Quote:
Originally Posted by Lillylillie
@minniemouse. Holy crap that was useful!! Thank you!!! You'd think they might explain that to a person just starting out in DBT! How confusing. Why didn't she (my DBT therapist) say any of that?
|
Wow, that's pretty surreal that they would not explain anything about DBT and then expect people to know what's going on! DBT is confusing and different from what people typically think of as psychotherapy, so it seems especially important to get people's informed consent...
Quote:
Originally Posted by sunrise
Can you say more about how stage 2 of DBT addresses the trauma? I guess I've only heard of stage 1, which is coping skills. It didn't seem to me that DBT went beyond coping skills to healing from and processing trauma. So it is good to hear there is a stage 2. How is the DBT trauma work done once the client has learned the coping skills?
|
sunrise, yes, DBT actually has four stages. This page has a pretty good description at the bottom:
http://www.sfdbt.com/DBT.htm
You're right that the DBT model is pretty underspecified for Stage 2 onwards- it doesn't articulate how to process trauma, for example. The therapist needs to get create here and use whatever other models and frameworks while still holding the overall ethos of DBT in mind. My T and I are using Schema Therapy at stage 2.
In my experience, most DBT services focus on Stage 1, and when people talk about DBT they are generally talking about Stage 1. Particularly in these cash-strapped times, it's easy for services to fous on reducing dangerous behaviour but then not follow through. Stage 1 is important of course as it's about saving people's lives, but I do feel it's important not to leave people in a state of 'quiet desperation' (as DBT calls it)- it's too difficult to maintain new skilful behaviours long term if the PTSD isn't addressed and if the client's life doesn't actually become more worth living.