Dialectical Behaviour Therapy

 

Dialectical means trying to understand how two things that seem opposite could both be true. For example, accepting yourself and your challenges and working towards changing unhealthy behaviours. DBT therapy will help you understand and accept intense emotions, learn skills to manage them and will help you make positive changes to live a life worth living.

 

Dialectical Behaviour Therapy (DBT) is a specific type of Cognitive Behaviour Therapy developed by Dr. Marsha Linehan for Borderline Personality Disorder. However, DBT is now commonly used for other mental health concerns. DBT is effective in managing suicidal thoughts, self-harming behaviours, intense emotions, impulsive behaviours and addressing interpersonal conflicts.

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DBT focuses on providing therapeutic skills in four key areas: 

 

Mindfulness: Focuses on being in the present moment and accepting/acknowledging reality as it is. 

 

​Emotion Regulation: Focuses on managing intense emotions sometimes result in impulsive behaviours.

 

Interpersonal Effectiveness: Focuses on assertive communication in a way that maintains self-respect and strengthens relationships. 

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Distress Tolerance: Focuses on increasing tolerance to manage crisis situations and painful emotions. 

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Cognitive Behavioural Therapy:

 

CBT focuses on the way people think ("cognitive") and acts ("behavioural"). The concept behind CBT is that our thoughts about a situation affect how we feel (emotionally and physically) and how we behave in that situation. As human beings, we give meaning to events that are happening around us. However, we often do not realize that two people can give two very different meanings to the same event. CBT is a research-based treatment for many mental health disorders, including anxiety-related disorders, mood disorders, psychotic disorders and many other mental health concerns.

 

Cognitive Processing Therapy:

 

Cognitive processing therapy (CPT) is a specific type of cognitive-behavioural therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events. CPT is generally delivered over 12 sessions and helps clients learn how to challenge and modify unhelpful beliefs related to the trauma. The client creates a new understanding of the traumatic event to reduce its ongoing adverse effects on current life. This treatment is strongly recommended for the treatment of PTSD.

 

Solution Focused Therapy:

 

Solution-focused therapy is a humanistic therapy, which focuses on self-development, growth and responsibility. This approach is based on solution-building rather than problem-solving. Although it acknowledges present problems and past causes, it mainly explores the client’s current resources and future hopes. Solution Focused Therapy can help clients to look forward and use their strengths to achieve their goals.

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Eye Movement Desensitization Reprocessing Therapy:

 

Traumatic events like an accident, natural disaster, war, violence or abuse, are so overwhelming that our memories are not stored properly; they remain unprocessed and are not filed away. As a result, these memories are easily accessible, and more things can trigger the traumatic memory, causing it to ‘replay.’ This means that individuals keep reliving the distress they have experienced. The mind can often process daily emotional experiences and heal naturally during sleep, particularly during rapid eye movement (REM) sleep. Where a traumatic experience or event occurs, this natural healing process may not always take place. EMDR offers a therapeutic way of dealing with feelings and emotions that we have held on to. Eye Movement Desensitization and Reprocessing (EMDR) therapy is an interactive psychotherapy technique used to relieve psychological stress. It is an effective treatment for trauma and post-traumatic stress disorder (PTSD). During EMDR therapy sessions, you relive traumatic or triggering experiences in brief doses while the therapist directs your eye movements.

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Acceptance Commitment Therapy:

 

Acceptance and commitment therapy (ACT) stems from cognitive behavioural therapy. Clients learn to stop avoiding, denying, and struggling with their intense emotions. Instead, they try to accept that these deeper feelings are appropriate responses to certain situations that should not prevent them from moving forward in their lives. ACT has been used effectively to treat chronic pain, diabetes, substance use, psychosis, obsessive-compulsive disorder, social anxiety and workplace stress.

 

Family Therapy:

 

Family therapy is often short term. Family sessions may include all family members or just those willing to participate. Your specific treatment plan will depend on your family's situation and goals. These sessions will help you learn skills to resolve family conflicts, improve communication, rebuild trust and connection.

 

An increasing number of immigrant families with children and adolescents can benefit from family therapy because of intergenerational conflicts specific to the adolescents’ problems/adjustments related to immigration and cultural transitions. Also, sometimes mental health stigma in certain cultures can make it difficult for families to support their adolescents with mental health concerns. Our therapists are culturally sensitive, flexible and mindful of family values and beliefs when delivering family therapy.

 

Family-Based Treatment for Eating Disorders

 

Family-based treatment (FBT, also sometimes referred to as the Maudsley method) is a leading treatment for adolescent eating disorders, including anorexia nervosa, bulimia nervosa and other specified feeding or eating disorder (OSFED).

Parents are asked to join with the healthy part of the child against the eating disorder, threatening to take their child away. Full nutrition is viewed as a critical first step in recovery; parents' role is to provide this nutrition by actively feeding their child.

 

Three Phases of FBT:

 

Phase 1:

 

Full parental control: Parents are encouraged to be in complete charge of meals as they help their child re-build regular eating patterns and interrupt problematic eating disorder behaviours such as bingeing, purging, and overexercise. The therapist works to empower the parents to take on these tasks and help them learn to manage the child at mealtimes. 

 

Phase 2:

 

A gradual return of control to the adolescent: This phase typically begins once the weight is mostly restored, when meals are going more smoothly, and when behaviours are more under control. Control is gradually handed back to the adolescent, depending on the client’s age. For example, the child may start to have some meals or snacks without the parents’ supervision. There can be backsliding, and parents may have to start supervising from time to time until the adolescent is fully ready; this is part of the process.

 

Phase 3:

 

Establishing healthy independence: When adolescents can eat with an age-appropriate level of independence and do not exhibit disordered eating behaviours, the focus of treatment shifts to helping them develop a healthy identity and focus on other developmental issues. Other comorbid problems may be addressed. The family is helped to reorganize now that the child is healthier.