Beyond Psychotherapy: Dialectical Therapy

Dialectical therapy is a common factors approach to psychotherapy integration, in which four general therapeutic strategies are taken as the cardinal points of a map of the field. It is said to be beyond psychotherapy because what is commonly referred to as psychotherapy is more than psychological treatment. It is a dialectic between two basic levels or axes: the psychological remaking, which deals with defect-driven disorders, and the philosophical uncovering, which deals with conflict-driven problems. The first level can be graphically represented as the horizontal axis of the field, connecting a maternal and a paternal pole, in which the therapist responds to the basic psychological needs of secure attachment and responsible cooperation. The second level can be represented as the vertical axis of the field, connecting a K (knowledge) vertex and an O (unknown) vertex, in which the therapist responds to the basic philosophical needs of knowledge (know thyself) and of unknown as unknowable (the noumenon of all phaenomena, the source of generative and healing powers). A map is necessary to organize the basic therapeutic needs and the range of responses to them in a coherent pattern. As a good map can help in orienting empirical research, this in turn can help in constructing better maps.     

辩证行为疗法的回顾与前瞻

辩证行为疗法(DBT)是最近十几年来兴起的一种主要针对边缘性人格障碍(BPD)的有效治疗方法。就辩证行为疗法的基本理论与治疗模式、治疗阶段与治疗策略进行综述,并介绍了国外最近的临床研究进展,最后对该疗法的应用前景进行了展望。     

Principles of Skills Assessment in Dialectical Behavior Therapy

Since its inception, increasing clients’ capabilities in experiencing and managing emotions, interpersonal relationships, and crises has been central to both the theory and practice of Dialectical Behavior Therapy (DBT; Linehan, 1993a, Linehan, 1993b, Linehan, 2015a, Linehan, 2015b). Enabling clients to learn new skills, and to effectively implement them to change behavior, requires both capability and motivation on the part of skills trainers and individual therapists alike. The most effective DBT practitioners precisely assess at each stage of skills acquisition, strengthening, and generalization to determine how well their clients perform new skills. They assess what barriers are preventing effective skills use, in order to implement a focused endeavour to overcome any obstacles. This paper reviews principles of skills assessment within each treatment modality and provides therapists with checklists for identifying problems, and case vignettes illustrating helpful therapeutic strategies.     

Family Therapy in China

This paper aims to provide an overview of the family therapy in mainland China, by analyzing its development, current situation and future directions. The authors argue that the history of family therapy can be understood as three stages: introductory stage from 1985 to 1994, “blossoming” stage from 1995 to 2004, and “fast growing” stage from 2005 to present. In every stage, we can see clear differences in each of the following fields: training (including training programs in universities and workshops held by companies or institutes), academics (including research articles, professional books and conferences), and general public environment (including media and policies). We also outline the development of China’s first university system family therapy training program as an example and evidence of family therapy’s significant present and future development in mainland China. Based on this, we highlight some points for future improvement in family therapy in mainland China, including developing indigenous theories and practice models, reinforcing training and research programs in university systems, and improving accreditation standard for all family therapists.     

Family Therapy in Romania

The article outlines the development of family therapy in Romania. Family therapy has a relatively brief history in this country, only beginning with the first training programs in the early to mid 1990s. However, as far as the number of professional associations is concerned, it is well represented on the map of psychotherapy approaches. There are several opportunities for training in family therapy. The accreditation of the training programs and the certification of the graduates of these programs is clearly regulated by law. From the legal point of view psychotherapy is considered a specialization of psychologists rather than an independent profession. The authors offer a brief overview of the history of family therapy in Romania, its present position in the health and social care system, the context of training, accreditation standards, the network of professional organizations and some of the possible future directions for family therapy. Finally, recently produced Romanian films are suggested as a medium for getting acquainted with the complex dilemmas faced by contemporary Romanian families.     

Modifying Dialectical Behavior Therapy for Deaf Individuals

Therapies that rely on written materials, information, or procedures involving familiarity with the dominant culture (e.g., colloquialisms, history) often pose barriers to people who use another language, have low English literacy, or are less familiar with the dominant culture. All this applies deaf individuals. One of the most well-validated mental health treatments for reducing suicidality in those diagnosed with borderline personality disorder is Dialectical Behavior Therapy (DBT; Koons et al., 2001; Linehan et al., 1999; Linehan et al., 2006; Linehan et al., 2002; Verheul et al., 2003). Unfortunately, its heavy reliance on written materials, prevalent use of metaphors, and other culture-bound characteristics make DBT inaccessible to the average deaf consumer. We describe the potential benefits that DBT could offer deaf clients, some of which are uniquely related to the life experiences and societal challenges faced by deaf people. Barriers to accessing standard DBT treatment and the materials used are described. Modifications of DBT materials and methods that we have found effective with deaf clients are detailed. It is concluded that DBT materials and methods can be successfully modified for use with this population. Available resources and additional benefits of employing DBT with deaf clients are noted.     

Dialectical Behavior Therapy for Managing Interpersonal Relationships

Dialectical Behavior Therapy (DBT) is a treatment designed for individuals having borderline personality disorder (BPD), patients having binge eating disorder, co-morbid substance dependence and BPD, and depressed older adults. This paper aims to explore the use of DBT and to ascertain the status of DBT education in treating difficulties in handling interpersonal relationships among clients seeking counseling and psychotherapy. The skills training mode can be employed for teaching skills to solve relationship problems. Validation and acceptance strategies can lessen rejection sensitivity and negative feelings that make interpersonal situations chaotic. Black and white thinking can be resolved by finding a middle path through acceptance and change. This paper suggests the possible utility of DBT for enhancing psychological well-being in clients.