Dialectical Behaviour Therapy: Description, research and future directions.

2009 ◽  
Vol 5 (2) ◽  
pp. 164-177 ◽  
Author(s):  
Michaela A. Swales

This handbook examines theoretical, structural, clinical and implementation aspects of dialectical behaviour therapy (DBT) for a variety of disorders such as borderline personality disorder (BPD), suicidal behaviour in the context of BPD, substance use disorders, cognitive disabilities, eating disorders, and post-traumatic stress disorder (PTSD). The volume considers the dialectical dilemmas of implementation with respect to DBT in both national and international systems, its adaptations in routine clinical settings, and its behavioural foundations. It also discusses evidence-based training in DBT, validation principles and practices in DBT, the biosocial theory of BPD, the structure of DBT programs, and the efficacy of DBT in college counseling centers. Finally, the book reflects on the achievements of DBT since the first treatment trial and considers challenges and future directions for DBT in terms of its theoretical underpinnings, clinical outcomes, adaptations and implementation in practice.


Author(s):  
Michaela A. Swales

The Oxford Handbook of DBT has reviewed and considered theoretical, structural, clinical, and implementation aspects of DBT, comprehensively detailing its journey in research and clinical practice since the landmark, yet small, RCT published in Archives of General Psychiatry over 25 years ago (Linehan et al, 1991).. This closing chapter reflects on the treatment’s achievements since that first trial and considers future directions in relation to theory, clinical outcomes, adaptations, and implementation in practice. Building on initial demonstrations of efficacy to deliver any intervention effectively at scale, reaching all those who may benefit, requires changes in dissemination, implementation and research strategies. Targeting research on treatment mechanisms that drive change may usefully inform this agenda. This chapter explores these issues and concludes by discussing challenges within the wider psychotherapy field and their implications for DBT.


Author(s):  
Jill H. Rathus ◽  
Alec L. Miller ◽  
Lauren Bonavitacola

Alec Miller and Jill Rathus adapted Dialectical Behaviour Therapy (DBT) for adolescents with suicidal behaviours, multiple disorders, and complex presentations using Marsha Linehan’s original DBT for adults. This chapter outlines this adaptation, provides discussion of the original components and strategies and how they apply to adolescents, and describes the modifications for adolescents and their caregivers. It describes DBT treatment stages and targets, as well as treatment strategies specific to adolescents. It outlines the modes of treatment, including the multi-family skills group, family sessions, parenting sessions, and telephone coaching for parents. Further, it describes the additional skills that were added and/or adapted, including the new skills module, Walking the Middle Path. It includes a case study that highlights the conceptualization, interventions, and outcomes of a typical adolescent’s progress through DBT. Lastly, it summarizes the outcome research of DBT-A and suggests future directions for adolescent DBT.


2020 ◽  
Author(s):  
Chantal P Delaquis ◽  
Kayla M. Joyce ◽  
Maureen Zalewski ◽  
Laurence Katz ◽  
Julia Sulymka ◽  
...  

Context: Emotion regulation deficits are increasingly recognized as an underlying mechanism of many disorders. Dialectical behaviour therapy (DBT) holds potential as a transdiagnostic treatment for disorders with underlying emotion regulation deficits.Objective: Systematically review the evidence for DBT skills training groups as a transdiagnostic treatment for common mental health disorders via meta-analysis. Study Selection: Randomized control trials (RCTs) of DBT skills training groups for adults with common mental health disorders, and no comorbid personality disorder, were included. Data Synthesis: Twelve RCTs met inclusion criteria (N = 425 participants). DBT had a moderate-to-large effect on symptom reduction (g = 0.79, 95% CI [0.52, 1.06], p < .0001). Improvements in emotion regulation yielded a small-to-moderate effect (g = 0.48, 95% CI [0.22, 0.74], p < .01). Results showed significant effects of DBT on depression (g = 0.50, 95% CI [0.25, 0.75], p = .002), eating disorders (g = 0.83, 95% CI [0.49, 1.17], p = .001) and anxiety (g = 0.45, 95% CI [0.08, 0.83], p = .03).Conclusions: Findings suggest DBT is an effective treatment for common mental health disorders and may be considered as a promising transdiagnostic therapy.


2011 ◽  
Vol 20 (2) ◽  
pp. 121-126 ◽  
Author(s):  
D. Fowler ◽  
R. Rollinson ◽  
P. French

All good quality trials of psychological interventions need to check formally that therapists have used the techniques prescribed in the published therapy manuals, and that the therapy has been carried out competently. This paper reviews methods of assessing adherence and competence used in recent large-scale trials of Cognitive Behaviour Therapy (CBT) for psychosis in the UK carried out by our research groups. A combination of the Cognitive Therapy Rating Scale and specific versions of the Cognitive Therapy for Psychosis Adherence Scales provides an optimal assessment of adherence and competence. Careful assessment of the competence and adherence can help identify the procedures actually carried out with individuals within trials. The basic use of such assessments is to provide an external check on treatment fidelity on a sample of sessions. Such assessment can also provide the first step towards moving research towards making sense of CBT for psychosis as a complex intervention and identifying which techniques work for which problems of people with psychosis, at which stages of disorder?


2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Robert John Searle ◽  
Ianiv Borseti

Purpose The purpose of this paper is to determine the effectiveness of an adapted dialectical behaviour therapy (DBT) treatment programme for individuals with an intellectual disability, via completion of a service evaluation. Design/methodology/approach Outcome measurements were competed at pre-, post- and 12 months follow-up, and the effectiveness of the intervention was assessed using a Friedman analysis. Findings Findings demonstrated that the treatment group showed significant differences in their “psychological distress” scores, but no significant differences were found in their “psychological well-being”, “anxiety” or “quality of life” (WHO-QOL) scores over time. Originality/value Overall, the current study adds to the small but growing literature that supports using the skills training group part of DBT as a stand-alone psychological intervention when working with people with an intellectual disability.


Author(s):  
Jennifer H. R. Sayrs ◽  
Marsha M. Linehan

Dialectics are a cornerstone of dialectical behaviour therapy (DBT; Linehan, 1993), and are considered an essential component of treating emotion dysregulation. Incorporating dialectics may enhance therapeutic collaboration, increase flexible thinking, and maximize solution generation. This chapter briefly describes a dialectical world view, then lays out steps for incorporating dialectics into a therapy session, including adopting a dialectical world view, maintaining balance in treatment, working toward synthesis whenever polarization occurs, and utilizing dialectical strategies. Dialectical strategies are any strategies that involve looking for what is left out, synthesizing two poles, and allowing the synthesis to move the interaction forward to a new position. These strategies include magnifying the tension between opposites (such as devil’s advocate and extending strategies), entering the paradox (such as ‘and versus but’ and ‘making lemonade out of lemons’ strategies), and the use of metaphors. While these strategies were developed within DBT, other treatments utilize dialectical approaches, as well.


Sign in / Sign up

Export Citation Format

Share Document