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.

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.

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.

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.

Adapted dialectical behaviour therapy skills group service evaluation

2021 ◽  
Vol 15 (1) ◽  
pp. 1-7
Author(s):  
Robert John Searle ◽  
Ianiv Borseti
Keyword(s):  
Intellectual Disability ◽  
Psychological Intervention ◽  
Training Group ◽  
Skills Training ◽  
Well Being ◽  
Service Evaluation ◽  
Behaviour Therapy ◽  
Dialectical Behaviour Therapy ◽  
Content Type ◽  
Friedman Analysis

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.

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.

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