Dialectical Behaviour Therapy for Pre-adolescent Children

2017 ◽  
pp. 690-718
Author(s):  
Francheska Perepletchikova
Keyword(s):  
Theoretical Model ◽  
Dialectical Behavior Therapy ◽  
Skills Training ◽  
Paediatric Population ◽  
Individual Therapy ◽  
Parental Role ◽  
Behaviour Therapy ◽  
Treatment Target ◽  
Cognitive Levels ◽  
Almost All

Dialectical Behavior Therapy for pre-adolescent children (DBT-C) targets severe emotional and behavioural dysregulation in the paediatric population by teaching adaptive coping skills and helping parents create a validating and a change-ready environment. It retains the theoretical model, principles, and therapeutic strategies of standard DBT, and incorporates almost all of the adult DBT skills and didactics into the curriculum. However, the presentation and packaging of the information are considerably different to accommodate for the developmental and cognitive levels of pre-adolescent children. Additionally, the treatment target hierarchy has been greatly expanded to incorporate emphasis on the parental role in attaining child’s treatment goals. This chapter discusses the theoretical model, presents the treatment target hierarchy, provides an overview of the adaptations made to skills training and individual therapy, discusses the addition of the parent training component, and finally, briefly presents an empirical evidence for the model.

Dialectical Behavior Therapy and Treatment of Emotion Dysregulation

2019 ◽  
pp. 462-476
Author(s):  
Alexander L. Chapman ◽  
Nora H. Hope
Keyword(s):  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Emotion Dysregulation ◽  
Behavioral Treatment ◽  
Distress Tolerance ◽  
Therapy Group ◽  
Skills Training ◽  
Individual Therapy ◽  
Cognitive Behavioral Treatment ◽  
Multimethod Research

Developed to treat highly suicidal patients and often associated with the treatment of borderline personality disorder (BPD), dialectical behavior therapy (DBT) has evolved into a transdiagnostic treatment addressing emotion dysregulation. DBT is an emotion-focused, comprehensive cognitive-behavioral treatment including individual therapy, group skills training, between-session skills coaching (phone coaching), and a therapist consultation team. Several elements of DBT address emotion dysregulation directly or indirectly, including emotion regulation skills, distress tolerance strategies to dampen physiological arousal and curb impulses to engage in problematic behaviors, and individual therapy interventions to reduce emotion dysregulation. Growing evidence suggests that DBT may address behavioral, cognitive, physiological, and neurobiological aspects of emotion dysregulation. Future directions should include increasing multimethod research on the effects of DBT on emotion dysregulation, streamlining treatment, making DBT more efficient and targeted, and conceptualizing DBT’s place within the spectrum of other emotion-focused transdiagnostic treatments.

A randomised trial of dialectical behaviour therapy and the conversational model for the treatment of borderline personality disorder with recent suicidal and/or non-suicidal self-injury: An effectiveness study in an Australian public mental health service

2020 ◽  
Vol 54 (10) ◽  
pp. 1020-1034
Author(s):  
Carla J Walton ◽  
Nick Bendit ◽  
Amanda L Baker ◽  
Gregory L Carter ◽  
Terry J Lewin
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Randomised Trial ◽  
Skills Training ◽  
Borderline Personality ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Psychotherapeutic Treatment ◽  
Dialectical Behaviour Therapy ◽  
Self Injury

Objectives: Borderline personality disorder is a complex mental disorder that is associated with a high degree of suffering for the individual. Dialectical behaviour therapy has been studied in the largest number of controlled trials for treatment of individuals with borderline personality disorder. The conversational model is a psychodynamic treatment also developed specifically for treatment of borderline personality disorder. We report on the outcomes of a randomised trial comparing dialectical behaviour therapy and conversational model for treatment of borderline personality disorder in a routine clinical setting. Method: Participants had a diagnosis of borderline personality disorder and a minimum of three suicidal and/or non-suicidal self-injurious episodes in the previous 12 months. Consenting individuals were randomised to either dialectical behaviour therapy or conversational model and contracted for 14 months of treatment ( n = 162 commenced therapy). Dialectical behaviour therapy involved participants attending weekly individual therapy, weekly group skills training and having access to after-hours phone coaching. Conversational model involved twice weekly individual therapy. Assessments occurred at baseline, mid-treatment (7 months) and post-treatment (14 months). Assessments were conducted by a research assistant blind to treatment condition. Primary outcomes were change in suicidal and non-suicidal self-injurious episodes and severity of depression. We hypothesised that dialectical behaviour therapy would be more effective in reducing suicidal and non-suicidal self-injurious behaviour and that conversational model would be more effective in reducing depression. Results: Both treatments showed significant improvement over time across the 14 months duration of therapy in suicidal and non-suicidal self-injury and depression scores. There were no significant differences between treatment models in reduction of suicidal and non-suicidal self-injury. However, dialectical behaviour therapy was associated with significantly greater reductions in depression scores compared to conversational model. Conclusion: This research adds to the accumulating body of knowledge of psychotherapeutic treatment of borderline personality disorder and supports the use of both dialectical behaviour therapy and conversational model as effective treatments in routine clinical settings, with some additional benefits for dialectical behaviour therapy for persons with co-morbid depression.

