Dialectical Behavior Therapy Cuts Self-Mutilating Behavior

Article excerpt

ATLANTA -- Dialectical behavior therapy reduces self-mutilating behavior by helping patients change dysfunctional attitudes, Katherine Comtois, Ph.D, told the annual meeting of the American Association of Suicidology

Patients see emotional dysregulation as a problem for which self-mutilation is the solution. Helping them understand that their emotions are normal can help them recognize that their responses are problematic, said Dr. Comtois, director of the dialectical behavior therapy program at Harborview Medical Center in Seattle.

Helping patients change their attitudes toward their emotions is only one component of a total program that also includes skills training and improving motivation for treatment.

Patients may want to replace self-injury with alternative behaviors. But if they lack the necessary skills, they will be unable to do so. Conversely patients who have skills but lack motivation will continue to self-injure, Dr. Comtois said.

Treatment includes psychoeducation, pharmacotherapy, and concrete skills training to help patients develop new responses to the emotions that previously triggered the behavior. Treatment also includes dialectical behavior therapy.

Since the relief patients achieve with self-injury is enormous, therapists may find it difficult to motivate clients to remain in treatment. Make sure the treatment matches the patient's goal, Dr. Comtois advised. …


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