WORKING WITH TRAUMA IN DIALECTICAL BEHAVIORAL THERAPY: LITERATURE REVIEW
Abstract
Modern society sees that war is becoming a permanent phenomenon. The consequences of war are always injuries of a physical and mental nature. The article focuses on the experience of a traumatic personal experience. The main diagnostic criteria for making a diagnosis of trauma are highlighted. The aim of this review is to discuss the theoretical and empirical evidence that examines the potential effectiveness of dialectical-behavioral therapy in working with the traumatic experience of an individual, as a way of building a theoretical model of working with trauma in DBT. The author’s model in working with trauma is considered, which is based on a dialectical-behavioral approach and contains the following components: balancing self-awareness, balancing consciousness, acceptance and actions of the individual, balancing with the help of adaptation, balancing thinking, balancing emotions, balancing relationships, harmonizing, and supporting the individual. In the theoretical and practical context, the essence of leading strategies in work with trauma is disclosed. The main dialectical contradiction of psychological trauma is the internal conflict between erasing everything from memory and the desire to share with someone.
References
1. American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596
2. Becker, C., & Zayfert, C. (2001). Integrating DBT-based techniques and concepts to facilitate exposure treatment for PTSD. Cognitive and Behavioral Practice, 8(2), 107–122.
https://doi.org/10.1016/S1077-7229(01)80017-1
3. Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse: A randomized clinical trial. JAMA Psychiatry, 77(12), 1235–1245. https://doi.org/10.1001/jamapsychiatry.2020.2148
4. Bohus, M., Schmahl, C., Fydrich, T., Steil, R., Müller-Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., Priebe, K. (2019). A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse. Borderline Personality Disorder and Emotion Dysregulation. Volume 6, Article number: 7
5. Bohus, M., Schmahl, C., Fydrich, T., Steil, R., Müller-Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., & Priebe, K. (2019). A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse. Borderline Personality Disorder and Emotion Dysregulation, 6. https://doi.org/10.1186/s40479-019-0099-y
6. Cameron, A., Eaton, E., Brake, C., & Capone, C. (2021). Moral injury as a unique predictor of suicidal ideation in a veteran sample with a substance use disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 13(8), 856–860.
7. Cornelisse, S., Biermann, M., Enning, F., Schmahl, C., & Kleindienst, N. (2021). [DBTPTSD-EA: Treatment of posttraumatic stress disorder after interpersonal traumatization in childhood in adolescents with borderline personality disorders : A pilot study]. Der Nervenarzt, 92(7), 679–685. https://doi.org/10.1007/s00115-021-01151-8
8. Farrell, N., Deacon, B., Dixon, L., & Lickel, J. (2013). Theory-based training strategies for modifying practitioner concerns about exposure therapy. Journal of Anxiety Disorders, 27(8), 781– 787. https://doi-org.ezaccess.libraries.psu.edu/10.1016/j.janxdis.2013.09.003
9. Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press.
10. Follette, V., Briere, J., Rozelle, D., Hopper, J., & Rome, D. (2015). Mindfulness-oriented interventions for trauma: Integrating contemplative practices. In New York, NY: Guilford Press, 2015.I-xi, 1-372 pp. (pp. i–xi, 1–372). Guilford Press. https://www.proquest.com/ptsdpubs/docview/1924870843/5E7DA1E115954AC8PQ/17parentSessionId=NJEx%2BxZwCk7KjV3cK3GBZNiLRH3V1EtqlhRcrl77tSE%3D
11. Geddes, K., Dziurawiec, S., & Lee, C. (2013). Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adoles
Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service. Psychiatry Journal, 2013, 145219. https://doi.org/10.1155/2013/145219
12. Görg, N., Böhnke, J., Priebe, K., Rausch, S., Wekenmann, S., Ludäscher, P., Bohus, M., & Kleindienst, N. (2019). Changes in Trauma-Related Emotions Following Treatment with Dialectical Behavior Therapy for Posttraumatic Stress Disorder After Childhood Abuse. Journal of Traumatic Stress, 32(5), 764–773. https://doi.org/10.1002/jts.22440
13. Görg, N., Priebe, K., Böhnke, J. R., Steil, R., Dyer, A., & Kleindienst, N. (2017). Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. Borderline Personality Disorder and Emotion Dysregulation, 4, 15. https://doi.org/10.1186/s40479-017-0065-5
14. Gratz, K., Berghoff, C., Richmond, J., Vidaña, A., & Dixon-Gordon, K. (2020). Examining posttraumatic stress disorder as a predictor of treatment response to dialectical behavior therapy. Journal of Clinical Psychology, 76(9), 1563–1574. https://doi.org/10.1002/jclp.22961
15. Harned, M. (2022). Treating trauma in dialectical behavior therapy: The DBT prolonged exposure protocol (DBT PE). Guilford Publications.
