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Essay on Dialectical Behavioural Therapy (DBT)
Essay on Dialectical Behavioural Therapy (DBT)
Therapy for borderline personality disorder and case studies
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Description of Dialectical Behavior Therapy Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Marsha M. Linehan for the treatment of complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat individuals diagnosed with borderline personality disorder (BPD; Carson-Wong, Rizvi, & Steffel, 2013; Scheel, 2000). However, DBT has evolved into a treatment for multi-disordered individuals with BPD. In addition, DBT has been adapted for the treatment of other behavioral disorders involving emotional dysregulation, for example, substance abuse, binge eating, and for settings, such as inpatient and partial hospitalization. Dimeff and Linehan (2001) described five functions involved in comprehensive DBT treatment. The first function DBT serves is enhancing behavioral capabilities. Secondly, it improves motivation to change by modifying inhibitions and reinforcement. Third, it assures that new capabilities can be generalize to the natural environment. Fourth, DBT structures the treatment environment in the ways essential to support client and therapist capabilities. Finally, DBT enhances therapist capabilities and motivation to treat clients effectively. In standard DBT, these functions are divided into modes for treatment (Dimeff & Linehan, Dialectical behavior therapy in a nutshell, 2001). Historical Development/Current use of groups Linehan addressed the need for effective and empirically supported psychotherapeutic treatment for borderline personality disorder. She discovered important shortcomings in standard cognitive and behavioral (CBT) treatments (Chapman & Robins, 2004). DBT was developed to address difficulties faced when implementing standard CBT to chron... ... middle of paper ... ...raft, et al. (1999) In a fourth study, Argas, Linehan, and Telch (2001) adapted DBT skills for the treatment of binge eating disorders. The researchers proposed that the essential problem in binge eating is underdeveloped and insufficient emotional regulation system. The researchers found that the individuals receiving treatment had significantly lower scores than the individuals that were assigned to the wait-list control group. In addition, 89% of the participants stopped binge eating by the end of the treatment. However, six months later, the number of participants that remained abstinence dropped to 56%. One limitation in this study was the sample size. There was a high rate of attrition in both the treatment group and the wait-list group. The study begun with forty-four participates, but at the end of the study only ten participants completed the study.
People with Borderline Personality Disorder tend to view the world as simple as possible. People who view the world like this, confuse the actions of others. (Hoermann et al, 2005) Recurrent thoughts about their relationships with others, lead them to experience extreme emotional reactions, great agony which they have a hard time controlling, which would result in engaging in self-destructive behaviors. Diagnosing a patient with this disorder can be challenging which is why is it is labeled as one of the difficult ones to diagnose. (Hoermann et al, 2005)
Recurrent episodes of binge eating is classified by eating large amounts of food in a discrete amount of time and a lack of control in over-consuming during an episode (Pomerantz, 2014). One then uses recurrent inappropriate purging behavior to prevent weight gain. DSM-5 has updated this occurrence to only once a week for three months. Those with the disorder cause self-evaluation to be strongly influenced by body shape and weight. These disturbances do not occur during episodes of anorexia nervosa, which is self starvation to limit calories and weight (American Psychiatric Association,
DBT is effective when working with clients experiencing anxiety disorder and depression. Individuals in DBT therapy are taught to notice, rather than react to thoughts and behaviors. DBT teaches clients to accept their emotional reactions and learn to tolerate distress while being mindful of their present experiences. DBT has four stages for therapy. In stage one the pre-commitment stage is where the therapist explains what types of treatment the client will receive. In this stage the client must agree to stop all self harm behavior and work toward developing other coping skills. In stage two the goal is to assist the client into controlling her emotions. Stage three and four involve assisting the client to gain the ability to develop self respect (Waltz, 2003).
Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. American Journal Of Psychiatry, 160(7), 1223--1232.
This article aims to prove that Acceptance and Commitment is the best method for treating eating disorders. Although Cognitive Behavior Therapy has shown some promising results. It supports this claim by stating that Cognitive Therapy is an effective treatment for bulimia and was given a grade A by the National Institute for Clinical Effectiveness Guidelines. The authors are aiming to determine which is an effective method, Acceptance and Commitment Therapy (ACT) or Cognitive Behavior Treatment (CBT). Although, it is a new theory it has proven very effective. Scientific studies of CBT have confirmed its effectiveness for a wide variety of mental illnesses including mood disorders, anxiety disorders, personality disorders, eating disorders, substance abuse disorders, sleep disorders and psychotic disorders. Studies have shown that CBT actually changes brain activity in people with mental illnesses who receive this treatment, suggestin...
