EMDR
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched and highly effective psychotherapy method proven to help people recover from trauma and other distressing life experiences, including PTSD, anxiety, depression, and panic disorders.
EMDR therapy does not require talking in detail about the distressing issue or completing homework between sessions. EMDR therapy, rather than focusing on changing the emotions, thoughts, or behaviors resulting from the distressing issue, allows the brain to resume its natural healing process.
EMDR therapy is designed to resolve unprocessed traumatic memories in the brain. For many patients, EMDR therapy can be completed in fewer sessions than other psychotherapies.
While many times traumatic experiences can be managed and resolved spontaneously, many may not be processed without help. Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create feelings of overwhelm, of being back in that moment, or of being “frozen in time.” EMDR therapy helps the brain process these memories, and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved.
Numerous national and international organizations recognize EMDR therapy as an effective treatment. Amon them, the American Psychiatric Association, the International Society for Traumatic Stress Studies, the Substance Abuse and Mental Health Services Administration, and the World Health Organization as well as many others.
TF-CBT
Trauma-Focused, Cognitive Behavior Therapy (TF-CBT) is an evidenced based practice treatment designed to support children, adolescents, and their parents overcome the impact of traumatic events. These traumatic events may include, but are not limited to, sexual abuse, physical abuse, domestic violence, an unexpected death of a loved one, and community violence. TF-CBT treatment typically lasts between 12 to 16 sessions and these sessions consist of individual sessions for the child/adolescents, individual sessions for parent, and conjoint sessions between child/adolescent and parents. Numerous studies have indicated that TF-CBT is more effective in supporting children and adolescents overcome trauma than other therapeutic interventions.
TF-CBT treatment is focused on assisting children and adolescents learn that the trauma is not their fault and that they are not the only one who have survived a similar traumatic event, identify feelings and learn how to manage them, learn how to relax and tolerate trauma reminders, learn how to replace negative thoughts with more helpful thoughts, and learn strategies to increase/enhance safety.
An important goal in treatment is to provide the child/adolescent an opportunity to discuss details about the trauma in a supportive and nurturing environment. In developing his or her trauma narrative the child’s brain begins to replace traumatic memories with more helpful thoughts about the trauma. Overtime, these powerful traumatic reminders begin to lose their impact on the child and become less frequent. At the end of trauma-focused treatment, some children/adolescents not only are able to overcome their traumatic event but also thrive and excel in their lives post-treatment.
DBT PROLONGED EXPOSURE (DBT PE)
The Dialectical Behavior Therapy Prolonged Exposure protocol (DBT PE) is a treatment for PTSD that is designed to be added to DBT. It is based on Prolonged Exposure (PE) therapy, a first-line evidence-based treatment for PTSD, and has been adapted to fit the needs and characteristics of typical DBT clients.
How Does it Work?
People with PTSD often avoid emotions, thoughts, and situations that remind them of the traumas they have experienced. Although avoidance reduces distress in the short run, it keeps you from recovering from PTSD in the long run. DBT PE works by helping you to gradually approach trauma-related memories and situations so that PTSD will improve and you will gain more control over your life.
What is Involved?
DBT PE uses three core procedures to treat PTSD:
- In vivo exposure involves confronting situations you avoid “in real life.” You will be asked to gradually approach people, places, and things you have been avoiding because they remind you of your trauma, feel dangerous, or bring up distressing emotions associated with your trauma. This will help you learn that these situations are safe and you can handle them so that they will no longer cause intense distress.
- Imaginal exposure involves repeatedly describing traumatic events out loud during your therapy sessions. By talking and thinking in detail about what happened to you, your trauma memories will become less overwhelming and will be less likely to come up unexpectedly at other times.
- Processing involves talking with your therapist about the emotions and thoughts that arise as a result of imaginal exposure. The goal is to help you gain a new perspective about the traumas you have experienced that will cause you less distress and enable you to change unhelpful trauma-related patterns in your life.
How Long Does it Last?
The length of DBT PE varies across people but typically lasts between 12-15 sessions. The number of sessions you need will be determined based on your progress during treatment.
How is DBT PE Combined with DBT?
The combined DBT and DBT PE treatment occurs in three stages. First, DBT is used to help you gain control over impulsive and self-damaging behaviors and learn coping skills to better tolerate and regulate your emotions. Once these goals are achieved, you will advance to the second stage of treatment in which DBT PE is used to treat your PTSD. DBT PE sessions are typically delivered in addition to your regular DBT individual and group sessions, which means that you may have more frequent and/or longer sessions during this stage of treatment. After DBT PE is complete, you will return to receiving DBT alone to address whatever goals are important to you at that time. For many clients, this third stage of treatment focuses on increasing self-respect and building a life that is no longer limited by PTSD.
© 2021, Melanie Harned, PhD
DBT-PTSD
DBT-PTSD is a comprehensive multicomponent treatment that focuses specifically on the treatment of Complex Post Traumatic Stress Disorder with and without the diagnosis of Borderline Personality Disorder.
Complex post-traumatic stress disorder (C-PTSD; also known as complex trauma disorder) is a psychological disorder that can develop in response to prolonged, repeated experience of interpersonal trauma in a context in which the individual has little or no chance of escape. This kind of trauma is combined with what is known as “traumatic invalidation”. In other words, the trauma is frequent and repeated, is experienced as inescapable and either cannot be shared due to threat or perceived threat to self or loved ones and/or the abuse is shared, and it is not believed.
Based on the principles of Dialectical Behavior Therapy (DBT), DBT-PTSD utilizes trauma-specific cognitive and skills-assisted exposure-based techniques and interventions to improve acceptance as well as compassion for self and others.
It has been developed for and tested in both a three-month residential treatment and a 12-month outpatient program and has been found to be effective in the treatment of Complex PTSD.
