Dialectical Behavior Therapy in Clinical Practice
Applications across Disorders and Settings
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This influential work has now been substantially revised with over 60% new material reflecting over a dozen years of research and clinical advances. Leading experts describe innovative ways to use dialectical behavior therapy (DBT) in a wide range of real-world clinical and community settings. The volume provides wise guidance on setting up, running, and evaluating a comprehensive DBT program. It also presents adaptations designed to meet the needs of particular client populations as time- and cost-effectively as possible. Vivid case examples illustrate diverse applications of DBT for helping adults, adolescents, and children reduce suicidal and self-harming behavior; overcome complex, multiple challenges; and build a life worth living.
New to This Edition
*Presents current best practices for making DBT more efficient and accessible while maximizing program fidelity.
*Chapters on additional populations, including persons with posttraumatic stress disorder and preadolescent children.
*Chapters on additional settings, including milieu-based programs, university counseling centers, and middle and high schools.
*Chapters on pharmacotherapy, promoting employment and self-sufficiency, training and supervision, and DBT beyond Stage 1.
See also Doing Dialectical Behavior Therapy: A Practical Guide, by Kelly Koerner, which demonstrates DBT techniques in detail.
Table of Contents
Foreword, Marsha M. Linehan
I. Overview and Getting Started with DBT
1. Overview of DBT, Kelly Koerner, Linda A. Dimeff, & Shireen L. Rizvi
2. Adopt or Adapt?: Fidelity Matters, Kelly Koerner, Linda A. Dimeff, Charles R. Swenson, & Shireen L. Rizvi
3. Evaluating Your DBT Program, Shireen L. Rizvi, Maria Monroe-DeVita, & Linda A. Dimeff
II. Applications across Settings
4. Implementing Standard DBT in an Outpatient Setting, Linda A. Dimeff, Kim Skerven, Andrew White, Shelley McMain, Katherine Anne Comtois, Cedar R. Koons, Soonie A. Kim, Sharon Y. Manning, & Elisabeth Bellows
5. DBT in Milieu-Based Programs, Charles R. Swenson, Suzanne Witterholt, & Juliet Nelson
6. Applications of DBT in a School-Based Setting, Elizabeth T. Dexter-Mazza, James J. Mazza, Alec L. Miller, Kelly Graling, Elizabeth Courtney-Seidler, & Dawn Catucci
7. DBT in University Counseling Centers, Jacqueline Pistorello & Carla D. Chugani
8. DBT in Juvenile Justice Programs, Debra M. Bond, Jesse Homan, & Bradley Beach
9. Comprehensive DBT Forensic and Correctional Programs: Orchids, Not Dandelions, Robin A. McCann & Elissa M. Ball
III. Applications across Populations
10. DBT—Accepting the Challenges of Employment and Self-Sufficiency, Katherine Anne Comtois, Lynn Elwood, Jenna Melman, & Adam Carmel
11. DBT for Individuals with Borderline Personality Disorder and Substance Use Disorders, Linda A. Dimeff, Shelley McMain, Jennifer H. R. Sayrs, Chelsey Wilks, & Marsha M. Linehan
12. Treating Posttraumatic Stress Disorder during DBT: Applying the Principles and Procedures of the DBT Prolonged Exposure Protocol, Melanie S. Harned & Sara C. Schmidt
13. DBT and Eating Disorders, Lucene Wisniewski & Debra L. Safer
14. DBT beyond Stage 1: An Overview of Stages 2, 3, and 4, Cedar R. Koons
15. An Overview of DBT for Preadolescent Children: Addressing Primary Treatment Targets, Francheska Perepletchikova & Donald Nathanson
16. DBT for Adolescents, Alec J. Miller, Jill H. Rathus, Elizabeth T. Dexter-Mazza, Chad S. Brice, & Kelly Graling
17. DBT with Families, Alan E. Fruzzetti, Luciana G. Payne, & Perry D. Hoffman
IV. Special Topics
18. Training and Supervision in Outpatient DBT Programs, Jesse Homan, Jennifer H. R. Sayrs, & Travis L. Osborne
19. Pharmacotherapy Guidelines for Treating Stage 1 DBT Patients, Elisabeth P. Bellows, W. Maxwell Burns, & Chelsy R. Wilks
Linda A. Dimeff, PhD, is Chief Scientific Officer at Jaspr Health (www.jasprhealth.com), Institute Director at Portland DBT Institute, and Clinical Faculty in the Department of Psychology at the University of Washington. Since 1994, Dr. Dimeff has collaborated closely with Marsha M. Linehan to develop and evaluate an adaptation of dialectical behavior therapy (DBT) for individuals with substance use disorders and borderline personality disorder; to produce DBT training materials for clinicians; and to train, consult, and supervise clinicians in their practice of DBT. She has worked with public- and private-sector systems throughout the world in their efforts to implement DBT. Dr. Dimeff is a recipient of the Cindy J. Sanderson Outstanding Educator Award from the International Society for the Improvement and Teaching of DBT. She has received over 20 federal grants to facilitate the dissemination of evidence-based therapies and has published over 55 peer-reviewed publications.
