I recently returned from the International Society for the Improvement and Teaching of Dialectical Behavior Therapy (ISITDBT) meeting in Chicago and wanted to share some of the impressive new research in the world of DBT. There were over 400 attendees from all over the world; registration needed to be closed because of room capacity.
After starting with mindfulness, there were three presentations on research happenings.
- Adapting DBT for Pre-Adolescent Children with Severe Emotional and Behavioral Dysregulation: Feasibility and Preliminary Efficacy Trials (Francheska Perepletchikova, Ph.D., Donald Nathanson, LCSW Weill Cornell Medical College) Francheska and her group at Cornell has been working on adapting DBT for younger children and her manual is in the process of getting finalized and released. How amazing it would be to be able to capture the younger children at risk and provide early intervention treatment for them and their families!
- Computerized Trans-Diagnostic Dialectical Behavior Therapy Skills Training for Emotion Dysegulation (Anita Lungu, Ph.D., Chelsey Wilks, M.S., Garret Zieve, B.Sc., Maya Krek B.Sc., Aleen Potts B.Sc., Hannah Lessing, B.Sc., Marivi Navarro, Ph.D., Marsha Linehan, Ph.D., University of Washington). There are an estimated 45 million people in the world who suffer from a mental or behavioral disorder (WHO, 2012) and in the developed countries 44-70% of people with mental health problems don’t get treated and even worse, in the developing countries, 90% of people with mental health issues don’t get treatment. Therefore, Anita along with help from Marsha Linehan and funding from the NIMH are in process of working on how to use technology to get treatment to more people. Addressing the goal of creating effective computerized therapy was also discussed in Marsha’s keynote address and is a current passion of hers. They have developed software called iDBT-ER which teaches DBT skills electronically. VERY interesting and the research shows it is quite effective.
- The Effect of Therapist Use of Validation Strategies on Change in Client Emotion in Individual DBT Treatment Sessions (Amanda Carson-Wong, Christopher D. Hughes, Shireen L. Rizvi, Rutgers University) Amanda presented on some research she has done in looking at validation levels and evaluating how each of these levels effect change in a client during a session. This is consistent with Marsha’s call to study the different parts of DBT to identify the role and effectiveness of specific modes and strategies on recovery. Conclusions were that although there is more research needed, it wasn’t the frequency of validation, it was the type of validation that effected different changes in client response in sessions. It was so nice to see a Masters level student presentation at this conference which usually has doctoral people presenting. (my bias ) 🙂
When we came back from lunch, we had our annual DBT Sing Along. Charlie, Marsha and the DBT singing group led us all in what is always a fun exercise in singing songs about DBT that have been re-written to the tunes of other songs. (of course, non judgmentally!)
The afternoon breakout workshops were all so interesting, it was hard to pick but I attended Charlie Swenson’s. As many workshops and trainings I’ve attended with Charlie (he was one of my intensive training teachers way back in 1998) he continues to be engaging and interesting and led us in looking more closely at the use of change, acceptance and dialectical strategies in sessions. These were afternoon breakout workshops:
- Purpose, Presence, and Flow: the Application of DBT’s Principles to Challenging Situations and Moments in Psychotherapy (Charlie Swenson, M.D., UMass Medical School)
- Therapy Interfering Behaviors (TIBs) in Phone Coaching (Julie Snyder, Psy.D., CBT California/DBT California, Julie Orris, Psy.D., CBT California/DBT California, and Kelly Graling, Ph.D., Cognitive Behavioral Consultants)
- Cultural Diversity in DBT (Suhadee Henriquez, LCSW; Lisa Bolden, Psy.D., Harbor UCLA Medical Center: Marcus Rodriquez, M.A., Duke University)
- DBT Problem-Solving in Action: Solving Common Therapist Errors in Behavioral Analyses (Dr Michaela Swales, Consultant Clinical Psychologist, Bangor University UK, Director British Isles DBT Training Team, & Preseident, Society for DBT in UK & Ireland; Heidi Heard, Consultant, private practice)
We then all got back together while Alan Fruzzetti, PhD presented on “Making Your Consultation Team Effective”. It is so easy to drift and he demonstrated, with his own team doing role plays, how we can keep each other on track and be the most effective therapists we can be. Our team definitely brought back some important messages to the rest of our team so that we can improve ourselves for the benefit of our clients.
Finally, Marsha presented her annual address. She excitedly announced the completion of DBT Certification, after many, many years and lots of donated money and time of countless people and she recognized all who helped and congratulated the first group of certified DBT therapists. The next steps are to certify DBT Skills Trainers, and DBT Programs. She talked about the need for certification, given that since she published, there has been a lot of DBT dissemination, yet there has been no system for monitoring and insuring that those therapists who are providing DBT are doing so with fidelity to the model and with accuracy and adherence. Therefore, people receiving DBT are actually at risk for not getting better and even worse, thinking DBT is not for them when they really haven’t had it the way it is suppose to be provided. Then, Marsha went on to talk about the new age of computerized treatment and as always, put out a call for all of us to get involved in research. She talked passionately about how the suicide rate is the highest in 25 years and how we need more clinicians trained in treating suicide, and more research to help us really understand what works and what doesn’t. She also presented some preliminary research on how hospitalization can be iatrogenic which means it can cause someone to get worse. She has always said that, but now there is preliminary research showing that after being discharged, there actually is an increased risk for suicide and that perhaps DBT decreases suicide because our focus is to keep people out of hospitals. Again….more research needed.
For those clinicians who are either DBT therapists, or are in training or thinking about becoming DBT therapists, I highly recommend this conference. It is tied to the annual ABCT conference which is one of the biggest conferences on Cognitive Behavioral Therapy in the world. As a matter of fact, ABCT helps support ISITDBT by donating the conference rooms. The quality and the professionalism of the presentations and dedication to empirically based treatments is leading the way on effective treatment for mental health problems. Save the date and come join us next year in the BIG APPLE, New York City. ISITDBT is October 27th, 2016 and the ABCT Meeting is October 27-30, 2016.