DBT for Post-Traumatic Stress Disorder (PTSD)
Approximately 3.5% of US adults struggle with PTSD each year.
DBT is an effective approach for treating PTSD and related issues such as emotion regulation. Schedule a Free Consultation
Is DBT effective for this diagnosis?
Dialectical Behavioral Therapy (DBT) is can be effective for treating Post-Traumatic Stress Disorder (PTSD) and as a precursor to other forms of trauma treatment. Methods of DBT that have been adapted specifically to treat PTSD have been shown to be even more effective. We, at the DBT Center of Marin, offer this adapted form of DBT as well as Standard and Informed DBT. Informed DBT integrates other evidence-based, cognitive-behavioral interventions into DBT to create a multidimensional treatment to best address your PTSD.
What is PTSD?
Post-Traumatic Stress Disorder is caused by experiencing or witnessing a terrifying, impactful event. In the case of Complex PTSD, it is a series of ongoing events that causes the trauma. Symptoms include intrusive memories, avoidance, changes in physical and emotional reactions, and negative changes in thinking and mood. The symptoms may start soon after the event or appear years later. In either case, PTSD is treatable. PTSD can be mild or debilitating and can harm your quality of life.
How does DBT support this diagnosis?
DBT can help minimize the symptoms of PTSD. Through Mindfulness, DBT instructs you in methods of grounding to stay in the present moment. Emotion regulation and distress tolerance DBT skills can help manage the upset you feel as a response to intrusive thoughts. Support for these symptoms extends beyond the therapy session through phone coaching as a crisis intervention tool in addition to individual weekly psychotherapy and skills groups. DBT provides clients with guidance on how to apply therapeutic skills to the unique situations in their lives.
Which specific modules are most relevant?
Learn how to manage your PTSD through the 4 components of DBT: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
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Which DBT modules are most relevant for substance abuse?
Mindfulness: Learn how to be truly present.
Mindfulness skills teach you how to focus on your current situation, stopping rumination on painful past experiences or future uncertainty. These skills can help you reduce dissociation and ground you in your body. Regular mindfulness practice can help keep you grounded and increase your mental stability. This makes you better able to recognize your ineffective behaviors and vacillating emotions and to cope ahead for future stressors.
Emotion Regulation: Learn to manage, change, and accept the different emotions, so that your emotions don’t control you.
Dysregulated emotions can be a result of other PTSD symptoms. DBT teaches Emotion Regulation skills to stop unwanted emotions from starting in the first place, regulate or change such emotions once they start, and learn to accept and become comfortable with unavoidable emotions. DBT prioritizes taking care of your body to stabilize your mind, helping effective behaviors become a habit.
Distress Tolerance: Learn to tolerate painful emotions and situations that seem unbearable, and avoid behavior that can make things worse.
Unwanted, intrusive thoughts can cause a lot of distress. Distress Tolerance offers tangible skills to use in place of ineffective behaviors that can make things worse. These techniques range from guided self-soothing skills to easy-to-use methods that activate the parasympathetic nervous system, using your own body’s chemistry to reduce distress.
Interpersonal Effectiveness: Learn to communicate with others in respectful ways while maintaining healthy boundaries and upholding positive self-respect.
Your PTSD may make it hard to trust or interact with others. DBT guides you in both being a good friend or partner and getting your needs met. Interpersonal effectiveness skills provide clear instruction on how to maintain relationships with others, ask for what you want, and uphold your self-respect. Interpersonal Effectiveness skills also provide tools to head off problems and resolve conflicts before they become overwhelming.
References to research that demonstrate the efficacy of the treatment for the diagnosis
1. This study found that DBT treatment reduced the behaviors preventing patients from entering PTSD treatment.
Harned, M. S., Jackson S. C., et al. Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self‐injuring women with borderline personality disorder. Journal of Traumatic Stress 23, 421-429 (2010). https://doi.org/10.1002/jts.20553
2. This research study compared DBT-PTSD with Cognitive Processing Therapy in treating complex PTSD and found that DBT-PTSD achieved greater symptomatic remission.
Bohus, M., Kleindienst, N., et al. 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. JAMA Psychiatry 77, 1235–1245(2020). doi:10.1001/jamapsychiatry.2020.2148
3. This study showed that DBT with Prolonged Exposure protocol led to larger, more stable treatment gains than DBT without PE.
Harned, M.S., Linehan, M.M., et al. A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy 55, 7-17 (2014). https://doi.org/10.1016/j.brat.2014.01.008