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Implementing dialectical behavior therapy.

Abstract

Dialectical behavior therapy (DBT) is a cognitive-behavioral approach to treating borderline personality disorder. Early empirical results are promising, although they are not sufficient to establish DBT as an evidence-based practice in community settings. Nevertheless, the treatment has been widely implemented by mental health authorities, program leaders, and clinicians. The authors describe DBT's four stages of treatment, the functional areas addressed, and the treatment modes used as well as the reasons for the appeal of DBT to practitioners. They review barriers encountered by those who have implemented the model and present strategies that have been developed to overcome the barriers.

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BibTeXRIS

Charles R Swenson, William C Torrey, Kelly Koerner. 2002. Implementing dialectical behavior therapy.. https://doi.org/10.1176/appi.ps.53.2.171

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A primary care "friendly" cognitive behavioral insomnia therapy.

OBJECTIVES: This study was conducted to test the effectiveness of an abbreviated cognitive-behavioral insomnia therapy (ACBT) with primary DESIGN: A single-blind, randomized group design was used in which study patients were randomized to either a brief, 2-session ACBT or a similarly brief intervention (SHC) that included only generic sleep hygiene recommendations. SETTING: A university-affiliated Department of Veterans Affairs medical center. PARTICIPANTS: Twenty (2 women) veteran patients (M(age) = 51.0 yrs., SD = 13.7 years) who met criteria for chronic primary insomnia. MEASUREMENTS AND RESULTS: Participants completed sleep logs for 2 weeks and questionnaires to measures insomnia symptoms, sleep-related self-efficacy, and dysfunctional beliefs about sleep before treatment, during a 2-week posttreatment assessment, and again at a 3-month posttreatment follow-up. Statistical analyses showed that ACBT produced significantly larger improvements across a majority of outcome measures than did SHC. Case-by-case analyses showed that only the ACBT produced consistent positive effects across study patients, and a sizeable proportion of these patients receiving this treatment achieved clinically significant improvements by their study endpoints. Approximately 52% of those receiving the ACBT reported at least a 50% reduction in their wake time after sleep onset, and 55.6% of ACBT-treated patients who entered the study with pathologic scores on an Insomnia Symptom Questionnaire (ISQ), achieved normal ISQ scores by their final outcome assessment. CONCLUSIONS: ACBT is effective for reducing subjective sleep disturbance and insomnia symptoms in primary care patients.

Cognitive Behavioral Therapy↗