Dialectical Behavior Therapy for BPD and more

DBT is a comprehensive behavioral treatment with cognitive-behavioral, humanistic, and mindfulness components and centers around dialectics - that two seemingly opposite ideas can exist at the same time and be true. Fully adherent treatment involves individual therapy, skills group training, phone coaching, and therapist consultation.

• Individual therapy is designed to increase motivation and work on client “life worth living” treatment goals.

• Group skills training is where individuals learn new skills for the week and are assigned homework to practice those skills. Group skills training is didactic, highly structured, and feels like you are taking a class. Group members learn skills in four main modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

  • mindfulness - increase awareness of your thoughts, emotions, and behaviors and do so without judging yourself or others

  • distress tolerance - manage your own crises and deal with intense pain and emotions to overall increase your resiliency

  • emotion regulation - learn about, manage, and change unwanted emotions

  • interpersonal effectiveness - manage and work through conflict, learn to say no, and invest in or reassess your interpersonal relationships

• Phone coaching is when the client is able to access the DBT therapist outside of therapy hours to help generalize the skills learned in therapy.

• Therapist consultation is to provide support for the therapists to make sure they are providing effective and adherent DBT treatment.

While fully adherent DBT yields the most effective results in reducing symptoms of BPD, research supports that an individual can still greatly benefit from exposure to the group skills component of DBT as a standalone option (Blackford and Love, 2011; Flynn et al., 2019; Heerebrand et al., 2021; Valentine et al., 2015; Van Dijk, Jeffrey, & Katz, 2013). Even more, research supports DBT skills being delivered virtually (Wilks et al., 2018).

DBT-informed art therapy (Clark, 2016; 2021) has been used in a variety of settings including hospitals and residential settings and with a variety of populations such as individuals struggling with substance abuse and eating disorders.

Coastal Art Therapy Services offers DBT skills group led by Lisa C. Thomas, LPC, ATR-BC, who has completed DBT Foundational via Psychwire. These skills groups also offer art-based interventions to enhance the skills learning process. Contact us to learn more!

References:

Blackford, J. U., & Love, R. (2011). Dialectical behavior therapy group skills training in a community mental health setting: a pilot study. International journal of group psychotherapy, 61(4), 645–657. https://doi.org/10.1521/ijgp.2011.61.4.645

Clark, S. M. (2016). DBT-informed art therapy. Jessica Kingsley Publishers.

Clark, S. M. (2021). DBT-informed art therapy in practice: Skillful means in action. Jessica Kingsley Publishers.

Flynn, D., Joyce, M., Spillane, A., Wrigley, C., Corcoran, P., Hayes, A., Flynn, M., Wyse, D., Corkery, B., & Mooney, B. (2019). Does an adapted Dialectical Behaviour Therapy skills training programme result in positive outcomes for participants with a dual diagnosis? A mixed methods study. Addiction science & clinical practice, 14(1), 28. https://doi.org/10.1186/s13722-019-0156-2

Heerebrand, S. L., Bray, J., Ulbrich, C., Roberts, R. M., & Edwards, S. (2021). Effectiveness of dialectical behavior therapy skills training group for adults with borderline personality disorder. Journal of clinical psychology, 77(7), 1573–1590. https://doi.org/10.1002/jclp.23134

Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.

Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.

Valentine, S. E., Bankoff, S. M., Poulin, R. M., Reidler, E. B., & Pantalone, D. W. (2015). The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. Journal of clinical psychology, 71(1), 1–20. https://doi.org/10.1002/jclp.22114

Van Dijk, S., Jeffrey, J., & Katz, M. R. (2013). A randomized, controlled, pilot study of dialectical behavior therapy skills in a psychoeducational group for individuals with bipolar disorder. Journal of affective disorders, 145(3), 386–393. https://doi.org/10.1016/j.jad.2012.05.054

Wilks, C. R., Lungu, A., Ang, S. Y., Matsumiya, B., Yin, Q., & Linehan, M. M. (2018). A randomized controlled trial of an Internet delivered dialectical behavior therapy skills training for suicidal and heavy episodic drinkers. Journal of affective disorders, 232, 219–228. https://doi.org/10.1016/j.jad.2018.02.053