16. Harned, M., & Schmidt, S. (2019). Perspectives on a Stage-Based Treatment for Posttraumatic Stress Disorder Among Dialectical Behavior Therapy Consumers in Public Mental Health Settings. Community Mental Health Journal, 55(3), 409–419. https://doi.org/10.1007/s10597-018-0358-1
17. Harned, M., Schmidt, S., Korslund, K., & Gallop, R. (2021). Does Adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) Protocol for PTSD to DBT Improve Outcomes in Public Mental Health Settings? A Pilot Nonrandomized Effectiveness Trial With Benchmarking. Behavior Therapy, 52(3), 639–655. https://doi.org/10.1016/j.beth.2020.08.003
18. Herman, J. (2015). Trauma and Recovery: The Aftermath of Violence--from Domestic Abuse to Political Terror. Published: New York : Basic Books.
19. Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Published: Penguin Books.
20. Krüger, A., Ehring, T., Priebe, K., Dyer, A., Steil, R., & Bohus, M. (2014). Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following
childhood sexual abuse. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.24470
21. Landes, S. J., Garovoy, N. D., & Burkman, K. M. (2013). Treating Complex Trauma Among Veterans: Three Stage-Based Treatment Models. Journal of Clinical Psychology, 69(5), 523–533. https://doi.org/10.1002/jclp.21988
22. Landes, S. J., Garovoy, N. D., and Burkman, K. M. (2013). Treating Complex Trauma Among Veterans: Three Stage-Based Treatment Models. Journal of Clinical Psychology. Volume 69. Issue 5. Pages 523–533.
23. Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
24. Linehan, M., Wilks, C. (2015). The course and evolution of dialectical behavior therapy. Am J Psychother. 69 (2), 97–110. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97
25. Choi-Kain, L. Wilks, C., Ilagan, G., Iliakis, E. (2021). Dialectical Behavior Therapy for early life trauma. Current Treatment options in Psychiatry. № 8, 111–124
26. Maslow, A. (1943). A theory of human motivation. Psychological Review, 50(4), 370-396. doi: 10.1037/h0054346
27. Nagy, S., Pickett, S., & Hunsanger, J. (2022). The relationship between mindfulness, PTSD-related sleep disturbance, and sleep quality: Contributions beyond emotion regulation difficulties. Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1073–1079. https://doi.org/10.1037/tra0000572
28. Raja, S. (2012). Overcoming Trauma and PTSD: A Workbook Integrating Skills from ACT, DBT, and CBT.
29. Reutter, K. (2019). The Dialectical Behavior Therapy Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder. Published: New Harbinger Publications.
