Introduction

Dialectical Behaviour Therapy (DBT) is a psychotherapeutic approach originally designed to treat the problems of chronically suicidal individuals with borderline personality disorder (BPD). Subsequent to the publication of the first edition of this book, DBT has been applied to an increasingly wider range of client populations, including individuals with less severe problems for whom researchers have experimented with using less comprehensive versions of the treatment. Research on these adaptations is still in its development phases, and therefore, this book focuses on comprehensive DBT as it is applied to clients presenting with complex psychological disorders. The book articulates the principles of the treatment, focusing particularly on those that distinguish DBT from other cognitive- behavioural treatments. In common with all the books in this series, this volume has two parts: the first devoted to theory and the second to practice. The theoretical component of the book illustrates distinctive features of DBT relating to its three foundations: behaviourism (Chapters 6-8), dialectical philosophy (Chapter 3) and Zen (Chapter 9). The second part of the book focuses on practice and how the philosophical and theoretical underpinnings of the treatment flow into the treatment structure and strategies.

Xi

DBT is based on a transactional biosocial theory of the aetiology of the affect regulation problems of BPD (Chapter 4). Individuals with a biological emotional vulnerability raised in environments that systematically invalidate their inner experiences and overt behaviours develop deficits in both the capacity and the motivation to manage their emotions and other aspects of their lives (Chapter 5). DBT treatment programmes comprehensively address these capability and motivational deficits, providing a multi-modal, staged treatment that targets the full range of comorbid disorders of the client in a hierarchical manner (Chapters 11-17). DBT integrates strategies from cognitive-behavioural treatment (Chapters 19-24) with aspects of Zen practice (Chapters 9 and 21). The treatment utilizes the dialectical philosophy (Chapters 3 and 25) to synthesize these two contrasting perspectives into a coherent set of treatment principles.

 
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