Dialectical-behavior therapy for complex PTSD

Abstract

DBT-PTSD is a modular treatment program, developed in close cooperation with M. Linehan, at the Central Institute of Mental Health, Heidelberg University. DBT-PTSD addresses the needs of patients with complex PTSD related to sexual or physical traumatization during childhood and adolescence. It was specifically designed to include patients with severe problems in emotion regulation, ongoing self-harm behaviour, suicidal ideations and dissociative symptoms, as well as negative self-concepts with high levels of guilt, shame, self-contempt and interpersonal problems. To target these core domains, DBT-PTSD merges evidence-based therapeutic strategies: principles and skills of DBT, trauma-specific cognitive and exposure-based techniques, compassion focused interventions, and behavior change procedures. The treatment program is designed to be delivered as an outpatient setting (45 weeks) or as a residential treatment program (three-months). Data from two large RCTs revealed large effect sizes in all relevant domains as well as significant superiority of DBT-PTSD to Cognitive Processing Therapy (CPT). Accordingly, DBT-PTSD is currently one of the most promising evidence based treatment programs for all features of complex PTSD.