3rd Wave: Mindfullness/acceptance based - DBT

Question 1

Why was DBT developed?

Answer 1

to treat women with BPD engaging in suicidal behaviours

Question 2

What does DBT integrate?

Answer 2

Dialectical Philosophy
- dialects assume every event/experience contains polarity, with each opposing position being seen as valid event if contradictory

Behaviourism
- aiming to help change/understand what they’re doing

Mindfulness
- fully accepting the patient as they are and the urgent need for them to change

Question 3

Aims of DBT

Answer 3

to help change their behaviour - reduce self-harm and increase self-care

to support changes DBT helps change relationship to intense/difficult, emotions/thoughts/memories

aims to balance acceptance of private experiences and change behaviours

Question 4

Linehan (2007)

Answer 4

overall goal of DBT is to help patients survive and create a life worth living

Question 5

Ideal structure of DBT

Answer 5

individual therapy - 1h/week for 12 months
- crisis and risk assessment

skills training group 2.5hr/week
- new acceptance and change skills learned

telephone consultations
-24/7 access to therapist outside of consultation for skills coaching

therapist consultation
- support and supervision for the therapist

sometimes a reduced version offered

Question 6

Mindfulness in DBT

Answer 6

core skills

practices should be frequent and brief

Question 7

Panos et al (2013)

Answer 7

meta analysis of 5 RCTs
DBT better than TAU for parasuicidal behaviours
DBT barely better than TAU for attrition
DBT equal for comorbid depression

Question 8

Lynch et al (2006)

Answer 8

suggests several mechanism of change for DBT

1) reduction of ineffective action tendencies linked with regulated emotions
2) people with BPD are likely to have strong emotional dysregulation resulting in destructive behaviours

Question 9

Braizer (2006)

Answer 9

Limittions of DBT: poor quality early RCTs
small sample sizes meaning underpowered
poor quality control conditions