30. Ross, C. (2005). A Proposed Trial of Dialectical Behavior Therapy and Trauma Model Therapy. Psychological Reports, 96(3_suppl), 901–911. https://doi.org/10.2466/pr0.96.3c.901-911
31. Stage-Oriented Trauma Treatment Using Dialectical Behaviour Therapy. (n.d.). https://doi.org/10.1177/070674370304800212
32. Steil, R., Dittmann, C., Müller-Engelmann, M., Dyer, A., Maasch, A.-M., & Priebe, K. (2018). Dialectical behaviour therapy for posttraumatic stress disorder related to childhood
sexual abuse: A pilot study in an outpatient treatment setting. European Journal of Psychotraumatology, 9(1), 1423832. https://doi.org/10.1080/20008198.2018.1423832
33. Steil, R., Müller-Engelmann, M., Stangier, U., Priebe, K., Fydrich, T., Weiß, J., & Dittmann, C. (n.d.). Scales for assessing therapeutic adherence and competence in dialectical behaviour
therapy for PTSD: Development and analysis of psychometric properties. European Journal of Psychotraumatology, 13(1), 2055293. https://doi.org/10.1080/20008198.2022.2055293
34. Steil, R., Schneider, A., & Schwartzkopff, L. (2021). How to Treat Childhood Sexual Abuse Related PTSD Accompanied by Risky Sexual Behavior: A Case Study on the Use of Dialectical
Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD). Journal of Child & Adolescent Trauma, 15(2), 471–478. https://doi.org/10.1007/s40653-021-00421-6
35. Sweezy, M. (2011). Treating trauma after dialectical behavioral therapy. Journal of Psychotherapy Integration, 21(1), 90–102. https://doi.org/10.1037/a0023011
36. Wagner, A., Rizvi, S., & Harned, M. (2007). Applications of dialectical behavior therapy to the treatment of complex trauma-related problems: When one case formulation does not fit all.
Journal of Traumatic Stress, 20(4), 391–400. https://doi.org/10.1002/jts.20268
37. Wilkinson, S. R. (2016). Enriching practice of dialectic behaviour therapy with the dynamic maturational model of attachment and adaptation. Clinical Child Psychology and Psychiatry,
21(1), 95–107. https://doi.org/10.1177/1359104514558430
38. Xiao, C. (2022). Efficacy and Risk Factor Analysis of DBT Therapy for PTSD-Related Symptoms in Mainland Chinese College Students Based on Data Mining. Computational Intelligence and Neuroscience, 2022, 3829623. https://doi.org/10.1155/2022/382962
2. Becker, C., & Zayfert, C. (2001). Integrating DBT-based techniques and concepts to facilitate exposure treatment for PTSD. Cognitive and Behavioral Practice, 8(2), 107–122.
https://doi.org/10.1016/S1077-7229(01)80017-1
3. Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse: A randomized clinical trial. JAMA Psychiatry, 77(12), 1235–1245. https://doi.org/10.1001/jamapsychiatry.2020.2148
4. Bohus, M., Schmahl, C., Fydrich, T., Steil, R., Müller-Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., Priebe, K. (2019). A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse. Borderline Personality Disorder and Emotion Dysregulation. Volume 6, Article number: 7
5. Bohus, M., Schmahl, C., Fydrich, T., Steil, R., Müller-Engelmann, M., Herzog, J., Ludäscher, P., Kleindienst, N., & Priebe, K. (2019). A research programme to evaluate DBT-PTSD, a modular treatment approach for Complex PTSD after childhood abuse. Borderline Personality Disorder and Emotion Dysregulation, 6. https://doi.org/10.1186/s40479-019-0099-y
6. Cameron, A., Eaton, E., Brake, C., & Capone, C. (2021). Moral injury as a unique predictor of suicidal ideation in a veteran sample with a substance use disorder. Psychological Trauma: Theory, Research, Practice, and Policy, 13(8), 856–860.
7. Cornelisse, S., Biermann, M., Enning, F., Schmahl, C., & Kleindienst, N. (2021). [DBTPTSD-EA: Treatment of posttraumatic stress disorder after interpersonal traumatization in childhood in adolescents with borderline personality disorders : A pilot study]. Der Nervenarzt, 92(7), 679–685. https://doi.org/10.1007/s00115-021-01151-8
8. Farrell, N., Deacon, B., Dixon, L., & Lickel, J. (2013). Theory-based training strategies for modifying practitioner concerns about exposure therapy. Journal of Anxiety Disorders, 27(8), 781– 787. https://doi-org.ezaccess.libraries.psu.edu/10.1016/j.janxdis.2013.09.003
9. Foa, E., Hembree, E., & Rothbaum, B. O. (2007). Prolonged exposure therapy for PTSD: Emotional processing of traumatic experiences therapist guide. Oxford University Press.
