Dialectical Behavior Therapy With Prolonged Exposure for Adolescents: Rationale and Review of the Research

He Waka Eke Noa at Korowai Manaaki: A Process Evaluation of a Dialectical Behaviour Therapy-informed skills programme for young people in a secure youth justice residence

“…The final module of DBT is Interpersonal Effectiveness skills training. DBT recognises that an individual's ability to interact effectively with others is influenced by factors across multiple domains including pathological learning patterns, developmental processes, previous trauma as well as family and peer influences (Andrew et al, 2014;Lang, Edwards, Mittler, & Bonavitacola, 2018). Negative or hostile interactions between these factors can result in an individual failing to regulate themselves internally, which may manifest in maladaptive external behaviours, which in turn can negatively impact their ability to effectively engage with others.…”

“…3) to ensure that skills are being translated into the client's life in a way that results in positive change; 4) to improve and maintain the therapist's motivation to deliver therapy; and 5) to assist the client in restructuring or changing his or her environment in a way that best promotes the generalisation and effective use of skills" (Tomlinson, 2018, p. 4) Empirical research has indicated that emotion dysregulation plays a central role, not only in BPD, but also in many other areas of psychopathology. The comprehensive and integrative nature of DBT means it can be effectively applied to a range of complex symptoms which allows it to be effective across a variety of severe and multiple psychopathologies (Banks & Gibbons, 2016;Lang, et al, 2018;MacPherson et al, 2013;Ritschel, Miller & Taylor, 2013). This transdiagnostic aspect of DBT has resulted in it being adapted for use to help treat other emotional and behavioural problems beyond BPD.…”

“…There is further evidence of DBT reducing other problem behaviours of young people including reducing symptoms of Anxiety (Hunnicutt Hollenbaugh & Lenz, 2018), Oppositional Defiant Disorder (Nelson-Gray et al, 2006, Bipolar Disorder (Goldstein et al, 2015), Post-Traumatic Stress Disorder (PTSD; Lang et al, 2018), eating disorders including Anorexia Nervosa and Bulimia Nervosa (Safer, Couturier & Lock, 2007;Salbach-Andrae, Bohnekamp, Pfeiffer, Lehmkuhl & Miller, 2008), and Trichotillomania (Welch & Kim, 2012). In most programmes, the DBT treatment implemented offered was adaptations of 'standard' DBT designed to be more understandable and applicable to young people.…”