Sunday, October 25, 2009

Patients drop out of DBT/CBT because...

DBT is a modification of standard cognitive behavioral treatment. As briefly stated above, Marsha Linehan and her team of therapists used standard CBT techniques, such as skills training, homework assignments, symptom rating scales, and behavioral analysis in addressing clients’ problems. While these worked for some people, others were put off by the constant focus on change. Clients felt the degree of their suffering was being underestimated, and that their therapists were overestimating how helpful they were being to their clients. As a result, clients dropped out of treatment, became very frustrated, shut down or all three.

**THIS IS A FACT! And this is because it is invalidating and retraumatizing.
I attended DBT classes and the instructor of the class actually told me the drop out rate is high.
And this is because why? Yes! Retraumatizing, makes symptoms worse by using BUCKETS!

reference: 1997-2008 Behavioral Tech, LLC; © 1997-2008 Cindy Sanderson


  1. Sometimes people drop out just because they want to stay alive.

  2. I've been part of two DBT groups and only two people have left; one moved away and the other was ask to leave because she kept violating the rule about not talking about previous suicide attempts and methods, etc.which the BPD people found distrubing.

    In both groups I've been the only non-BPD person. I have clinical depression with occasional suicidal ideation and spend most of my time dwelling in reasonable mind, with occasional ventures into emotional mind that I find difficult to process intellectually. I've found DBT to be beneficial in helping me gain a greater balance between reasonable and emotional mind, primarily through the technique of labelling and describing thoughts and emotions, and that allows me to look at them objectively to find out if there's any evidence to support those thoughts and feelings. As a result I'm better able to deal with my troublesome thoughts and emotions, I don't "beat myself up" as much as I once did.

    I understand that the technique may not be effective for everyone, we (the people in the groups I've participated in) have never been told that DBT is anything other than a tool that can be used to reduce suffering in our lives. If DBT doesn't work for you then find another technique that will work, but don't discourage others from trying a method that could bring them relief from their suffering.

  3. Sarkasticus, Thank you for your comments, and I am happy for you that you found DBT to be helpful. I'm curious, are you a childhood sexual abuse survivor?
    I am not discouraging anyone from trying any therapy that might work for them - I am simply sharing my experience with DBT (persaonl experience - I did go to th classes and out of 9 members, there were 3 left when I stopped going (and one of the 3 was the assigned intern).
    Interesting that the group member was asked to leave after not being able to throw her previous sui thoughts in a bucket...I was told that Marsha preaches accecptance and there is a reason why everyone does what they do...may be a 'maladaptive' reason, but there is a reason. I find myself wondering if that group member was coached and validated....hum...seems to me that being 'asked to leave' the class because of talking about her experiences was very invalidating. Sounds like the class/instructor failed that memeber.... hope he/she is okay today.

  4. I just happened on this posting because I'm searching for alternatives. I'm currently in DBT (which the therapists say id the only therapy that works for people with severe BPD like me). I've been in the intensive programme (3 days a week) for 6 months out of a 12 month programme and quite frankly I'm worse now than when I began. I hadn't self harmed for nearly two years and now have started self harming again (cutting and burning). I'm at my witz end! I don't know what to do! The whole thing has left me traumatised and raw to the bone!

  5. I didn't find DBT as helpful as I thought it could be and it was not for my lack of trying. I think one day I practiced every distress tolerance skill and other skills trying to hold back tears. Once I just let go and had a good cry, I felt better. Sometimes DBT felt like I as using a small hammer to chip through a wall when there was a doorway right there I needed to just walk through. In short, I find some of it insulting.