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DBT

By Sheri Van Dijk, MSW

Clients come to therapy because they require objective feedback that others are unable to give them (or that they are unable to accept from others). The very nature of our work is confronting maladaptive behaviors, but we need to do so in ways that are acceptable to the client, even when the feedback we must provide is painful.

It’s not exactly news that mindfulness-based therapies are effective. A recent meta-analysis including 209 published empirical outcome studies indicated that mindfulness-based treatments in general were effective in treating a variety of psychological disorders, and as effective as cognitive behavior therapy and pharmacological treatments in the nine studies in which they were compared (Khoury et al., 2013).

When it comes to treatment for psychosis, CBT and acceptance- and mindfulness-based approaches have, at times, been assumed to be incongruent with respect to the goals of “control” and “change.” However, in their integration these approaches can complement one another by emphasizing the understanding, exploration, observation, and acceptance of thoughts and feelings rather than the “stopping” and “controlling” of unwanted thoughts and feelings.

Editor’s note: The following is a Q&A with Pat Harvey, ACSW, LCSW-C, and Britt H. Rathbone, ACSW, LCSW-C, authors of Dialectical Behavior Therapy for At-Risk Adolescents: A Practitioner’s Guide to Treating Challenging Behavior Problems.

Why are DBT methods so well-suited for teens’ emotions and psychological development?

Editor's note: The following was adapted from the edited volume, Mindfulness and Acceptance in Social Work, edited by Matthew S. Boone. Boone will be presenting a two-day Introduction to ACT Training in Oakland, California on August 1 - 2, 2015. Don't miss your chance to learn the fundamentals of ACT with an award-winning trainer and exceptional clinician.

Dialectical Behavior Therapy (DBT), developed by Marsha Linehan to teach clients emotional regulation and coping skills, was first used with adult patients who responded to emotional pain with self-harming mechanisms, like cutting, engaging in intentionally dangerous behaviors, or attempting suicide. Today we’re taking a look at how DBT helps teens and adolescents develop healthier coping skills and responses to emotional duress and discover new ways to work through their pain.

The support and understanding of parents if often vital to successful Dialectical Behavioral Therapy (DBT) treatment for adolescents; however, parents (or parental figures) may feel a range of negative emotions surrounding the child and the therapeutic intervention, like shame, guilt, anger, or helplessness. Working with parents to create an open, compassionate environment where their feelings are validated helps ensure that everyone is focused on the recovery of the adolescent—and, by extension, the entire family.

One of the best things about Friday is digging into the New Harbinger archives to unearth backlist gems so we can give them away to our readers. Today we're offering up Acceptance and Mindfulness Treatments for Children and Adolescents: A Practitioner's Guide.

Using mindfulness to treat the suffering that comes with the symptoms of borderline personality disorder is a difficult task because it requires you to attend to what’s going on in your mind. The explicit application of mindfulness used in dialectical behavior therapy provided a way for people with BPD to get unstuck from their judgments and the intense emotions that lead to suffering.

In psychotherapy, particularly in mindfulness and acceptance camps, psychological flexibility is the primary goal of intervention. As we’ve seen in acceptance and commitment therapy (ACT) interventions, the core processes such as mindfulness, self-as-context, and defusion are used as tools to achieve the overall goal of increasing one’s “ability to contact the present moment more fully as a conscious human being, and to change or persist on behavior when doing so serves valued ends” (Hayes & Strosahl, 1999).

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