Dialectical Behaviour Therapy (DBT) is a psychotherapeutic approach used to treat individuals with complex psychological disorders, particularly chronically suicidal individuals with borderline personality disorder (BPD). The therapy articulates a series of principles that effectively guide clinicians in responding to problematic behaviours. Treated problems include, among others, attempting suicide, bingeing, purging, using illegal drugs and behaviours that directly impede the treatment.
Dialectical Behaviour Therapy: Distinctive Features highlights theoretical and practical features of the treatment using extensive clinical examples to demonstrate how the theory translates into practice. This updated edition reviews recent modifications to the structure of the treatment and considers more recent research evidence for both the biosocial theory underpinning the treatment and treatment efficacy. The book provides a clear overview of a complex treatment, through a unique application of strategies and a discussion of a comprehensive treatment programme that structures the therapeutic journey for the client.
The book will be of interest to clinicians wanting to develop their knowledge about the treatment, prior to formal training; post-graduate students in mental health seeking to learn how to conceptualize complex problems; DBT trained clinicians who require a useful précis of the treatment with clinical examples, and clients about to embark upon this treatment. This book provides a clear and structured overview of a complex treatment. It is written for both practising clinicians and students wishing to learn more about DBT and how it differs from the other cognitive behaviour therapies.
Table of Contents
Introduction Acknowledgements Part 1 THE DISTINCTIVE THEORETICAL FEATURES OF DBT 1. Principle-driven treatment 2. Integrative treatment 3. Dialectical principles 4. Emphasis on the primacy of affect 5. Transactional theory of capability and motivational deficits 6. Learning theory I: Classical conditioning 7. Learning theory II: Operant conditioning 8. A behavioural approach to diagnosis 9. Zen principles Part 2 THE DISTINCTIVE PRACTICAL FEATURES OF DBT 10. Developing modalities to fulfil specific functions 11. Coaching on the phone 12. Consulting in a team 13. Treating the system 14. Structuring the treatment in stages 15. Strengthening commitment in pre-treatment 16. Targeting behaviours according to a hierarchy 17. Validating in the current context or clients’ inherent capabilities 18. Analysing behaviours, with a twist or two 19. Integrating multiple CBT procedures in a solution analysis 20. Using skilful means 21. Exposing to a variety of affects 22. Managing contingencies in the therapeutic context 23. Changing cognitive behaviours 24. Being dialectical 25. Using self-disclosure 26. Confronting and being irreverent 27. Consulting to the client 28. Treating the client’s therapy-interfering behaviour 29. Treating the therapist 30. Evidence for efficacy and effectiveness References Index
Michaela A. Swales is a Reader in Clinical Psychology on the North Wales Clinical Psychology Programme, Bangor University and a consultant clinical psychologist with Betsi Cadwaladr University Health Board. She is the Director of the British Isles DBT Training Team and co-author of Changing Behavior in DBT.
Heidi L. Heard is the co-author of Changing Behavior in DBT. She is a senior trainer for BehavioralTech, USA and an international consultant and supervisor in Dialectical Behaviour Therapy. She has written extensively about DBT and borderline personality disorder.
'For those already familiar with the original version of DBT: Distinctive Features, the second edition fulfils the same function of simplifying and clarifying the theoretical concepts underlying the therapy. The same practical summary of the treatment components are there, with clinical examples to demonstrate the main points. This revised version brings the research evidence up to date, including reference to DSM-V, and some thought provoking discussion on full-program DBT versus skills only interventions. This book is the perfect accompaniment to Linehan's own manuals, either to facilitate understanding for new students, or to provide condensed summaries for the more experienced therapist. Every practitioner of DBT will benefit from reading it.' - Dr Christine Dunkley, Honorary lecturer, University of Bangor, Chair of the Society for DBT of the UK and Ireland
'I am always impressed by the superb job the authors do of clearly outlining the essential features of a complex treatment like DBT in an accessible manner. This is a great contribution that will increase the reach of DBT.' - Tony DuBose, PsyD, Chief Training Executive, Linehan Institute/Behavioral Tech
'Swales and Heard have done it again - a classic text no DBT practitioner should be without. Therapists will find their clear explanations and clinical examples provide a refreshing insight into the art and application of DBT. This engaging book, by two exceedingly well-informed and renowned authors, leads us on a journey of discovery from the principles that underpin DBT to the details of how to apply it in practice. Their discussion of generating, selecting and implementing solutions alone makes it the go-to book for all DBT practitioners and essential reading for those curious to find out more.' - Dr. Maggie Stanton, Consultant Clinical Psychologist and Clinical Lead, Honorary Lecturer University of Southampton.