Dialectical behavioral therapy in London

Dialectical behavioral therapy, or DBT therapy in London for short, is a form of cognitive behavioral therapy, disorder-specific Borderline Personality Disorder is applied and combines many therapeutic methods. It builds on a dialectic approach. This means that conflicting problem areas or points of view should be recognized and accepted, and a balance should be developed between them. 2nd story Dialectical behavioral therapy was pioneered by Marsha M. Linehan in the 1990s therapy chronic suicidal patients with borderline personality disorder developed.

1. Areas of application

• outpatients well as stationary therapy of Peoplewith with borderline personality disorder
• therapy for people with self-injurious behaviour (SVV), which is part of other psychiatric disturbances that occurs
• therapy of eating disorder

1. Elements of Therapy

The best DBT therapy in London includes the building blocks of individual therapy, group therapy, telephone counselling, supervision and pharmacotherapy. 4.1. individual therapy In the context of individual therapy, individual problems are addressed. Furthermore, the patient is required to keep a diary of his inner states of tension, their consequences, the countermeasures taken and their success. As a basis for the therapy, a therapy contract is concluded that reflects the typical behavior of borderline personality disorder, such as acting from the affect and action should counteract. In this agreement, the patient undertakes to behave according to the rules discussed and to participate in the therapy, the therapist in exchange for providing the best possible help. 4.2. group therapy In group therapy, skill training takes place in five modules. The modules of the DBT are:

• Inner mindfulness: Learning to perceive one’s own sensations and to describe what is or is happening.
• Stress Tolerance: Skills (skills) that make it possible to endure a difficult situation, to relieve inner tension and to accept reality as it is.
• Dealing with feelings: observing, describing and understanding feelings with the aim of emotional regulation.
• Interpersonal Skills: The ability to build and maintain relationships should be learned. To question the intentions of the contact and to put aside one’s own wishes in the sense of a friendship.
• Self-esteem: Learning to do something good for yourself and to allow positive thoughts about yourself.

The modules are usually completed in different groups:

• Reference group: Pure patient group, no presence of staff, according to DBT group rules. This is where the exchange of skills, behavioral analyzes and “homework” takes place. The solution to everyday problems or weekend leave is planned.
• Basic group: Here you will find the meaning of psychoeducation Topics such as symptoms, affect regulation, dissociation, difficulties with interaction, etiological models, and pharmacotherapy/psychotherapy place.
• Skills group: Together with skills trainer(s), new skills from all areas are developed here in the patient group and their application is checked.
• Mindfulness group: exercises for mindfulness can be practiced here in the group in their various forms. Depending on the group dynamics and current issues on the ward, the therapy can have an activating or calming character.

4.3. pharmacotherapy The application of psychotropic drugs does not play a major role in the therapy of borderline personality disorders. In individual cases neuroleptics, antidepressants or tranquillizers to make it easier for patients to enter therapy and to cushion crises. 4.4. Proceed The therapy is divided into two stages:

1. learning from self control: The patient learns to perceive and control his own feelings, to avoid risky behavior by using learned skills and thus to take responsibility for himself.
2. Reduction of emotional suffering: trauma processing, social skills training, reduction of avoidance behavior, building a more positive attitude towards yourself, etc.

4.5. status After some controlled randomized trials DBT is recognized as “state of the art” therapy and is classified as the therapy of choice in the S2 guidelines for the treatment of borderline personality disorder. How does Dialectical Behavior Therapy (DBT) work?   DBT was originally developed to be applied in group therapy, supported by individual therapy. Participants attend two weekly sessions, one in a group for social skills training and another individual session, where the skills learned are discussed in more depth in relation to the individual’s private life. However, few groups are available in Brazil and therapists who work with the technique try to use flexibility to offer effective treatment. In this way, at Núcleo Interface, individual sessions alternate between skills training and individual therapy, with the main objective of offering space to learn new strategies to deal with uncontrolled emotions. Skills to be developed:

• Mindfulness (being in the “here and now”)
• Interpersonal effectiveness (dealing appropriately with others)
• Emotional regulation (dealing with strong emotions)
• Stress tolerance (practicing being more stress tolerant)