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Dialectical Behavior Therapy: Empirical Study

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Dialectical behavior therapy is a comprehensive treatment combining “individual psychotherapy, group skills training, telephone coaching, and a therapist consultation team” (Lineham & Wilks, 2015) which was originally developed by Dr. Marsha Linehan for clients who were highly suicidal. Based on empirical studies, this paper will review the effectiveness of dialectical behavior therapy treatment within various disorders; borderline personality disorder and suicidal and self-harming behaviors, posttraumatic stress disorder, eating disorders, as well as a brief study of using dialectical behavior therapy to treat adolescents with substance use disorder. Review of Empirical Studies Borderline Personality Disorder The majority of available research …show more content…

Gutteling et al. (2012) stated that the study results of this study were promising; with outcome measures such as less anxiety and suicidal thoughts than the baseline measurements, it was concluded that group dialectical behavior therapy is effective in lessening borderline symptoms, despite the client lacking a clinical diagnosis of borderline personality disorder. Two studies measuring clinical outcomes and functioning over one and two years (McMain et al., 2009; McMain, Guimond, Streiner, Cardish & Links, 2012) compared efficacy of dialectical behavior therapy and general psychiatric management for clients with borderline personality disorder, in which clients were found to benefit from therapy, reporting reduced frequency in suicidal episodes and improvement in general psychiatric symptoms. However, participants who received individualized psychiatric treatment instead of dialectical behavior therapy also showed major …show more content…

While treatment outcomes have been successful, a great majority of the studies focus on a limited population focus, of which most do not include male participants at all. According to the American Psychiatric Association (2013), females make up 75% of the population diagnosed with borderline personality disorder. However, 25% is still a significant number of males that could benefit from the same empirical studies of dialectical behavior therapy for treatment of borderline personality disorder. Likewise, researching the treatment across different cultures of clients with borderline personality disorder could also be

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Phase One (Sessions 1 through 3) • The session 1 and 2 consists of the assessment of the client’s clinical problems and background information. Questions relate to her clinical problems, including (a) the nature of her problems (depression and difficulty with making decisions), (b) reason of seeking psychotherapy, and (c) previous attempts to deal with the problems. For the background information, the client’s histories are assessed in the areas of intimate/family relationship, educational/vocational activities, past history of psychological treatment, and physical condition. Session 3 primarily consists on the further functional assessment around her coping skills (e.g., avoidance) in the areas of interpersonal relationships. Phase Two

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A depressed elderly female patient was admitted to the Senior Care Unit of Memorial to treat her diagnoses. Using Dialectical Behavior Therapy the client was able to learn that she was afraid to express her needs to her family due to fear of disappointing them. Using the Generalized Contentment Scale consist of ten items the tool was able to measure the effect DBT had on the patient’s depression. The small sample size small proportion frequency did not note any significant changes between the phases (p=0.11). However the D-Index noted a 4% increase in the desired direction.

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Marsha Linehan started off life with major difficulties in functioning, moved passed and learned to cope these difficulties, and created a successful and widely-used therapeutic approach that can help people who suffer from chronic disorders. She struggled most of her early adult life, but was able to work past her issues after she had a realization in her chapel one night. After a sudden realization, she was able to learn how to cope with her thoughts and feelings. Linehan, after working hard to complete her education following her institutionalization, apply everything she had realized to create a successful therapeutic approach. Her past experiences helped her shape Dialectical Behavior Therapy (DBT) into a successful therapeutic approach to help people who suffer from Borderline Personality Disorder (BPD), suicidal thoughts and attempts, and other chronic mental disorders.

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In the study done by Drossel, Fisher, & Mercer (2011), a Dialectical Behavior Therapy Skills training manual (DBT Skills) was used for caregivers of patients with dementia, mainly in community clinical settings. This was designed because of the lack of effective therapy options currently in healthcare for elderly abuse. Researchers studied the DBT Skills training manual to examine if its effect would not only help at-risk caregivers to decrease the harm towards elderly patients with dementia, but also improve quality of life for the patients. There were 24 caregivers (19 women and five men) and most were family members. The DBT Skills training entailed one introductory meeting and eight weekly sessions.

