DBT-Prolonged Exposure (DBT-PE) is a treatment option for those who have experienced trauma or traumatic invalidation, and are experiencing symptoms of complex posttraumatic stress disorder (PTSD). The treatment protocol combines DBT to help you learn skills to control behaviors that keep you form being able to target trauma symptoms effectively, such as life threatening behavior or substance use that interferes with the ability to adequately treat PTSD, among other issues.
Prolonged exposure is combined with DBT once appropriate, to target the experience of trauma directly, using in vivo and imaginal exposure. Through these techniques, clients are able to organize their trauma in such a way that it can be intentionally put away when needed, as opposed to avoiding all or most things that remind one of the distressing experience or experiences. In imaginal exposure sessions, clients are asked to return to the trauma and describe it repeatedly. Through repetition and processing, imaginal exposure will decrease PTSD symptoms and help to shift problematic beliefs about the distressing experience. In vivo exposure targets areas in your life that you are avoiding due to the trauma in a gradual way in order to help you handle them effectively and with decreased anxiety or fear. Avoidance and reliving are two symptoms of PTSD that maintain it, and for this reason PE aims to target these areas to help you find freedom. Dr. Melanie Harned developed the DBT-PE protocol, and chose PE as the treatment to supplement DBT due to exposure treatments being the most highly effective research based treatments for PTSD. There are research studies testing the effectiveness of DBT-PE specifically, and upwards of 80% of participants no longer met criteria of PTSD post treatment (Harned, 2016).
As mentioned before, DBT-PE is optional, with the client choice of doing the “DBT only track” or the “DBT-PE track”. In regard to treatment structure, clients interested would still receive standard DBT (weekly individual sessions, skills group and phone coaching) while also attending weekly PE sessions for a period of about 15 weeks on average. Please let your therapist know if you are interested in DBT-PE.