DBT PE
Treatment for the ‘haunted’
Many of my clients are ‘haunted’ by symptoms of PTSD/trauma as well as personality disorders, mood disorders, dissociative disorders, etc. To address this common issue, Melanie Harned developed a protocol that integrates Prolonged Exposure treatment alongside Dialectical Behavior Therapy (DBT): DBT Prolonged Exposure protocol. This treatment format allows clients to treat both emotion dysregulation with related problems and PTSD at the same time.
Exposure treatment is the most researched and most highly recommended treatment for PTSD. DBT PE has shown significant remission of PTSD.
Who is DBT PE for?
Adults and adolescents who are currently, or will be, participating in DBT that also have trauma they want to address in therapy.
The DBT PE protocol treats life-threatening behaviors, multiple mental disorders, behaviors that make treatment difficult and severe impairment in functioning along with PTSD. DBT PE has been shown to be extremely effective at reducing PTSD.
What DBT PE Treatment Looks Like
An individual will participate in standard DBT, including weekly individual therapy, weekly skills training and phone coaching – and their therapist will be involved in a DBT consultation team. When the individual’s most threatening behaviors are stabilized through DBT, they may begin the PE work.
This is considered Stage 2 of DBT treatment. The focus is on treating PTSD/trauma.
The PE portion of treatment typically starts about four months after beginning DBT and lasts 13 weeks. During PE, sessions increase in length to 90 minutes (from 60 minutes for DBT alone). After the individual has completed PE, sessions will go back to 60 minutes, and the individual will complete the DBT treatment.
How It Works
Exposure therapy works against the reasons PTSD happens in the first place – avoidance and cognitions about the trauma. Understandably, people who have experienced trauma avoid thinking about the trauma and escape situations that remind them of the trauma.
Healing happens by ‘exposure’ to the trauma experience and forming new ways of thinking about the trauma.
Prolonged exposure achieves this in two ways:
- Imaginal exposure – re-telling of the trauma memory out loud in therapy sessions, followed by processing of the experience, particularly thoughts and emotions that came up during the exposure; this works to reduce trauma-related symptoms and to gain new perspectives about what happened.
- In Vivo exposure – “in real life” exposure of the situations, events, objects that serve as reminders of the trauma that the person usually avoids; this works to reduce avoidance and excessive fear.
But I don’t need DBT. Can I do Prolonged Exposure by itself to treat my trauma?
Yes. I offer prolonged exposure treatment alone (without DBT) to individuals who qualify.