scholarly journals Dialectical behavior therapy skills training: Paving the way to healthy relationships

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Ricardo Lucena
Keyword(s):  
Interpersonal Relationships ◽  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Health Care Professionals ◽  
Behavioral Treatment ◽  
Skills Training ◽  
Individual Therapy ◽  
Central Component ◽  
Cognitive Behavioral Treatment ◽  
Healthy Relationships

Dialectical behavior therapy (DBT) is a comprehensive multiple mode cognitive-behavioral treatment. It includes weekly individual therapy, weekly group skills training, and as-needed phone coaching along with therapist consultation team meetings. DBT skills training is a central component of DBT effectiveness. Skills training programs have been reported to be effective in different populations, such as health care professionals, caregivers of the elderly, and college students. Skills training has also been effective to treat individuals with a range of mental disorders. The overall objective of the workshop is to describe a set of behavioral, cognitive and dialectical skills which can facilitate the development and maintenance of healthy relationships. Participants will be able to apply the principles of dialects, validation and behavioral analysis to their thoughts and actions; be able to develop effective communication; and find a kernel of truth in other people’s views. The skills presented are important for individuals with or without a diagnosis of mental disorder, and they can be helpful in any relationship. There are three skill sets: dialectics, validation, and behavior change strategies. Taken together, the skills focus on balancing our own priorities with the demands of others in interpersonal relationships. During the ninety-minute interactive workshop, skills will be presented alongside individual and small group exercises given by one presenter. The language of the workshop will be English, however questions can be asked in French, Spanish or Portuguese and will be answered in English.

Dialectical Behavior Therapy of Borderline and Other Personality Disorders

2012 ◽  
pp. 784-794
Author(s):  
Thomas R. Lynch ◽  
Prudence F. Cuper
Keyword(s):  
Behavior Therapy ◽  
Dialectical Behavior Therapy ◽  
Behavioral Science ◽  
Behavioral Therapy ◽  
Therapy Group ◽  
Skills Training ◽  
Individual Therapy ◽  
Dialectical Philosophy ◽  
Consultation Team ◽  
Telephone Coaching

Dialectical behavior therapy (DBT) is a form of cognitive-behavioral therapy that draws on principles from Zen practice, dialectical philosophy, and behavioral science, and it is based on a biosocial model of borderline personality disorder. The treatment has four components—individual therapy, group skills training, telephone coaching, and therapist consultation team—and it progresses through four stages, depending on the client’s level of disorder. In the current chapter, we expand on the theory behind the treatment and the treatment structure, as well as present evidence for the efficacy of DBT from several randomized controlled trials. We also discuss implications for the use of DBT for multidiagnostic patients—including a review of a new adaptation of DBT for emotionally constricted and overcontrolled disorders.

