Atlanta DBT Center
building a life worth living
2150 Peachford Road Suite A
Atlanta, GA 30338
ph: 770-833-0227
fax: 770-452-0046
minalsha
About the Program
Basically, DBT maintains that some people, due to invalidating environments during upbringing and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up much more quickly, peaks at a higher level, and takes more time to return to baseline. This explains why people with BPD are known for crisis-strewn lives and extreme emotional lability (emotions that shift rapidly). Because of their past invalidation, they don't have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this process.
How dbt works
Dialectical Behavioral Therapy (DBT) consists of two parts:
1. Once-weekly psychotherapy sessions in which a particular problematic behavior or event from the past week is explored in detail, beginning with the chain of events leading up to it, going through alternative solutions that might have been used, and examining what kept the client from using more adaptive solutions to the problem. Both between and during sessions, the therapist actively teaches and reinforces adaptive behaviors, especially as they occur within the therapeutic relationship. The emphasis is on teaching patients how to manage emotional trauma rather than reducing or taking them out of crises. Telephone contact with the individual therapist between sessions is part of DBT procedures (Linehan, 1991). DBT targets behaviors in a descending hierarchy:
- decreasing high-risk suicidal behaviors
- decreasing responses or behaviors (by either therapist or patient) that interfere with therapy
- decreasing behaviors that interfere with/reduce quality of life
- decreasing and dealing with post-traumatic stress responses
- enhancing respect for self
- acquisition of the behavioral skills taught in group
- additional goals set by patient
2. Weekly 2.5-hour group therapy sessions in which interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills are taught. Group therapists are not available over the phone between sessions; they refer patients in crisis to the individual therapist.
DBT Treatment targets
Pre-treatment Targets:
- Orientation
- Agreement on goals
Stage 1 Targets:
- Reduction or elimination of life-threatening behaviors
- Reduction or elimination of therapy-interfering behaviors
- Reduction or elimination of hospitalization as a way of handling crisis
- Reduction or elimination of behaviors which interfere with quality of life
- Increase in behaviors which improve quality of life and make it worth living
- Increase in behavioral skills which help build relationships, manage emotions, and increase tolerance of various life problems
Stage 2 Targets:
- Reduction of Post-Traumatic Stress Disorder symptoms
Stage 3 Targets:
- Increased self-respect
- Increased ability to set individual goals
- Increased ability to solve ordinary life problems
Stage 4 Targets:
- Development of the capacity for freedom and joy
Getting The real Thing
A program or person who says they do DBT but only offers skills groups is not doing the comprehensive type of DBT that is effective.
The following questions should be asked to know if a therapist does true DBT:
- Have you completed a 10-day intensive DBT training ?
- Are you a member of a DBT consultation team ?
- Have you been supervised by an expert DBT therapist?
- Are you familiar with the main sets of DBT strategies (cognitive behavioral therapy, validation, dialectics)?
- Do you teach skills, practice behavior analysis, review diary cards?
- Do you do phone coaching?
The answer to these questions should always be "yes." You have a right to check the therapist’s credentials; to know if the therapist is licensed in his/her state; to know the extent and nature of the therapist’s education and training; the extent of the therapist’s experience in treating clients with similar problems; the therapist’s arrangements for coverage or emergency contacts.
WHY IS IT IMPORTANT TO SEE A TRAINED DBT THERAPIST?
DBT may be the most hopeful and helpful of any new therapy available for people with BPD. Many people with BPD have problems trusting others, have “failed in treatment” or have been dropped by former therapists. When DBT is not done as designed, the results may not be the same, causing the person with BPD to lose hope and trust and then be reluctant to ever try DBT again. If DBT is not practiced according to the research model that produces effective change but is practiced “my way” by a therapist without adequate training, it probably won’t produce the same kind of results as the research programs. Outcomes from this kind of DBT will not justify additional DBT training or new DBT programs in the community. Currently. Dr. Linehan is working on a way to certify therapists who practice DBT so that people can determine if a therapist is truly qualified to practice DBT.
Taken from tara4bpd.org website
For pamphlet, call 1-888-4-TARA APD 1-888-4-TARA APD
Copyright 2010 Atlanta DBT Center. All rights reserved.
2150 Peachford Road Suite A
Atlanta, GA 30338
ph: 770-833-0227
fax: 770-452-0046
minalsha