10. Follette, V., Briere, J., Rozelle, D., Hopper, J., & Rome, D. (2015). Mindfulness-oriented interventions for trauma: Integrating contemplative practices. In New York, NY: Guilford Press, 2015.I-xi, 1-372 pp. (pp. i–xi, 1–372). Guilford Press. https://www.proquest.com/ptsdpubs/docview/1924870843/5E7DA1E115954AC8PQ/17parentSessionId=NJEx%2BxZwCk7KjV3cK3GBZNiLRH3V1EtqlhRcrl77tSE%3D
11. Geddes, K., Dziurawiec, S., & Lee, C. (2013). Dialectical Behaviour Therapy for the Treatment of Emotion Dysregulation and Trauma Symptoms in Self-Injurious and Suicidal Adoles
Females: A Pilot Programme within a Community-Based Child and Adolescent Mental Health Service. Psychiatry Journal, 2013, 145219. https://doi.org/10.1155/2013/145219
12. Görg, N., Böhnke, J., Priebe, K., Rausch, S., Wekenmann, S., Ludäscher, P., Bohus, M., & Kleindienst, N. (2019). Changes in Trauma-Related Emotions Following Treatment with Dialectical Behavior Therapy for Posttraumatic Stress Disorder After Childhood Abuse. Journal of Traumatic Stress, 32(5), 764–773. https://doi.org/10.1002/jts.22440
13. Görg, N., Priebe, K., Böhnke, J. R., Steil, R., Dyer, A., & Kleindienst, N. (2017). Trauma-related emotions and radical acceptance in dialectical behavior therapy for posttraumatic stress disorder after childhood sexual abuse. Borderline Personality Disorder and Emotion Dysregulation, 4, 15. https://doi.org/10.1186/s40479-017-0065-5
14. Gratz, K., Berghoff, C., Richmond, J., Vidaña, A., & Dixon-Gordon, K. (2020). Examining posttraumatic stress disorder as a predictor of treatment response to dialectical behavior therapy. Journal of Clinical Psychology, 76(9), 1563–1574. https://doi.org/10.1002/jclp.22961
15. Harned, M. (2022). Treating trauma in dialectical behavior therapy: The DBT prolonged exposure protocol (DBT PE). Guilford Publications.
16. Harned, M., & Schmidt, S. (2019). Perspectives on a Stage-Based Treatment for Posttraumatic Stress Disorder Among Dialectical Behavior Therapy Consumers in Public Mental Health Settings. Community Mental Health Journal, 55(3), 409–419. https://doi.org/10.1007/s10597-018-0358-1
17. Harned, M., Schmidt, S., Korslund, K., & Gallop, R. (2021). Does Adding the Dialectical Behavior Therapy Prolonged Exposure (DBT PE) Protocol for PTSD to DBT Improve Outcomes in Public Mental Health Settings? A Pilot Nonrandomized Effectiveness Trial With Benchmarking. Behavior Therapy, 52(3), 639–655. https://doi.org/10.1016/j.beth.2020.08.003
18. Herman, J. (2015). Trauma and Recovery: The Aftermath of Violence--from Domestic Abuse to Political Terror. Published: New York : Basic Books.
19. Kolk, B. (2015). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Published: Penguin Books.
20. Krüger, A., Ehring, T., Priebe, K., Dyer, A., Steil, R., & Bohus, M. (2014). Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following
childhood sexual abuse. European Journal of Psychotraumatology, 5. https://doi.org/10.3402/ejpt.v5.24470
21. Landes, S. J., Garovoy, N. D., & Burkman, K. M. (2013). Treating Complex Trauma Among Veterans: Three Stage-Based Treatment Models. Journal of Clinical Psychology, 69(5), 523–533. https://doi.org/10.1002/jclp.21988
22. Landes, S. J., Garovoy, N. D., and Burkman, K. M. (2013). Treating Complex Trauma Among Veterans: Three Stage-Based Treatment Models. Journal of Clinical Psychology. Volume 69. Issue 5. Pages 523–533.
23. Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York, NY: Guilford Press.
