Introduction Dialectical behavior therapy (DBT) was created by Marsha Linehan, a clinical psychologist and Professor of Psychology at the University of Washington, to help treat individuals who have been diagnosed with borderline personality disorder (BPD) (Linehan, et al., 1999). The term dialectical means an integration of opposites; the opposing phenomenon’s are acceptance and change. The core of DBT consists of four different behavioral skills, distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness (Linehan 1993). Distress tolerance is used in DBT to teach the client how to actively cope and tolerate the pain and agony that one will inevitably experience in life (Linehan 1993). Emotional regulation attempts …show more content…
DBT has strong empirical support behind it (Swenson, 2000) and the affect that DBT has on clients diagnosed with borderline personality disorder has been the most studied therapy compared to the variety of other approaches (Stoffers et al. 2012). However, there lacks research that has been able to mesaure the success of DBT on borderline clients. A viable objective approach to measuring how DBT affects its clients is measuring the neural responses of the borderline personality disorder cleints. Cognitive behavioral therapy has been studied and supported neurologically to have an effect on its clients (Ritchey et al. …show more content…
Development, use, and psychometric properties of the Trauma History Questionnaire. Journal of Loss and Trauma, 16, 258-283. doi: 10.1080/15325024.2011.572035 Linehan M.M., Armstrong H.E., Suarez A.,et al. (1991) Cognitive behavioural treatment of chronically suicidal borderline patients. Archives of General Psychiatry 48, 1060–1064. Linehan, M. M. (1993). Cognitive Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press. Linehan, M. M., Schmidt, H., Dimeff, L. A., Kanter, J. W., Craft, J. C., Comtois, K. A., & Recknor, K. L. (1999). Dialectical Behavior Therapy for Patients with Borderline Personality Disorder and Drug-Dependence. American Journal on Addiction, 8, 279-292. Neacsiu A.D., Ward-Ciesielski E.F. & Linehan, M.M. (2012) Emerging approaches to counseling intervention: dialectical behavior therapy.Counseling Psychologist 40, 1003–1032. Rizvi S. (2011) Treatment failure in dialectical behaviour therapy. Cognitive and Behavioural Practice 18, 403–412. Stoffers J.M., Völlm B.A., Rücker G., et al. (2012) Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews (8), CD005652. Swenson, C. (2000). How can we account for DBT’s widespread popularity? York: Guilford
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)
Stern, Richard. "Behavioural-Cognitive Psychotherapy Training for Psychiatrists." Pb.rcpsych.org. The Royal College of Psychiatrists, 1993. Web. 24 Feb. 2014.
While CBT has many advantages, it alone does not encompass all of the concepts I believe are necessary to tackle a client’s needs. Therefore, I draw upon concepts from various theories to assist clients in achieving their goals. Pulling from Reality therapy, a key concept I utilize is focusing on what the client is doing and how to get them to evaluate whether they’re present actions are working for them. CBT does use some form of this in the sense that one must examine and establish their cognitive misconceptions; however, I prefer to extract this concept from Reality therapy because CBT tends to do so by focusing on the past. I am a firm believer that while the past can shape who you are, it does little good to remain focused on it. Focusing on overt behavior, precision in specifying the goals of treatment, development of specific treatment plans, and objective evaluation of therapy outcomes all come from Behavior therapy (Corey, 2013, p. 474). Behavior therapy is highly structured much like that of CBT. By utilizing this aspect of Behavior therapy, I am better able to closely observe where a client is currently and where they are headed. Lastly, I pull from Person-Centered therapy as the final key concept of my counseling approach. PCT focuses on the fact that client’s have the potential to become aware of their problems and resolve them (Corey, 2013). This Person-Centered therapy concept has overlap with CBT as
Borderline personality disorder is a hard-mental disease to diagnose, according to The National Institute of Mental health the definition of borderline personality disorder is: “… a serious mental disorder marked by a pattern of ongoing instability in moods, behavior, self-image, and functioning. These experiences often result in impulsive actions and unstable relationships” (pg 1). When we look at that definition alone this is a very vague description of the disorder that anyone that is experiencing just a rough time in life, can be diagnosed with this mental disorder. Roughly about 3 million Americans are diagnosed with borderline personality disorder a year. To find out who really has this mental disorder we should look at case studies,
This paper looks at a person that exhibits the symptoms of Borderline Personality Disorder (BPD). In the paper, examples are given of symptoms that the person exhibits. These symptoms are then evaluated using the DSM-V criteria for BPD. The six-different psychological theoretical models are discussed, and it is shown how these models have been used to explain the symptoms of BPD. Assessment of
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.
Borderline Personality Disorder (BPD) affects about 4% of the general population, and at least 20% of the clinical psychiatric population. (Kernberg and Michels, 2009) In the clinical psychiatric population, about 75% of those with the disorder are women. BPD is also significantly heritable, with 42-68% of the variance associated with genetic factors, similar to that of hypertension. BPD can also develop due to environmental factors such as childhood neglect and/or trauma, insecure attachment, and exposure to marital, family, and psychiatric issues. (Gunderson, 2011)
CBT has been known to cure a variety of disorders both in clinical environments and non-clinical environments. This type of therapy technique has been tested for efficacy and has proven to be highly effective. Furthermore, the future for CBT looks very positive as well. Researchers and theorist are now working on making this type of therapy available for suicide prevention, schizophrenia, and other psychopathologies.
Hollon, S. D. & Beck, A. T. (2004). Cognitive and cognitive behavioral therapies. Bergin And Garfield’S Handbook Of Psychotherapy And Behavior Change, 5 pp. 447--492.
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)
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 ...
Borderline Personality Disorder (BPD) hinders people’s security, makes interpersonal and interpersonal relationships difficult, worsens the person suffering from the disorder’s life and those around them, effects their affect and self-image, and generally makes a person even more unstable (Davidon et al., 2007). This disorder is a personality disorder which effects the people’s emotions, personality, and daily living including relationships with other and job stability. People with BPD may experience a variation of symptoms including but not limited to: intense contradictory emotions involving sadness, anger, and anxiety, feelings of emptiness, loneliness, and isolations (Biskin & Paris, 2012). This disorder makes it hard for the person with the disorder to maintain relationships since they have tendentious believe that people are either strictly good or bad. Also, they are sensitive to other people’s actions and words and are all over the place with their emotions so those in their life never know which side to expect. (Biskin & Paris, 2012)
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.
The history of BPD can be traced back to 1938 when Adolph Stern first described the symptoms of the disorder as neither being psychotic nor psychoneurotic; hence, the term ‘borderline’ was introduced (National Collaborating Centre for Mental Health, 2009, p. 15). Then in 1960, Otto Kernberg coined the term ‘borderline personality organization’ to describe persistent patterns of behavior and functioning consisting of instability, and distressed psychological self-organization (National Collaborating Centre for Mental Health, 2009, p. 15).