Dialectical Behaviour Therapy for Substance Use Disorders

2018 ◽  
pp. 594-614
Author(s):  
Seth R. Axelrod
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Dialectical Behavior Therapy ◽  
Management Strategies ◽  
Borderline Personality ◽  
High Risk Population ◽  
Behaviour Therapy ◽  
Treatment Target ◽  
Group Members ◽  
Treatment Structure

This chapter discusses Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD), which expands standard comprehensive DBT to treat individuals with co-occurring Borderline Personality Disorder (BPD) and SUDs—a particularly high-risk population. It explores the compassionate formulation of addictive behaviour that underlies the treatment model, and describes the DBT-SUD treatment structure, e.g., addictions-focused skills and guidelines for targeting substance use within the DBT treatment target hierarchy. It covers strategic modifications of DBT-SUD as applied to the DBT case management strategies, and specific suggestions for overcoming common addictions treatment obstacles. It reviews the challenges of synthesizing replacement drug medications and drug toxicology screening with DBT, working with individuals who are prescribed potentially addictive medications, and avoiding substance use contagion among group members. It reviews research supporting DBT-SUD and preliminary studies of DBT-SUD with non-BPD populations, and suggests that DBT-SUD modifications can help to better target substance use within general DBT practice settings.

scholarly journals Reviewing the availability, efficacy and clinical utility of Telepsychology in dialectical behavior therapy (Tele-DBT)

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Hanneke van Leeuwen ◽  
Roland Sinnaeve ◽  
Ursula Witteveen ◽  
Tom Van Daele ◽  
Lindsey Ossewaarde ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Dialectical Behavior Therapy ◽  
Clinical Utility ◽  
Skills Training ◽  
Individual Therapy ◽  
Face To Face ◽  
Empirically Supported ◽  
Search Terms ◽  
Consultation Team ◽  
Search And Selection

Abstract Background Telepsychology is increasingly being implemented in mental health care. We conducted a scoping review on the best available research evidence regarding availability, efficacy and clinical utility of telepsychology in DBT. The review was performed using PRISMA-ScR guidelines. Our aim was to help DBT-therapists make empirically supported decisions about the use of telepsychology during and after the current pandemic and to anticipate the changing digital needs of patients and clinicians. Methods A search was conducted in PubMed, Embase, PsycARTICLES and Web of Science. Search terms for telepsychology were included and combined with search terms that relate to DBT. Results Our search and selection procedures resulted in 41 articles containing information on phone consultation, smartphone applications, internet delivered skills training, videoconferencing, virtual reality and computer- or video-assisted interventions in DBT. Conclusions The majority of research about telepsychology in DBT has focused on the treatment mode of between-session contact. However, more trials using sophisticated empirical methodologies are needed. Quantitative data on the efficacy and utility of online and blended alternatives to standard (i.e. face-to-face) individual therapy, skills training and therapist consultation team were scarce. The studies that we found were designed to evaluate feasibility and usability. A permanent shift to videoconferencing or online training is therefore not warranted as long as face-to-face is an option. In all, there is an urgent need to compare standard DBT to online or blended DBT. Smartphone apps and virtual reality (VR) are experienced as an acceptable facilitator in access and implantation of DBT skills. In addition, we have to move forward on telepsychology applications by consulting our patients, younger peers and experts in adjacent fields if we want DBT to remain effective and relevant in the digital age.

Conceptual and Practical Issues in the Application of Emotion Regulation in Dialectical Behaviour Therapy

2017 ◽  
pp. 282-306
Author(s):  
Christine Dunkley
Keyword(s):  
Emotion Regulation ◽  
Muscle Tone ◽  
Training Group ◽  
Skills Training ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Case Examples ◽  
Specific Emotion ◽  
Skills Training Group ◽  
The Individual

While emotion regulation skills are taught in skills training group, the individual therapy modality is an opportunity for therapists to further strengthen these skills. This chapter describes a variety of reasons why therapists might not take up this opportunity. It summarizes the differential features, or “signature” of each emotion, in the domains of temperature, facial expression, body posture, breathing, muscle-tone, voice tone, and actions within the environment. It then describes the coaching of a discernment skill; i.e., how to “check the facts” to see not only whether the emotion is justified, but if so, also if it is being experienced with more (or less) intensity than the situation warrants. Finally, case examples are given to show the down-regulation of a specific emotion. The end of the chapter provides a summary of key points for the clinician to remember in strengthening emotion regulation skills.

Dialectical Behaviour Therapy Skills Training Groups for Common Mental Health Disorders: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Chantal P Delaquis ◽  
Kayla M. Joyce ◽  
Maureen Zalewski ◽  
Laurence Katz ◽  
Julia Sulymka ◽  
...  
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Meta Analysis ◽  
Skills Training ◽  
Mental Health Disorders ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Transdiagnostic Treatment ◽  
Training Groups ◽  
Health Disorders

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.

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