Amy W Wagner Marsha M Linehan

Dialectical behavior therapy (DBT) was initially developed for the treatment of chronically suicidal individuals who meet criteria for borderline personality disorder (BPD). Because the majority of people with BPD have histories of trauma and meet criteria for posttraumatic stress disorder (PTSD), it seems appropriate to describe DBT in a book on the treatment of trauma. There are two potential applications of DBT to individuals with histories of trauma. One main application is to achieve...

Integrative Behavioral Couple Therapy

An important development in behavioral couple treatment has been the development of integrative behavioral couple therapy (IBCT Christensen, Jacobson, & Babcock, 1995). This approach to the treatment of couple distress is consistent in many ways with the principle-based intervention that we present in this chapter. IBCT is an empirically validated intervention that combines the change-oriented strategies of traditional behavioral couple therapy (TBCT Jacobson, & Margolin, 1979), including...

Cognitive Models Of Ptsd

Information-processing theory has been widely used to understand the development and maintenance of anxiety disorders, including PTSD (Lang, 1979, 1985). This theory suggests that emotions, such as fear, are encoded in memory in the form of networks, where representations of anxiety-provoking events are stored. Fear networks are hypothesized to contain three important types of information (1) information about the feared stimuli or situation (2) information about the person's response to the...

Does Asd Predict Ptsd

There are now 12 prospective studies of adults that have assessed the relationship between ASD in the initial month posttrauma and development of subsequent PTSD (Brewin, Andrews, Rose, & Kirk, 1999 Bryant & Harvey, 1998 Creamer, O'Donnell, & Pattison, 2004 Difede et al., 2002 Harvey & Bryant, 1998a, 1999b, 2000a Holeva, Tarrier, & Wells, 2001 Kangas, Henry, & Bryant, 2005 Murray, Ehlers, & Mayou, 2002 Schnyder, Moergeli, Klaghofer, & Buddeberg, 2001 Staab, Grieger,...

Complications And Obstacles For Fap Therapists In Treating Complex Ptsd

Trauma-focused treatments can be emotionally difficult for therapists of any theoretical orientation, leading to the potential for vicarious traumatization (Brady, Guy, Poelstra, & Fletcher-Brokaw, 1999) and secondary traumatic stress disorder and compassion fatigue (Figley, 1995). Histories of trauma are also found among mental health professionals, with studies suggesting that about 30 report a history of trauma during childhood (Follette, Polusny, & Milbeck, 1994 Pope &...

Recent Advances in Psychological Assessment of Adults with Posttraumatic Stress Disorder

Brief Terence M. Keane Originally conceptualized in the DSM-III American Psychiatric Association, 1980 as relatively rare, traumatic events and posttraumatic stress disorder PTSD are now viewed as common across the world. As interest in PTSD grows internationally, so does the need for sensitive and specific diagnostic interviews, questionnaires, and psychological tests. As progress is made in understanding the impact of trauma on psychological functioning, the...

Overview of Treatment Approach Acceptance Theory and Intervention

Hexaflex Case Monitoring Tool Act

The following section provides detailed information about how to use ACT in a clinical setting. There are several main goals that are generally presented in order when using ACT. This is not to say, however, that the ACT goals cannot be presented in a different order, or that the ACT therapist cannot choose to emphasize one goal over another, depending on the client's specific issues. ACT is diverse and flexible and allows for a range of concepts to be presented depending on client needs. Here...

Case Example Illustrating Common Obstacles

Sam was a 34-year-old unemployed European American male with a college education. He had a long history of alcohol and drug abuse, starting with his first drink at the age of 8. In addition, Sam had an extensive history of being physically and sexually assaulted. At the time he sought treatment, he had already been abstinent from alcohol and drugs for 6 months, due to a previous traumatic incident. Thus, at his initial assessment, Sam met criteria for PTSD, major depressive disorder, and...

Persistent Avoidance of Stimuli Associated with the Trauma

A child who is physically and sexually abused over an extended period of time is, of course, motivated to escape and avoid the pain and humiliation. In contrast to a circumscribed trauma, the direct avoidance of the aversive stimuli would be impossible because the child cannot physically escape or prevent the exposure. When a beloved parent or caretaker is also the perpetrator of the abuse, the trauma is particularly heart-wrenching. Incest creates an association between love, dependence, and...

Edward S Kubany Tyler C Ralston

There is considerable evidence that cognitions play an important role in the maintenance or chronicity of posttraumatic stress e.g., Brewin, Dalgleish, amp Joseph, 1996 Ehlers amp Clark, 2000 Foa, Ehlers, Clark, Tolin, amp Orsillo, 1999 Kubany et al., 1996 Kubany amp Watson, 2002, 2003a . This research has emphasized survivors' phenomenology, much of which involves guilt and shame see Kubany, 1998, for a brief review . Research reviewed elsewhere shows that trauma-related guilt is a common...

Guilt Assessment

Assessment is an integral part of the CT-TRG model. We use a structured interview and specially designed questionnaires 1 to identify idiosyncratic sources of trauma-related guilt, 2 to assess clients' faulty thinking patterns, and 3 to evaluate treatment efficacy. Structured Guilt Assessment Interview We use a structured interview to identify important issues across five domains of guilt Kubany amp Manke, 1995 . This interview which also includes follow-up probes consists of five core...

Overview of Treatment Approach

As mentioned, DBT is structured into stages of treatment, and these correspond to stages of disorder. Stage I DBT targets severe behavioral dyscontrol, with the goal of achieving overall behavioral control. Once behavioral control is achieved, it becomes possible to work on other important goals Stage II targets problems with emotional experiencing including PTSD-related problems , with the goal of increasing the capacity for normative emotional experiencing without escalating or blunting stage...