Dialectical Behavior Therapy in Clinical Practice: Applications across Disorders and Settings

Overview of Dialectical Behavior Therapy   Kelly Koerner   Linda A. Dimeff     1Adopt or Adapt?: Fidelity Matters   Kelly Koerner   Linda A. Dimeff   Charles R. Swenson     19Implementing Standard Dialectical Behavior Therapy in an Outpatient Setting   Katherine Anne Comtois   Cedar R. Koons   Soonie A. Kim   Sharon Y. Manning   Elisabeth Bellows   Linda A. Dimeff     37Dialectical Behavior Therapy on Inpatient Units   Charles R. Swenson   Suzanne Witterholt   Martin Bohus     69Implementing Dialectical Behavior Therapy in Residential Forensic Settings with Adults and Juveniles   Robin A. McCann   Andre Ivanoff   Henry Schmidt   Bradley Beach     112Dialectical Behavior Therapy for Individuals with Borderline Personality Disorder and Substance Dependence   Shelley McMain   Jennifer H. R. Sayrs   Linda A. Dimeff   Marsha M. Linehan     145Dialectical Behavior Therapy and Eating Disorders   Lucene Wisniewski   Debra Safer   Eunice Chen     174Dialectical Behavior Therapy with Families   Alan E. Fruzzetti   Daniel A. Santisteban   Perry D. Hoffman     222Dialectical Behavior Therapy for Adolescents   Alec L. Miller   Jill H. Rathus   Anthony P. DuBose   Elizabeth T. Dexter-Mazza   Arielle R. Goldklang     245Dialectical Behavior Therapy for Depression with Comorbid Pcrsonality Disorder: An Extension of Standard Dialectical Behavior Therapy with a Special Emphasis on the Treatment of Older Adults   Thomas R. Lynch   Jennifer S. Cheavens     264Dialectical Behavior Therapy for Assertive Community Treatment Teams   Sarah K. Reynolds   Randy Wolbert   Gwen Abney-Cunningham   Kimberly Patterson     298Evaluating Your Dialectical Behavior Therapy Program   Shireen L. Rizvi   Maria Monroe-DeVita   Linda A. Dimeff     326Index     351

\ From The CriticsReviewer: Christopher J. Graver, PhD, ABPP-CN(Madigan Healthcare System)\ Description: Dialectical Behavior Therapy (DBT), a psychological treatment developed by Marsha Linehan, has received significant attention from both clinical and research perspectives during the last two decades, it. This book describes DBT principles and guides the reader in the application of this treatment.\ Purpose: The purpose is to introduce DBT and provide practical suggestions for the implementation of it, ways to avoid common pitfalls, and suggestions for difficult situations.\ Audience: The target audience is primarily clinicians, most of whom will probably be clinical psychologists, but may also include marriage and family therapists and social workers. The editors are students of Marsha Linehan and helped to develop DBT during their tenure at the University of Washington. Readers should be aware, however, that they also have a financial interest in two of Linehan's companies that promote DBT and some of contributing authors are either students of hers or have connections to her companies.\ Features: The well organized nature of this book is immediately apparent. There are clear headings in each chapter that logically progress through the theme of the chapter. Some chapters, such as chapter 2, have subsections that are divided into a series of "tips" for the clinician and provide flowcharts, sample dialogues, and tables that summarize key skills in DBT. DBT is addressed in different settings, such as outpatient and inpatient settings, with practical advice on setting up a DBT program, selecting a team leader, integrating it into current managed care practices, building a referral base, skills training, and measuring outcomes. The book also covers specific uses of DBT in residential forensic settings that include recidivism, decreasing staff burnout, and forensic modification of DBT treatment. The latter chapters are focused on the use of DBT in particular disorders. In general, the book is filled with useful tables, charts, and other tools for implementing DBT. The references are fairly current and pertinent. The index is also rather comprehensive.\ Assessment: This is well written, practical book for clinicians seeking to expand their knowledge and use of DBT. While the original book, Cognitive Behavioral Treatment of Borderline Personality Disorder, Linehan (Guilford Press, 1993) remains a good starting place, this book will help to enrich the clinician's delivery of DBT with practical advice from authors with nearly two decades of experience.\ \ \ \ \ Bulletin of the Menninger Clinic\ "A pragmatic volume that discusses current advances in dialectical behavioral therapy and presents practical applications for a wide range of complex problems....An excellent resource for clinicians....It is an excellent introduction to the important advances in clinical practice."--Bulletin of the Menninger Clinic\ \ \ From the Publisher"Learning DBT changed my life. DBT concepts and skills take my clinical work to a completely new level. I urge clinicians who are eager to learn more about DBT, and how to adapt it to their clinical setting, to read this book. Contributors are leading DBT practitioners and researchers, and their work in this volume expands and extends this amazing therapy."--Jacqueline B. Persons, PhD, Director, San Francisco Bay Area Center for Cognitive Therapy\ "This book is a great resource for anyone and everyone interested in using DBT. Written by accomplished clinician-researchers, it tackles situational pragmatics and the thorny issues of program fidelity. It is well organized, lucidly written, and easily digested. Students of cognitive-behavioral therapies will learn a great deal from this text, as will seasoned clinicians, including those thinking of starting a DBT program. Like DBT itself, the volume is thoughtful, provocative, and oriented toward real-world problem solving."