Dialectical Behavioural Therapy: A 2-day workshopInstructor: Dr. Shelley McMain, Ph.D., C. Psych. Dialectical behaviour therapy (DBT) is a comprehensive cognitive-behavioural treatment for complex, difficult-to-treat mental disorders. Originally, DBT was developed to treat chronically suicidal individuals; however, DBT has evolved into a treatment for multi-disordered individuals with borderline personality disorder (BPD). DBT has since been adapted for other seemingly intractable behavioral disorders involving emotion dysregulation, including substance dependence in individuals with BPD and binge eating, to other clinical populations (e.g., depressed, suicidal adolescents), and to a variety of settings (e.g., inpatient, partial hospitalization, forensic).
DBT is based on a combined capability deficit and motivational model of BPD which states that (1) people with BPD lack important interpersonal, self-regulation (including emotional regulation) and distress tolerance skills, and (2) personal and environmental factors often both block and/or inhibit the use of behavioral skills that clients do have, and reinforce dysfunctional behaviors. DBT combines the basic strategies of behavior therapy with eastern mindfulness practices, residing within an overarching dialectical world view that emphasizes the synthesis of opposites.
The fundamental dialectic in DBT is between validation and acceptance of the client as they are within the context of simultaneously helping them change. Acceptance procedures in DBT include mindfulness (e.g., attention to the present moment, assuming a non-judgmental stance, focusing on effectiveness) and a variety of validation and acceptance-based stylistic strategies. Change strategies in DBT include behavioral analysis of maladaptive behaviors and problem-solving techniques, including skills training, contingency management (i.e., reinforcers, punishment), cognitive modification, and exposure-based strategies.
As a treatment model, DBT aims address the following goals: (1) enhancing behavioral capabilities, (2) improving motivation to change (by modifying inhibitions and reinforcement contingencies), (3) assuring that new capabilities generalize to the natural environment, (4) structuring the treatment environment in the ways essential to support patient and therapist capabilities, and (5) enhancing therapist capabilities and motivation to treat patients effectively.
In standard DBT, these functions are divided among modes of service delivery, including individual psychotherapy, group skills training, phone consultation, and therapist consultation team.
Workshop Description:
This 2-day course will provide an overview of DBT. Participants will learn how to explain the DBT biosocial theory and competently structure DBT sessions. Core treatment strategies for managing difficult behaviours and avoiding therapeutic impasses will be presented.
Date: December 10 & 11, 2010
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About the Instructor:
Dr. McMain is a registered psychologist as well as a researcher, clinician and educator whose focus has been in psychotherapy methods and outcomes for borderline personality disorder. Dr. McMain is the Head of the Borderline Personality Disorder Clinic at the Centre for Addiction and Mental Health. She is an Assistant Professor in the Department of Psychiatry at the University of Toronto. She is also currently the principal investigator on a Canadian Institute of Health Research funded multi-site trial for the treatment of borderline personality disorder.
Widely recognized as a leader in DBT, Dr. McMain is frequently invited to give presentations on DBT and has offered consultation to hospitals on the co-ordination of DBT services for people diagnosed with Borderline Personality Disorder. In addition, she has published a number of journal articles and book chapters on DBT, personality disorders, the treatment of people diagnosed with concurrent disorders and psychotherapy research. Dr. McMain obtained her Ph.D. in clinical psychology from York University.
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