Dialectical Behavior Therapy is a comprehensive treatment program for difficult-to-treat clients who have severe, chronic emotion and behavioral dysregulation.  Marsha Linehan originally developed this treatment for chronically suicidal women, and demonstrated its efficacy for reducing suicidal and parasuicidal behaviors as well as days of hospitalization.  In a number of randomized, controlled trials DBT has been shown to benefit a variety of outpatient groups, including those with eating disorders, depression, and substance use disorders; and is being widely implemented with inpatients as well as in community programs.  A study published in the Archives of General Psychiatry showed that DBT was more effective in reducing suicidal behaviors than treatment provided by expert, non-DBT therapists.

 

This workshop will provide an introduction to DBT, showing how treatment principles structure the functions and modes of treatment, outlining the behavioral targets and stages of treatment, and presenting tools and strategies for increasing client and therapist skills as well as motivation for addressing life-threatening and therapy-interfering behaviors.  

 

To increase participation and encourage the practice of therapeutic strategies, a workshop that includes two sessions is offered.  The first, full-day session will introduce DBT biosocial theory, assumptions and treatment strategies, using lecture, video and role play demonstrations. Updates to skills modules from Linehan’s excellent new manual will be presented.  Participants will be asked to complete practice assignments for key strategies in their clinical settings, including validation and behavior chain analysis.  Two weeks later, during the second, full day session, participants’ experiences with their practice will be reviewed and discussed with feedback.  In addition, DBT approaches to treatment of suicidal behaviors will be presented during the second session.  Finally, participants will consolidate their understanding of DBT approaches to crisis consultation and targeting in-session dysfunctional behaviors through practice balancing validation, problem solving, and dialectical strategies.

 

Upon completion of the workshop, participants should be able to:

 

1.    Explain how the behaviors and experiences characteristic of Borderline Personality Disorder result from chronic emotion dysregulation, in transactions with invalidating environments

 

2.    Identify the four treatment modalities that are provided in standard, outpatient DBT

 

3.    Explain how Behavior Analysis can be used to identify effective interventions

 

4.    Identify four skills modules taught in DBT, including the two skills modules that promote acceptance, and the two skills modules that promote change; orient to updates in the current manual.

 

5.    Describe the difference between validation, problem solving, and dialectical strategies, and explain how balancing these strategies helps emotionally dysregulated clients

 

6.    Show how a staff person provides crisis consultation to a distressed client, by balancing core DBT strategies to achieve commitment to an effective plan for coping

 

7.    Describe distinctive elements of treating suicidal behaviors in DBT

 

Rebecca Hanson Richardson, Ed.M. (Harvard University), M.A., Ph.D. (Clark University)  Licensed Psychologist and Health Service Provider. Clinical Psychologist, Worcester Recovery Center and Hospital; Faculty, University of Massachusetts Medical School.

Dr. Hanson Richardson completed intensive training in DBT in July, 2002, and has collaborated with colleagues to implement DBT with inpatients at Worcester Recovery Center and Hospital.  She has completed additional DBT training in Skills Teaching, Individual Therapy, Emotion Regulation, Treatment of Multiply Disordered, Chronically Suicidal Clients, DBT for Substance Use Disorders, DBT Training in Emotion Regulation and Distress Tolerance Skills, Advanced DBT Training:  Case Conceptualization, Treating In-Session Dysfunctional Behaviors & Providing DBT Skills Groups;  Treating Anxiety Disorders in Multi-Problem Clients with BPD: How, When and Why to Use Exposure Procedures in DBT; Adapting DBT to Inpatient Units; and “Marsha Linehan on DBT: Where We Were, Where We Are, and Where We Are Going.  She is currently providing individual and group DBT and crisis consultation to clients, DBT consultation to adult and adolescent inpatient treatment teams, and supervision to psychology doctoral interns in a specialized DBT rotation.  She also supervises psychiatry residents in outpatient DBT and CBT.  She teaches introductory DBT concepts and strategies to psychiatry residents, psychology interns and trainees, residential and community mental health center staff, and received the Paul J. Barreira Teaching Award from UMASS psychiatry residents. Together with colleagues from her original, intensively trained consultation team, she regularly leads DBT training workshops for inpatient staff.