Treating Trauma in Dialectical Behavior Therapy The DBT Prolonged Exposure Protocol (DBT PE)

Many DBT clients suffer from posttraumatic stress disorder (PTSD), but until now the field has lacked a formal, tested protocol for exactly when and how to treat trauma within DBT. Combining the power of two leading evidence-based therapies--and designed to meet the needs of high-risk, severely impaired clients--this groundbreaking manual integrates DBT with an adapted version of prolonged exposure (PE) therapy for PTSD. Melanie S. Harned shows how to implement the DBT PE protocol with DBT clients who have achieved the safety and stability needed to engage in trauma-focused treatment. In a convenient large-size format, the book includes session-by-session guidelines, rich case examples, clinical tips, and 35 reproducible handouts and forms that can be downloaded and printed for repeated use.

I. Background 1. The Development and Foundations of DBT PE 2. The Target Population II. Stabilization and Preparation 3. Setting the Stage for DBT PE in Pretreatment 4. Achieving Safety, Stability, and Skills in Stage 1 5. Building Motivation for DBT PE 6. Determining Readiness for DBT PE 7. Preparing to Start DBT PE III. The DBT PE Protocol 8. Session 1 9. Session 2 10. Joint and Family Sessions 11. Session 3 12. Intermediate Sessions (Sessions 4+) 13. The Final Session IV. Troubleshooting and Tailoring Treatment 14. Troubleshooting Problems 15. Targeting Specific Trauma-Related Emotions 16. Working with Different Trauma Types 17. Treating Diverse Populations V. Next Steps 18. Stage 3 and Beyond Appendix A. DBT PE Client Handouts Appendix B. Therapist Forms Appendix C. Session Checklists Appendix D. Measures References Index

Melanie S. Harned, PhD, ABPP, is Coordinator of the DBT Program at the VA Puget Sound Health Care System and Associate Professor in the Department of Psychiatry and Behavioral Science and Adjunct Associate Professor in the Department of Psychology at the University of Washington. Dr. Harned previously served as Research Director of the Behavioral Research and Therapy Clinics at the University of Washington, Director of Research and Development for Behavioral Tech, and Director of Behavioral Tech Research. Her research focuses on the development and evaluation of the DBT Prolonged Exposure protocol (DBT PE), as well as methods of disseminating and implementing this and other evidence-based treatments in clinical practice. She regularly provides training and consultation nationally and internationally in DBT and DBT PE, and has published numerous articles and book chapters.