Description
For the average clinician, individuals with borderline personality disorder (BPD) often represent the most challenging, seemingly insoluble cases. This volume is the authoritative presentation of dialectical behavior therapy (DBT), Marsha M. Linehan's comprehensive, integrated approach to treating individuals with BPD. DBT was the first psychotherapy shown in controlled trials to be effective with BPD. It has since been adapted and tested for a wide range of other difficult-to-treat disorders involving emotion dysregulation. While focusing on BPD, this book is essential reading for clinicians delivering DBT to any clients with complex, multiple problems.
Companion volumes: The latest developments in DBT skills training, together with essential materials for teaching the full range of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance skills, are presented in Linehan's DBT® Skills Training Manual, Second Edition, and DBT® Skills Training Handouts and Worksheets, Second Edition. Also available: Linehan's instructive skills training videos for clients--Crisis Survival Skills: Part One, Crisis Survival Skills: Part Two, From Suffering to Freedom, This One Moment, and Opposite Action.
Chapter
The Concept of Parasuicidal Behaviors
The Overlap Between Borderline Personality Disorder and Parasuicidal Behavior
Therapy for Borderline Personality Disorder: A Preview
CH$2. Dialectical and Biosocial Underpinnings of Treatment
Borderline Personality Disorder as Dialectical Failure
Case Conceptualization: A Dialectical Cognitive-Behavioral Approach
Biosocial Theory: A Dialectical Theory of Borderline Personality Disorder Development
Implications of the Biosocial Theory for Therapy with Borderline Patients
CH$3. Behavioral Patterns: Dialectical Dilemmas in the Treatment of Borderline Patients
Emotional Vulnerability versus Self-Invalidation
Active Passivity versus Apparent Competence
Unrelenting Crises versus Inhibited Grieving
PART II. TREATMENT OVERVIEW AND GOALS
CH$4. Overview of Treatment: Targets, Strategies, and Assumptions in a Nutshell
Crucial Steps in Treatment
Assumptions About Borderline Patients and Therapy
Therapist Characteristics and Skills
Agreements of Patients and Therapists
Therapist Consultation Agreements
CH$5. Behavioral Targets in Treatment: Behaviors to Increase and Decrease
The Overall Goal: Increasing Dialectical Behavior Patterns
Primary Behavioral Targets
Secondary Behavioral Targets
CH$6. Structuring Treatment Around Target Behaviors: Who Treats What and When
The General Theme: Targeting Dialectical Behaviors
The Hierarchy of Primary Targets
Progress Toward Targets Over Time
Setting Priorities within Target Classes in Outpatient
Individual Therapy
Skills Training: Hierarchy of Targets
Supportive Process Groups: Hierarchy of Targets
Telephone Calls: Hierarchy of Targets
Target Behaviors and Session Focus: Who Is in Control?
Modification of Target Hierarchies in Other Settings
Turf Conflicts with Respect to Target Responsibilities
PART III. BASIC TREATMENT STRATEGIES
CH$7. Dialectical Treatment Strategies
Defining Dialectical Strategies
Balancing Treatment Strategies: Dialectices of the therapeutic relationship
Teaching dialectical behavior patterns
Specific dialectical strategies
CH$8. Core Strategies: Part 1. Validation
Emotional validation strategies
Behavioural validation strategies
Cognitive validation strategies
CH$9. Core Strategies: Part II. Problem Solving
Levels of Problem Solving
Overview of Problem-Solving Strategies
Behavioral analysis strategies
Insight (interpretation) strategies
Solution analysis strategies
CH$10 Change Procedures: Part I. Contingency Procedures (Managing Contingencies and Observing Limits)
The Rationale for Contingency Procedures
Contingency Management Procedures
Observing-limits procedures
CH$11. Change Procedures: Part II. Skills Training, Exposure, Cognitive Modification
Skills training procedures
Exposure-based procedures
Cognitive modification procedures
CH$12. Stylistic Strategies: Balancing Communication
Reciprocal Communication Strategies
Irreverent Communication Strategies
CH$13. Case Management Strategies: Interacting with the Community
Environmental intervention strategies
Consultation-to-the-patient strategies
Therapist supervision/consultation strategies
PART IV. STRATEGIES FOR SPECIFIC TASKS
CH$14. Structural Strategies
CONTRACTING STRATEGIES: STARTING TREATMENT
SESSION-BEGINNING STRATEGIES
SESSION-ENDING STRATEGIES
CH$15. Special Treatment Strategies
SUICIDAL BEHAVIOR STRATEGIES
THERAPY-INTERFERING BEHAVIOR STRATEGIES
ANCILLARY TREATMENT STRATEGIES
Appendix 15.1 Scale Points for Lethality Assessment
Appendix: Suggested Reading
Cognitive-Behavioral Treatment of Borderline Personality Disorder
( Diagnosis and Treatment of Mental Disorders )
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