is now being
used in many settings as a viable therapy for the treatment of
bipolar disorder.
Treatment in DBT has four parts, which are all important to
effective treatment:

Individual Therapy

Telephone Contact

Therapist Consultation
- good communication between group therapist and individual
therapist is essential to the successful outcome of DBT.

Skills Training
- Conducted by a behavioral technician or another therapist usually
in a group context.
- Conducted in weekly sessions of 2.5 hours with a break half way
through each session.
- The focus is on learning and practicing adaptive skills, not
personal or specific complaints of the clients and thus, any
specific or personal issues are redirected to be discussed in
individual therapy.
There are four modules in DBT group skills training:

Core Mindfulness Skills
- These are derived from Buddhist meditation techniques to enable
the client to become aware of the different aspects of experience
and to develop the ability to stay with that experience in the
present moment.
- Treatment lasts for about 2-3 weeks.

Interpersonal Effectiveness Skills
- These focus on effective ways of achieving one's objectives with
other people: to ask for what one wants effectively, to say no and
be taken seriously, to maintain relationships and to maintain self-
esteem in interactions with other people (comparable to
assertiveness training).
- Treatment lasts for about 8 weeks.

Emotion Modulation Skills
These skills are ways of coping with intense emotional experiences
and their causes. They also allow for an adaptive experience and
expression of intense emotions.
- Treatment lasts for about 8 weeks.

Distress Tolerance Skills
- These include techniques for putting up with, finding meaning for,
and accepting distressing situations if there is no conceivable
solution at present.
- Treatment lasts for about 8 weeks.

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As Popeye once said,"I ams what I am." But then again maybe I'm not