Shireen L. Rizvi, PhD, ABPP, is Associate Professor of Clinical Psychology in the Graduate School of Applied and Professional Psychology at Rutgers, The State University of New Jersey. At Rutgers, she holds affiliate appointments in the Department of Psychology, School of Arts and Sciences, and the Department of Psychiatry, Robert Wood Johnson Medical School. Her research interests include improving outcomes, training, and dissemination of DBT for the treatment of complex and severe problems. Board certified in Behavioral and Cognitive Psychology and in Dialectical Behavior Therapy, she is past president of the International Society for the Improvement and Teaching of DBT and was the Society's Conference Program Chair for 2 years. Dr. Rizvi is a recipient of the Spotlight on a Mentor Award from the Association for Behavioral and Cognitive Therapies and the Presidential Fellowship for Teaching Excellence from Rutgers.
Kelly Koerner, PhD, is CEO of Jaspr Health (www.jasprhealth.com) and Clinical Faculty in the Department of Psychology at the University of Washington. Weaving together science, design, and social entrepreneurship, she develops highly collaborative, technology-based solutions to get evidence-based practices (EBPs) to the right point of care. Dr. Koerner has extensive practical experience in supporting individuals and systems as they learn, implement, and sustain EBPs in diverse settings (e.g., from paraprofessionals in juvenile justice facilities, to master’s-level counselors in community mental health and substance abuse treatment centers, to research therapists in academic clinical trials). Most recently, she and her human-centered design team have worked closely with scientists, people with lived experience, and emergency medicine providers to develop a tablet-based application for suicidal people. She maintains an active research program and is a recipient of the Career Achievement Award from the Dissemination and Implementation Science Special Interest Group of the Association for Behavioral and Cognitive Therapies.
“I am so pleased to see the second edition of this excellent work, which has been a much-tapped resource on my bookshelf over the years! The second edition shares all the excellent qualities of the first—it is theoretically sound, clinically relevant, engaging, and written by preeminent DBT clinicians and researchers. The book covers an even broader diversity of settings and client groups in which DBT is applied, thoroughly showcasing all that we have learned about the treatment in the last decade. Clinicians will find much of value, whether they are at the start of their DBT journey or have worked in the field for a while and want to review and update their programs and practices.”—Michaela A. Swales, PhD, Professor of Clinical Psychology and Program Director, North Wales Clinical Psychology Program, Bangor University, United Kingdom
"As application of DBT has expanded beyond its original clinical setting, it has moved into settings such as hospital units, residential programs, and the school classroom. This expertly edited second edition comprehensively addresses how DBT has evolved and how to ensure that implementation remains adherent to the treatment. The book builds on essential DBT concepts and applies them effectively to various contexts. This book is an indispensable contribution for therapists who want to develop a deeper understanding of the treatment and for graduate educators who want to teach a comprehensive DBT course."--Blaise Aguirre, MD, Medical Director, 3East DBT Continuum, McLean Hospital; Department of Psychiatry, Harvard Medical School
"DBT has earned a unique place in our clinical toolkits due to its rigorous scientific evidence base and its enthusiastic reception among clinicians, other health care decision makers, and clients and their families. This volume offers practical guidance on DBT, grounded in research and clinical experience. Chapters cover implementation issues, strategies for using DBT across diverse settings and populations, approaches for integrating pharmacological treatments and DBT, and training and supervision issues. This book is a 'must' for any clinician interested in DBT; instructors will find it to be a valuable text or supplemental reading for courses on psychotherapy and psychosocial treatment."--Joan Asarnow, PhD, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles
"Superbly edited by Dimeff, Rizvi, and Koerner, the second edition of this seminal work is a DBT tour de force. Building on the strong foundation of the first edition, the volume includes nine new chapters related to cutting-edge clinical delivery of DBT. The contributors are a veritable who’s who of DBT science, training, and clinical practice. Marsha Linehan has fundamentally revolutionized our understanding and treatment of suicidal risk, self-harm behaviors, and complex case presentations. This second edition is a worthy testament to Linehan's vision and genius and will prove to be an invaluable resource for students and providers of DBT around the world."--David A. Jobes, PhD, ABPP, Professor of Psychology and Director, Suicide Prevention Laboratory, The Catholic University of America-