DBT with Adolescents

2018 ◽  
pp. 546-572 ◽  
Author(s):  
Jill H. Rathus ◽  
Alec L. Miller ◽  
Lauren Bonavitacola
Keyword(s):  
Outcome Research ◽  
Treatment Strategies ◽  
Behaviour Therapy ◽  
Future Directions ◽  
Dialectical Behaviour Therapy ◽  
Skills Group ◽  
Telephone Coaching ◽  
Group Family

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.

A case study and practitioner perspective on the application of Radically Open Dialectical Behaviour Therapy (RO DBT)

2021 ◽  
pp. 20-35
Author(s):  
Maggie Stanton ◽  
Sophie C. Rushbrook ◽  
Michaela A. Swales ◽  
Thomas R. Lynch
Keyword(s):  
Controlled Trial ◽  
Coping Styles ◽  
Treatment Strategies ◽  
Skills Training ◽  
Behaviour Therapy ◽  
Voluntary Work ◽  
Dialectical Behaviour Therapy ◽  
Refractory Depression ◽  
Novel Treatment

Radically Open Dialectical Behaviour Therapy (RO DBT) is a new treatment for overcontrolled mental health disorders, including refractory depression. This case study provides the therapist's description of delivering RO DBT to a client who took part in a randomised controlled trial of RO DBT. It describes novel treatment strategies and their implementation. Sam attended weekly individual sessions and group skills training sessions over 7 months. The treatment involved collaboratively explaining the RO DBT model whilst linking it to Sam's history and experiences. Coping styles that served to keep Sam isolated from others were identified with a focus on social signalling. RO DBT skills were introduced to activate her social safety system and enhance connectedness. Percentage improvement in depression scores from baseline was 50% at 7 months (end of treatment) and 65% at 18 months.Sam was in full remission at 12 and 18 months. Subjective feedback from Sam was that she felt happier in her marriage, had started voluntary work and made friends locally. She reported being more compassionate to herself and having increased flexibility in adapting to situations.The therapist reported using the RO DBT skills herself and finding them useful, both in learning the new therapy and in the therapy sessions. RO DBT's focus on the overcontrolled coping style and teaching of new strategies to address social signalling and enhance connectedness is a novel treatment approach. It offers promise as an intervention for those with depression.

Beyond exposure therapy: formulation-based therapy treating a fear of urinary incontinence – a case study

2021 ◽  
pp. 1-5
Author(s):  
Torstein Stapley ◽  
Tracey Taylor ◽  
Victoria Bream
Keyword(s):  
Urinary Incontinence ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Specific Phobia ◽  
Behaviour Therapy ◽  
Behavioural Treatment ◽  
Subjective Report ◽  
Cognitive Behaviour ◽  
Behavioural Factors

Abstract Background: The current literature on the specific phobia of urinary incontinence is limited, with no specific empirically established model or treatment protocol. Aims: This article consists of a case study of formulation-driven cognitive behaviour therapy (CBT) for phobia of urinary incontinence. Method: Martin attended a total of 12 treatment sessions. The treatment included the development of an idiosyncratic formulation, and the use of well-established cognitive and behavioural treatment strategies from other anxiety disorders. Results: Both outcome measures and Martin’s subjective report indicate that the treatment was effective. Conclusion: This case study contributes to the current limited literature on this phobia, and emphasises the importance of formulation-driven CBT to map for idiosyncratic features and target cognitive and behavioural factors.

Teaching Mindfulness Skills in DBT

2017 ◽  
pp. 366-388
Author(s):  
Maggie Stanton ◽  
Christine Dunkley
Keyword(s):  
Cognitive Therapy ◽  
Stress Reduction ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Mindfulness Skills ◽  
Skills Group ◽  
Phone Contact ◽  
Mindfulness Based Stress Reduction ◽  
The Way

Dialectical Behaviour Therapy (DBT) differs from other approaches by teaching mindfulness as a set of skills. In contrast to mindfulness-based therapies such as Mindfulness Based Stress Reduction (MBSR) and Mindfulness Based Cognitive Therapy (MBCT), DBT makes a distinction between observe, describe, and participate (the “What Skills”) and teaches each as a separate skill. DBT makes explicit the way in which these skills are practised, i.e. non-judgementally, one-mindfully, and effectively (the “How Skills”). In addition, the skill of “Wise Mind” teaches the client how to make decisions and choices that provide a synthesis of both logical and emotional perspectives. Mindfulness skills are acquired in skills group, strengthened in individual therapy, and generalized via phone contact. Thus, the chapter is organized around these three modes of delivering therapy. Client examples and scenarios demonstrate the process and strategies used with attention to overcoming challenges that can arise when teaching these skills.

