DBT for PTSD Related to Childhood Sexual Abuse in Patients with Borderline Personality Disorder – A Multicomponent Program
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[Radison Blu, Östergatan 10]

Tamar Neubaer


Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) was tailored to treat adult PTSD following childhood sexual abuse (CSA) including patients with borderline personality disorder (BPD). Since most of these patients are experiencing severe problems in emotion regulation, we merged DBT principles and trauma-specific techniques. The treatment program was initially conducted as a three month residential program but is also applicable under outpatient conditions.

From a DBT perspective, PTSD-typical dysfunctional behaviors can predominantly be understood as strategies for the avoidance or escape from trauma-associated primary emotions like powerlessness, threat, anxiety, disgust, humiliation, or lust. Corroborated by dysfunctional cognitive assumptions, dysfunctional behaviors such as self-injury, suicidal ideation, dissociation, or intoxication and dysfunctional secondary emotions such as shame, guilt, self-hatred, or chronic anger, develop over time into inappropriate self-concepts which strongly impair quality of life.

DBT-PTSD primarily aims to help patients a) revise their fear of trauma-associated primary emotions, b) question whether secondary emotions like guilt and shame are appropriate, and c) radically accept trauma facts in order to establish a life worth living.

Safety, acceptance and effectiveness of DBT-PTSD have been evaluated within pre-post studies and randomized controlled studies at the Central Institute of Mental Health, University of Heidelberg. The data revealed that the treatment program is highly acceptable (dropout-rates < 10%) and safe and effective (PDS CAPS effect sizes > 1.3).

The workshop will provide an introduction to DBT-P: Prerequisites, treatment targets, and structure of the treatment basic principles and rules treatment modules: emotion regulation skills, mindfulness group therapy, discrimination training, cognitive interventions and moderated exposure.