Adapting Dialectical Behavior Therapy for the Treatment of Dissociative Identity Disorder
Open accessAbstract
Dialectical Behavior Therapy (DBT), created by Marsha Linehan, has been shown to be an effective therapy for the treatment of borderline personality disorder (BPD) and for suicidal and self-harming behavior. Dissociative identity disorder (DID) is a complex post-traumatic disorder which is highly comorbid with BPD, shares a number of clinical features with BPD, and which like BPD features a high degree of suicidality. The DID treatment literature emphasizes the importance of a staged approach, beginning with the creation of a safe therapeutic frame prior to addressing traumatic material; DBT is also a staged treatment, in which behavioral and safety issues are addressed in Stage 1, and trauma work reserved for Stage 2. The authors describe adapting DBT, and especially its techniques for Stage 1 safety work, for work with DID patients. Basic theoretical principles are described and illustrated with a case example.
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A small but growing body of empirical evidence indicates that the phased psychotherapeutic treatment model is effective for people with DID.
“A small, but growing, body of empirical evidence indicates that the phased psychotherapeutic treatment model is effective for people with DID [25,89–93].”
From Treatment of dissociative identity disorder: leveraging neurobiology to optimize success (2024) · cites this paper as [89]
The Abstract reports that case reports and uncontrolled trials suggest psychotherapy can improve symptoms and functioning in people with DID, and that guidelines based partly on outcome studies recommend staged treatment. It does not establish that the reported improvements resulted specifically from the phased model; it also notes that randomized trials of DID treatment are absent. (LLM, conf=0.82)
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References 45 · Cited by 27
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- Authors
- Foote, B., & van Orden, K.
- Affiliations
- Albert Einstein College of Medicine (US)
- University of Rochester Medical Center, Rochester, NY.
- Venue
- American Journal of Psychotherapy
- Published
- 2016-10
- Volume
- 70
- Issue
- 4
- Pages
- 343-364
- ISSN
- 0002-9564 (ISSN-L)
- 2575-6559
- PMC
- PMC5293140
- OpenAlex
- W2587059565
- Cited by
- 27
- References
- 45
- Citations by year
- 2026: 4 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 1 · 2019: 2
- FWCI
- 0.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (K23MH096936)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- dialectical behavior therapy, dissociative identity disorder, borderline personality disorder, staged treatment, safety work, trauma work, suicidality, self-harm, comorbidities, post-traumatic disorders
- MeSH terms
- Adult, Behavior Therapy, Female, Humans, Dissociative Identity Disorder, Self-Injurious Behavior
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