24. Linehan, M., Wilks, C. (2015). The course and evolution of dialectical behavior therapy. Am J Psychother. 69 (2), 97–110. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97
25. Choi-Kain, L. Wilks, C., Ilagan, G., Iliakis, E. (2021). Dialectical Behavior Therapy for early life trauma. Current Treatment options in Psychiatry. № 8, 111–124
26. Maslow, A. (1943). A theory of human motivation. Psychological Review, 50(4), 370-396. doi: 10.1037/h0054346
27. Nagy, S., Pickett, S., & Hunsanger, J. (2022). The relationship between mindfulness, PTSD-related sleep disturbance, and sleep quality: Contributions beyond emotion regulation difficulties. Psychological Trauma: Theory, Research, Practice, and Policy, 14(7), 1073–1079. https://doi.org/10.1037/tra0000572
28. Raja, S. (2012). Overcoming Trauma and PTSD: A Workbook Integrating Skills from ACT, DBT, and CBT.
29. Reutter, K. (2019). The Dialectical Behavior Therapy Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder. Published: New Harbinger Publications.
30. Ross, C. (2005). A Proposed Trial of Dialectical Behavior Therapy and Trauma Model Therapy. Psychological Reports, 96(3_suppl), 901–911. https://doi.org/10.2466/pr0.96.3c.901-911
31. Stage-Oriented Trauma Treatment Using Dialectical Behaviour Therapy. (n.d.). https://doi.org/10.1177/070674370304800212
32. Steil, R., Dittmann, C., Müller-Engelmann, M., Dyer, A., Maasch, A.-M., & Priebe, K. (2018). Dialectical behaviour therapy for posttraumatic stress disorder related to childhood
sexual abuse: A pilot study in an outpatient treatment setting. European Journal of Psychotraumatology, 9(1), 1423832. https://doi.org/10.1080/20008198.2018.1423832
33. Steil, R., Müller-Engelmann, M., Stangier, U., Priebe, K., Fydrich, T., Weiß, J., & Dittmann, C. (n.d.). Scales for assessing therapeutic adherence and competence in dialectical behaviour
therapy for PTSD: Development and analysis of psychometric properties. European Journal of Psychotraumatology, 13(1), 2055293. https://doi.org/10.1080/20008198.2022.2055293
34. Steil, R., Schneider, A., & Schwartzkopff, L. (2021). How to Treat Childhood Sexual Abuse Related PTSD Accompanied by Risky Sexual Behavior: A Case Study on the Use of Dialectical
Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD). Journal of Child & Adolescent Trauma, 15(2), 471–478. https://doi.org/10.1007/s40653-021-00421-6
35. Sweezy, M. (2011). Treating trauma after dialectical behavioral therapy. Journal of Psychotherapy Integration, 21(1), 90–102. https://doi.org/10.1037/a0023011
36. Wagner, A., Rizvi, S., & Harned, M. (2007). Applications of dialectical behavior therapy to the treatment of complex trauma-related problems: When one case formulation does not fit all.
Journal of Traumatic Stress, 20(4), 391–400. https://doi.org/10.1002/jts.20268
37. Wilkinson, S. R. (2016). Enriching practice of dialectic behaviour therapy with the dynamic maturational model of attachment and adaptation. Clinical Child Psychology and Psychiatry,
21(1), 95–107. https://doi.org/10.1177/1359104514558430
38. Xiao, C. (2022). Efficacy and Risk Factor Analysis of DBT Therapy for PTSD-Related Symptoms in Mainland Chinese College Students Based on Data Mining. Computational Intelligence and Neuroscience, 2022, 3829623. https://doi.org/10.1155/2022/382962
Abstract views: 808 PDF Downloads: 525
Published
2023-07-25
How to Cite
Andrushko, Y. (2023). WORKING WITH TRAUMA IN DIALECTICAL BEHAVIORAL THERAPY: LITERATURE REVIEW . Scientific Journal of Polonia University, 57(2), 8-19. https://doi.org/10.23856/5701
Section
LANGUAGE, CULTURE, COMMUNICATION
