Dialektisch-behaviorale Therapie nach der Akutphase - Die Herausforderung annehmen, das System zu verlassen (DBT-ACES)

Abstract

Recent process analyses on patients with borderline personality disorder (BPD) show that the acute symptomatology apparently is subject to considerable fluctuations, for example suicidal, self-harming or impulsive behavior. Emotional problems, like a continuing depressive mood or feelings of anger, identity disturbances, lack of skills in reaching social goals and insufficient life satisfaction as well as longterm injuries such as pain syndromes or metabolic syndromes all have a high risk to become chronic. Today, the psychotherapeutic treatment with dialectic behavioral therapy (DBT) provides ample empiric evidence of efficacy in clinical work with BPD patients; but the manual focuses predominantly on interventions at the first stage of treatment. All following stages have not been sufficiently researched and manualized yet. Developed by the team of K.A. Comtois in Seattle, a 2-year DBT program (DBT-ACES) is currently being tested. The first year of the program deals with acute symptoms, the second year concentrates on reaching the goal of social integration with finding paid work, establishing normative social networks and becoming independent of the health and social system. Already some data from an American research project show the efficacy of DBT-ACES. The approach of DBT-ACES, which is also tested in Germany, is outlined in the following article. Copyright © 2011 S. Karger AG, Basel.