Hello,

Wondering if anyone has experience or advice or knowledge in using Dialectical Behavioral Theraepy for CSA survivors.

I posted a message from the Web about it below.

Thanks.

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Dialectical Behavior Therapy for Survivors

Dialectical Behavioral Therapy for Survivors of Sexual Trauma

Many adult survivors share similar childhood experiences of exposure to physical, sexual, and/or psychological abuse. They often suffer from a spectrum of symptoms that includes problems with relationships, identity, and vulnerability to repeated victimization. Adult survivors of recurring sexual violence also frequently suffer from a number of psychological problems. In addition they often struggle with issues related to power, sexuality, shame, and control (Maker and Buttenheim, 2000).

While not all victims of sexual violence develop serious mental health issues, many of them may find themselves overwhelmed in varying degrees by the challenges and demands of their lives (Briere, 1996; Gold, 2000). A variety of therapy models have been developed over the years to help these individuals as well as those experiencing crisis reactions. Dialectical behavior therapy (DBT) is a cognitive behavioral treatment approach that was originally developed by Marsha Linehan (1987) to treat chronically suicidal individuals and individuals who were diagnosed with borderline personality disorder. DBT is based on the premise that the purpose of therapy should not just be to guide survivors towards integration of past and present traumatic experiences, but also to teach them to cope more effectively in their daily lives and in the face of any future trauma.

The DBT model incorporates a number of techniques from various orientations including client-centered, psychodynamic, gestalt, strategic, and systems orientations, as well as Eastern and Zen meditation theory. In DBT the survivor's experience must first be recognized, accepted, and validated, and this takes place in a collaborative, therapeutic environment. The survivor is supported by the therapist while at the same time the therapist allows for and encourages the possibility of change. Both acceptance and change are balanced opposite one another. As the survivor becomes empowered by the validating and supportive therapeutic relationship she/he is able to be open to the possibility of change. The therapeutic relationship in DBT is extremely important because it provides the avenue for the survivor's acquisition of key behavioral skills including 1) achieving one's objectives while maintaining relationships and self-respect, 2) recognizing the function of emotions and experiencing them appropriately, and 3) being able to tolerate distress when it occurs and cannot be avoided.

Controlled empirical data examining the effectiveness of DBT in individuals with a history of physical and/or sexual abuse has been slowly gathered over recent years. Research has shown promising results for the use of DBT with adult survivors of prolonged childhood physical and/or sexual abuse (Loonstra, 2004).

DBT includes both individual and group therapy. It is divided into four phases. Each phase consists of a skills training module that addresses a specific area of behavioral, emotional, or cognitive instability. The skills training modules are named as follows: Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. Skills training sessions occur weekly. Individual therapy focuses on a hierarchy of goals specific to the needs of each individual. To find a DBT therapist in your area, check with your local hospital, guidance clinic, university-based counseling program, or community mental health center.