Terapia dialectica del comportamiento

DBT – Poster presentation/ Canterbury University/ 2011
Brief Overview:
Dialectical Behaviour Therapy (DBT) was originally formulated by Marsha Linehan (1993). It is a cognitive-behavioural treatment for individuals with complex and difficult to treat mental disorders and for those who struggle to regulate their emotions. DBT has strong bio-social theoretical underpinnings.
The DBT approach isto balance the behavioural focus on change (problem solving) with the emphasis on acceptance (validation). It makes use of the philosophical principles of Zen Buddhism and integrates these two contrasting approaches using dialectical philosophy.
DBT’s goal is to help change the behavioural, emotional, and thinking patterns associated with everyday problems, while promoting the development of andconfidence in inner wisdom.
Standard DBT treatment modes include: individual therapy, group skills training (mindfulness, interpersonal effectiveness, emotion regulation, distress tolerance, self-management), telephone consultation and therapist consultation meetings.
DBT five essential functions: improving client motivation to change; enhancing client capabilities; generalization of newbehaviours; structuring the environment; enhancing therapist capability and motivation.

Background:
DBT has been experimentally demonstrated to be generally effective in treating individuals with borderline personality disorder (BPD) and was originally developed for chronically suicidal individuals with BPD. Other evidence suggests that DBT can also be an effective therapy in treating patients whopresent with a variety of symptoms and behaviours associated with a range of mood disorders and anger-related problems.
Many people exhibiting significant mental health and behavioural problems have come into contact with the justice system. Often they present with emotional dysregulation and antisocial behaviour, consequently increasing their potential for suicidal ideation, mood disturbance,anger and aggression. Some offenders have particular difficulty adjusting to the rules and routines of life within prison and are more likely to incur violations and accumulate disciplinary consequences while incarcerated.
Without appropriate treatment, these behaviours are likely to persist, causing distress to the respective population and adding stress to the correctional environment.QUESTION:
Can the implementation of dialectic behavioural therapy programmes in prisons prove effective in addressing mood disorders and behavioural problems with offenders?

INVESTIGATION:
In answering this question a search of relevant literature was undertaken. The investigation revealed a number of studies that have implemented DBT programmes to treat inmates.
Three of these studies wereselected that are representative of the general findings of such research. Table 1.0 provides a summary of these three studies and their results.

Table 1.0
STUDIES | POPULATION | METHOD | RESULTS |
STUDY 1 2002 | Juvenile female offenders correctional facilityN=90 | Quasi-experimental study comparing pre and post outcomes from implementing DBT treatment, compared to treatment as usual (TAU) |Behavioural problems decreased during intervention with DBT.Improved transition to and participation in prison services.Use of punitive responses by staffdecreased compared to the year prior on one unit.The evaluation demonstrated the efficacy of providing DBT to female offenders in a residential setting. |
STUDY 22009 | Female and male incarcerated offenders N=18 menN=45 women | DBT-CM groupswereheld over 16 weeks followed by random assignment to DBTcoaching or case management condition, with sessions taking place individually for eight weeks | Significant reduction in targeted behaviour was found from baseline to following the 16 week DBT-CM skills treatment groups. The study supports the value of DBT-CM for management of aggressive and impulsive behaviours in prison settings. |...