--Robert L. Trestman, PhD, MD, Departments of Medicine and Psychiatry and Director, Center for Correctional Mental Health Services Research, University of Connecticut Health Center\ "Dimeff and Koerner have assembled an excellent group of authors to translate DBT theory into real-word practice. Each chapter details the process for using DBT with specific populations and deals with the day-to-day issues confronting practitioners. This is an excellent text for graduate instructors who want to teach evidence-based practices to their students, as well as for clinicians who have longed for practical advice on how to start and maintain a successful DBT program. It is also an excellent guidebook for payors who need to understand what a DBT program should look like and how to assess its value."--George Smart, LICSW, Vice-President of Clinical Operations, Massachusetts Behavioral Health Partnership\ "When I first heard Marsha Linehan speak on DBT, I felt that she had saved me 20 years of figuring things out on my own. This book leads the next wave, bringing the accumulated practical wisdom of several 'first adopters' of DBT who have successfully adapted this principle-based, flexible approach to unique settings and populations. Those wishing to develop services for patients with multiple problems can jump-start their fledgling programs and avoid common pitfalls, all the while staying true to the empirical base of the treatment."--Elizabeth B. Simpson, MD, Director, Dialectical Behavior Therapy Program, Massachusetts Mental Health Center\ "DBT is one of the most important advances in clinical practice in the last two decades. What began as a specific intervention for borderline personality disorder is in the process of evolving into a major approach that can be applied to a wide range of patients across multiple settings. This book impressively demonstrates this evolution, providing a resource that will be of value to therapists and students alike. I highly recommend it."--Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University\ \ \ \ \ \ Psychiatric Services\ "Each chapter is written by individuals who have extensive first-hand experience implementing and operating DBT successfully in the setting about which they are writing—and the experience shows."--Psychiatric Services\ \ \ \ \ PsycCRITIQUES\ "I like this book. It meets its stated design and purpose....Its first chapter offers a clear overview of DBT. More important, its second chapter is a gold mine of practical information about whether to adopt the full (and quite extensive) DBT protocol and components, or whether to adapt elements of the philosophy or components to one's particular setting or client population. The costs and benefits are clearly laid out and often tabled....Each chapter is consistent in its format and sections, and the book is formatted in an attractive and very readable style....The coeditors have made careers of consulting and training very widely across different populations and settings. Their own practical experience shows through not only in their own chapters but also in those of the other authors in this edited volume....The final chapter on evaluating your DBT program is also written in such a simple, practical, and user-friendly way that it goes a long way toward encouraging even the most research-averse clinician or administrator to evaluate his or her work as a clinical scientist. This is a text to be used by clinicians, administrators, and students alike. It does what it advertises in its title. It clearly and practically offers guidelines for applying dialectical behavior therapy in clinical practice as it is applied across a range of disorders and settings. Well done!"--PsycCRITIQUES\ \ \ \ \ The Family Journal\ "The authors of this edited text make compelling arguments for the use of DBT across the many treatment settings. The text is easy to read and would be relevant to those practitioners unfamiliar with DBT as well as those who may already be quite conversant with the approach. Many of the chapters feature reproducible handouts for use with clients. Given the comprehensive nature of this text, it would be a useful addition to any counseling professional's library, and it is an absolute must for any practitioner interested in DBT or as a useful addition to an advanced counseling theories course....An invaluable reference for any practitioner who is interested in learning more about DBT."--The Family Journal\ \ \ \ \ Drug and Alcohol Review\ "Endorsed by Marsha Linehan, this timely and very useful book is aimed explicitly at current or aspiring DBT practitioners seeking to adopt or adapt the approach for working with various diagnostic groups in either hospital or community settings, including those working with people with substance use disorders. The editors, Linda Dimeff and Kelly Koerner, both experienced DBT consultants and practitioners, succeed in achieving their overarching goal of presenting a concise set of information about the applications of DBT that draws on the first-hand clinical experience of clinicians and programme directors to inform practitioners and highlight ways to avoid or, alternatively, to overcome creatively common pitfalls and problems....This book is highly recommended and is likely to find an appreciative audience among practitioners seeking to understand DBT and its clinical applications."--Drug and Alcohol Review\ \ \ \ \ Bulletin of the Menninger Clinic"A pragmatic volume that discusses current advances in dialectical behavioral therapy and presents practical applications for a wide range of complex problems....An excellent resource for clinicians....It is an excellent introduction to the important advances in clinical practice."--Bulletin of the Menninger Clinic\ \ \