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As a psychology and sociology major, I have developed a foundational knowledge of the environmental, social, and psychological conditions that can contribute to mental health issues and dysfunctional behavior. My undergraduate coursework in abnormal psychology, clinical psychology, clinical/counseling psychology research lab, and a graduate course in evidence-based treatment has exposed me to theories of mental illness, the different types of psychological interventions, and proper research practices. In my Clinical/Counseling Psychology Research Lab we were responsible for developing experiments on stress and anxiety in students and what factors moderate the relationship between stress and negative mental health outcomes. In my evidence-based treatment seminar, I worked alongside 2nd-year PhD students to study different types of evidence-based interventions, learn techniques and skills to be implemented in therapy, and consider the current limitations and ways to improve our definitions of empirically-supported treatments and evidence-based practice. In addition to the above course-work, I have been a research assistant for professors in the sociology department and psychology department which has helped develop my critical thinking and data-analysis skills.

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The Dialectical Behavior Therapy for Wellness and Recovery is a great resource for boarding my knowledge in understanding how to implement the techniques in a group setting. The concept of regulating moods can be a complex unique journey for an individual with a mental health disorder. Bein, (2014) identifies an interesting way to view how mood, behavior, and emotions, are regulated within in our unique biological systems. Bein (2014) uses a metaphor to indicate the process of regulation by highlighting the ways a thermostat works, so a working thermostat regulates temperature as needed and keeps the environment comfortable. This would signify the ability to regulate moods, and behaviors effectively.

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The complicated mental health illness known as borderline personality disorder (BPD) causes individuals to battle with their self-perception, mood swings, impulsive control, a severe fear of abandonment, and low emotions of self-worth. Unbeknownst to many, it affects an estimated 1.6% of adult U.S. citizens. It is crucial to be aware of its warning signs and symptoms because the earlier BPD is identified, the quicker it can be treated. Dr. Lois Choi-Kain aids in our comprehension of the fundamentals of BPD and how it manifests in adolescents. Emerging BPD is characterized by behavioral dysregulation, which can cause self-harming behavior, relationship issues, intense emotional responses, and irrational or paranoid beliefs.

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Intervention Summary Provide a general overview of the intervention, including who developed it, the theoretical background of the intervention, what problems/issues it addresses, what client groups it is most appropriate for, and define important concepts and principles, etc. The cognitive behavioral therapy was developed in the early 1960s by Aaron T. Beck, a psychiatrist (Beck, 2017). The cognitive behavioral therapy aim to break behavioral cycles by changing what a person think or what she/he do. The person or/and clinician start by looking at what might be easiest/ quick to change. The principles and concepts of Cognitive Behavioral Therapy is based on an ever-evolving formulation of the patient and their problems in cognitive terms.

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Good, G. E., Dell, D. M., Mintz, L. B. (1989). Male role and gender role conflict: Relations to help seeking in men. Journal of Counseling Psychology, 36 (3), 295– 300. Jacobson, N. S., Christensen, A., Prince, S. E., Cordova, J., & Eldridge, K. (2000). Integrative Behavioral Couple Therapy:

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I used Dialectic Behavior Therapy (DBT) techniques with some of my clients. I was not trained in this therapy but was familiar with the idea of being in the here-and-now. This technique worked for my schizophrenic client by keeping her focused on what was happening each day by writing in a journal and distracting her from what she thought had been happening in her past. I was able to use Art Therapy with the client I had with PTSD, depression, and suicidal thoughts. I had one client on probation who was ordered to be in counseling before she could get off of probation.

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Psychotherapy is as effective as medication in treating depression and is more effective than medication in preventing relapse (DeRubeis, Siegle, & Hollon, 2008). Cognitive-behavioral therapy (CBT) pertains to a class of interventions whose premise is that mental disorders and psychological distress are maintained by cognitive factors. Beck (1970) and Ellis (1962), were the pioneers Cognitive Behavioral Therapy approach of the core premise of holds that maladaptive cognitions contribute to the maintenance of emotional distress and behavioral problems. A review of meta-analytic studies by Hofmann, Asnaani, Vonk, Sawyer, and Fang (2012) examined the efficacy of CBT and it demonstrated that this treatment has been used for a wide range of psychological problems such as cannabis and nicotine dependence, schizophrenia and other psychotic disorders, depression, anxiety disorders, bulimia, insomnia, personality disorders, stress management and more studies being conducted to study its effectiveness. There is a well-established literature regarding effective cognitive behavioral therapy in treating mental health problems, specifically those utilizing face-to-face counseling.

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