Community dialectical behaviour therapy for emotionally dysregulated adults with intellectual disabilities

2014 ◽  
Vol 8 (3) ◽  
pp. 165-173 ◽  
Author(s):  
Aubrey Baillie ◽  
Sean Slater
Keyword(s):  
Intellectual Disabilities ◽  
Detailed Examination ◽  
Outcome Data ◽  
Lessons Learned ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Client Group ◽  
Adults With Intellectual Disabilities

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

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.

Future Directions for Dialectical Behaviour Therapy

2018 ◽  
pp. 1004-1016
Author(s):  
Michaela A. Swales
Keyword(s):  
Clinical Practice ◽  
Clinical Outcomes ◽  
Behaviour Therapy ◽  
Research Strategies ◽  
Future Directions ◽  
Dialectical Behaviour Therapy ◽  
General Psychiatry ◽  
Implementation Aspects ◽  
Treatment Mechanisms

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.

Dialectical behaviour therapy ‘Skills for Living’ for young people leaving care: A qualitative exploration of participants’ experiences

2021 ◽  
pp. 135910452110566
Author(s):  
Charlene Rouski ◽  
Sinitta Yu ◽  
Amanda Edwards ◽  
Lisa Hibbert ◽  
Andi Covax ◽  
...  
Keyword(s):  
Qualitative Evaluation ◽  
Psychosocial Needs ◽  
Behaviour Therapy ◽  
Structured Interviews ◽  
Dialectical Behaviour Therapy ◽  
Emotional Acceptance ◽  
Care Leavers ◽  
Transition Into Adulthood ◽  
Skills Group ◽  
Qualitative Exploration

It is acknowledged that care leavers experience an accelerated transition into adulthood, despite often having complex psychosocial needs with limited support networks. The ‘Skills for Living’ programme was designed to improve the psychological wellbeing of care leavers and offers an adapted Dialectical Behaviour Therapy skills group as its primary intervention. This paper provides a qualitative evaluation of the programme. Semi-structured interviews were undertaken with 10 participants, and the data were analysed using thematic analysis ( Braun & Clarke, 2006 ). Four key themes emerged: ‘Initial Apprehension and Reluctance to Participate’, ‘Connection, Understanding and Validation’, ‘Confidence with Social Skills’, and ‘Emotional Acceptance and Self-Soothing’. Clinical implications and recommendations are discussed.

“Something feels different..” delivering skills from dialectical behaviour therapy in a recovery college

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Toni King ◽  
Joanna Dawson ◽  
Francess SmilleyAnderson ◽  
Richard Taylor
Keyword(s):  
Design Methodology ◽  
Mechanisms Of Action ◽  
Behaviour Therapy ◽  
Effect Change ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Novel Approach ◽  
Similar Content

Purpose This paper aims to explore why a course with similar content feels different when delivered in a Recovery College as compared to an NHS therapy. Design/methodology/approach It is offered as a case study based on reflections from several perspectives. Findings This novel approach emphasises predictable factors such as the educational and recovery focussed environment. It also contributes further to thinking around how relationships are differently navigated and developed in Recovery Colleges compared to NHS settings. Originality/value The reflections are offered to act as a stimulus to promote wider conversations about how Recovery Colleges effect change, with an emphasis on comparing how relationships and power are influenced for those involved. This paper considers this in relation to the Mechanisms of Action identified in Toney et al., 2018 paper.

scholarly journals Preventing mental health symptoms in adolescents using dialectical behaviour therapy skills group: a feasibility study

2017 ◽  
Vol 23 (1) ◽  
pp. 70-85 ◽  
Author(s):  
Rowan Burckhardt ◽  
Vijaya Manicavasagar ◽  
Frances Shaw ◽  
Andrea Fogarty ◽  
Philip J. Batterham ◽  
...  
Keyword(s):  
Mental Health ◽  
Feasibility Study ◽  
Behaviour Therapy ◽  
Mental Health Symptoms ◽  
Health Symptoms ◽  
Dialectical Behaviour Therapy ◽  
Skills Group ◽  
Group A
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