Psychotherapy integration is best explained as an attempt to look beyond and across the dimensions of a single therapy approach, to examine what one can learn from other perspectives, and how one’s client’s can benefit from various ways of administering therapy (Corey, 2013). Research has shown that a variety of treatments are equally effective when administered by therapist who believe in them and client’s that accept them (Corey, 2013). Therefore, one of the best aspects of utilizing an integrative approach is that, in most cases, if a therapist understands how and when to incorporate therapeutic interventions, they usually can’t go wrong. While integrating different approaches can be beneficial for the client, it is also important for the
Borderline Personality Disorder (BPD) has been a disability surrounded by stigma and confusion for a long time, and the time to bring awareness and public understanding to this disability is long overdue. The disability itself often gets misdiagnosed as an other disability since the symptoms overlap with many other disabilities (NIMH, n.d, para 16), or worse case scenario, a medical professional refuses to diagnose or treat the disability due to the belief that these people are untreatable because of a negative schema about the disability and clinical controversies on whether BPD is a legitimate diagnosis (Hoffman, 2007) . However, after nearly three decades of research, it has come to light that BPD does indeed exist, does have a good prognosis for remission with treatment (BPD Overview, n.d, para 3), and that there are many treatment options available such as three different types of psychotherapy (Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and Schema-focused therapy), omega-3 fatty acid supplements, and/or medications (NIMH, n.d, para 29, 30, 31, and 39, 41). Even though the disability started as a psychoanalytic colloquialism for untreatable neurotics (Gunderson, 2009), BPD is very treatable and doesn’t deserve the stigma it currently carries throughout society.
In most cases Borderline Personality Disorder develops with comorbidity. Often times people cope or self medicate with alcohol, drugs, and food. Eating Disorders, Alcoholism, and other similar mental health issues develop in coax with BPD alo...
In this paper, I will present my analysis of two methods used to treat bulimia nervosa. The first method is cognitive-behavioral therapy for bulimia nervosa; this method is quite popular among psychologist...
Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy, specifically developed for borderline personality disorder (BPD), in which the clinician attempts to motivate the client towards change in behavior while simultaneously validating existing thoughts and feelings. (DeVylder) The goal of dialectical behavior therapy is to minimize maladaptive behaviors related to impulse control and emotion regulation, especially those that may result in self-injury or death. (DeVylder) The desired outcome of DBT is a resolution of maladaptive behaviors related to impulse control and emotion regulation, especially those behaviors that may result in self-injury or death. (DeVylder)
Eldredge, K.L., et al. "The Effects of Extending Cognitive-Behavioral Therapy for Binge Eating Disorder Among Initial
DBT was originally developed to focus on individuals suffering from Borderline Personality Disorder (BPD). As described by the National Institute of Mental Health, the criteria an individual must meet to be diagnosed with BPD are some of the following: extreme emotional reactions, a pattern of intense and stormy relationships with family, distorted and unstable self-image or sense of self, impulsive and dangerous behaviours, recurring suicidal/self-harming behaviours, intense and highly changeable moods, chronic feelings of emptiness/boredom, inappropriate and intense anger, and having stress-related paranoid thoughts or severe dissociative symptoms (n.d.). To meet the needs of these complex symptoms, a four module skills training group was developed to known as “DBT skills”, 1) mindfulness, 2) interpersonal effectiveness, 3) emotion regulation, and 4) distress tolerance (Feigenbaum, 2008). The model of DBT assumes that individuals with BPD lack in the areas of interpersonal, self-regulation, and distress tolerance skills, and recognize that an individual’s personal and environment factors are influenti...
Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Marsha M. Linehan for the treatment of complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat individuals diagnosed with borderline personality disorder (BPD; Carson-Wong, Rizvi, & Steffel, 2013; Scheel, 2000). However, DBT has evolved into a treatment for multi-disordered individuals with BPD. In addition, DBT has been adapted for the treatment of other behavioral disorders involving emotional dysregulation, for example, substance abuse, binge eating, and for settings, such as inpatient and partial hospitalization. Dimeff and Linehan (2001) described five functions involved in comprehensive DBT treatment. The first function DBT serves is enhancing behavioral capabilities. Secondly, it improves motivation to change by modifying inhibitions and reinforcement. Third, it assures that new capabilities can be generalize to the natural environment. Fourth, DBT structures the treatment environment in the ways essential to support client and therapist capabilities. Finally, DBT enhances therapist capabilities and motivation to treat clients effectively. In standard DBT, these functions are divided into modes for treatment (Dimeff & Linehan, Dialectical behavior therapy in a nutshell, 2001).
Cognitive behavioral therapy (CBT) is a form of treatment that focuses on examining the relationships between thoughts, feelings and behaviors (NAMI, 2012). It is designed to modify the individual’s normative dysfunctional thoughts. The basic cognitive technique consists of delineating the individual's specific misconceptions, distortions, and maladaptive assumptions, and of testing their validity and reasonableness (Beck, 1970). By exploring thought patterns that lead to maladaptive behaviors and actions and the beliefs that direct these thoughts, people with mental illness can alter their thought process to improve coping. CBT is different from oth...
The cognitive processes that serve as the focus of treatment in CBT include perceptions, self-statements, attributions, expectations, beliefs, and images (Kazdin, 1994). Most cognitive-behavioral based techniques are applied in the context of psychotherapy sessions in which the clients are seen individually, or in a group, by professional therapists. Intervention programs are designed to help clients become aware of their maladaptive cognitive processes and teach them how to notice, catch, monitor, and interrupt the cognitive-affective-behavioral chains to produce more adaptive coping responses (Mah...