The Oxford Handbook of Dialectical Behaviour Therapy

2017 ◽  
Keyword(s):  
College Counseling ◽  
Clinical Settings ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Future Directions ◽  
Dialectical Behaviour Therapy ◽  
Biosocial Theory ◽  
Post Traumatic ◽  
International Systems ◽  
College Counseling Centers

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.

Integrating Post-Traumatic Stress Disorder Treatment into Dialectical Behaviour Therapy

2017 ◽  
pp. 796-814
Author(s):  
Melanie S. Harned ◽  
Sara C. Schmidt
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Integrated Treatment ◽  
Routine Practice ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Post Traumatic

Many individuals receiving Dialectical Behaviour Therapy (DBT) meet criteria for post-traumatic stress disorder (PTSD), a debilitating disorder associated with increased impairment in multiple domains of functioning. While DBT has been shown to be effective in treating a wide variety of mental health problems, it has historically been less effective at treating PTSD. This chapter describes an integrated treatment model that combines DBT with the DBT Prolonged Exposure (DBT PE) protocol, which is based on Prolonged Exposure therapy and is designed to increase formal and systematic targeting of PTSD during DBT. It reviews DBT’s stage model of treatment and describes how DBT is used in Stage 1 to stabilize and prepare high-risk and multi-problem clients for the DBT PE protocol in Stage 2. It then describes the rationale and procedures of the DBT PE protocol, highlights common clinical challenges, and reviews the developing evidence base for the treatment. Finally, it discusses common barriers to implementing DBT PE in routine practice settings and suggest potential solutions.

Interventions for Mental Health Problems in Later Life

2010 ◽  
pp. 810-837
Author(s):  
Jason M. Holland ◽  
Dolores Gallagher-Thompson
Keyword(s):  
Older Adults ◽  
Mental Health Problems ◽  
Later Life ◽  
Clinical Psychologist ◽  
Post Traumatic Stress ◽  
Future Directions ◽  
Use Of Technology ◽  
Worldwide Population ◽  
Challenges And Opportunities ◽  
Post Traumatic

Older adults are increasingly making up a larger segment of the worldwide population, which presents both challenges and opportunities for the clinical psychologist in the 21st century. In this chapter, we address some of the unique aspects of working with this population, focusing on general guidelines for tailoring interventions for older adults, specific treatments for particular problems commonly faced in later life, as well as issues of diversity and how they might impact psychotherapy with older clients. We also outline several areas in geropsychology that are in need of further investigation, namely the use of technology, post-traumatic stress, and family therapy, and offer some recommendations for future directions in this field of study.

Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder

2007 ◽  
Vol 38 (4) ◽  
pp. 555-561 ◽  
Author(s):  
R. A. Bryant ◽  
K. Felmingham ◽  
A. Kemp ◽  
P. Das ◽  
G. Hughes ◽  
...  
Keyword(s):  
Treatment Response ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Cognitive Behaviour Therapy ◽  
Stress Disorder ◽  
Anterior Cingulate ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Post Traumatic

BackgroundAlthough cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), approximately half of patients do not respond to CBT. No studies have investigated the capacity for neural responses during fear processing to predict treatment response in PTSD.MethodFunctional magnetic resonance imaging (fMRI) responses of the brain were examined in individuals with PTSD (n=14). fMRI was examined in response to fearful and neutral facial expressions presented rapidly in a backwards masking paradigm adapted for a 1.5 T scanner. Patients then received eight sessions of CBT that comprised education, imaginal and in vivo exposure, and cognitive therapy. Treatment response was assessed 6 months after therapy completion.ResultsSeven patients were treatment responders (defined as a reduction of 50% of pretreatment scores) and seven were non-responders. Poor improvement after treatment was associated with greater bilateral amygdala and ventral anterior cingulate activation in response to masked fearful faces.ConclusionsExcessive fear responses in response to fear-eliciting stimuli may be a key factor in limiting responses to CBT for PTSD. This excessive amygdala response to fear may reflect difficulty in managing anxiety reactions elicited during CBT, and this factor may limit optimal response to therapy.

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