August 22, 2022 | 9:00am
Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by Dr. Marsha Linehan over the last 25 years. DBT was originally developed to treat suicidal patients, evolved into a treatment for suicidal BPD patients, and has since been adapted for the treatment of BPD patients with presenting problems other than suicidal behaviors. DBT is designed to treat BPD patients at all levels of severity and complexity of disorder and is conceptualized as occurring in stages.
In Stage I, the primary focus is on stabilizing the patient and achieving behavioral control. Stage I treatment targets are addressed in the following hierarchical order:
1.) life-threatening behaviors (primarily suicidal and self-injurious behavior)
2.) therapy-interfering behaviors (e.g., poor attendance)
3.) severe quality of life-interfering behaviors (e.g., frequent use of crisis services, substance abuse)
Stage I DBT consists of several modes of treatment, each designed to achieve specific functions:
Individual therapy focuses on increasing client motivation (i.e., identifying specific factors maintaining problem behavior and providing interventions)
Group skills training teaches basic capabilities (i.e., behavioral skills including distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness);
Phone coaching provides the basis for generalization of skills to the natural environment and the therapist consultation team functions to increase therapist capabilities and motivation.
Penny Kruger, LCSW, says “My style of therapy is supportive, however, I am willing to tolerate the discomfort it takes to move towards behavioral change. I have been in practice for 20 years treating men and women who were struggling with impulsive behavior patterns. My experience has included many specialty issues, including anger management, self injury, sexual compulsivity, and binge/purge behavior.
The work I have done in these areas has shaped me in many ways. My practice has become much more “skill based” over the years. I have learned that most of my clients want me to take an active role in their treatment. I teach the skills that we ALL need to manage the delicate balance of acceptance and change in our lives. People already possess many resilient qualities, and these skills are meant to build on the strengths that we already possess. We can not change our biological temperaments, but we can certainly learn skills that will help us to feel like a “better fit” with our lives.”