DBT Protocols for Prolonged Exposure Therapy for the Treatment of PTSD
“We have to learn how to embrace and cradle our own suffering and the suffering of the world, with a lot of tenderness.”
– Thich Nhat Hanh
The DBT Protocols for Prolonged Exposure Therapy (DBT-PE) were developed by Dr. Melanie Harned. Building upon Dr. Edna Foa’s foundational research and Prolonged Exposure Therapy structure, she adapted PE to fit a more high-risk population.
It was designed to treat the complex traumas and experiences of traumatic invalidation that far too many people have endured. It is an evidenced-based treatment with supporting research that continues to grow.
DBT-PE is implemented in Stage 2 of DBT treatment when all self-injurious and self-destructive behaviors have been mitigated and controlled, normally after a minimum 20 weeks of DBT based therapy.
A person must be capable of utilizing core mindfulness, distress tolerance and emotional regulation skills that will allow them to safely experience memories and intense emotions related to their traumatic events.
The philosophy driving DBT-PE is that traumatic responses are maintained and reinforced over time due to consistent avoidance of potential reminders, both internal and external, of their traumas and the beliefs a person has come to accept about themselves and the world as a result of their traumatic experiences. These are both addressed during the treatment process.
The DBT-PE process incorporates two unique type types of exposure. Both are used to systematically decrease vulnerability to trauma-related thoughts and feelings, and increase confidence in your ability to tolerate and reduce discomfort.
The first is In Vivo exposure. This helps to begin confronting and re-experiencing feared yet objectively safe situations. For example, if you tend to avoid crowds because of a traumatic event, we will gradually approach reengaging in groups of people, so long as it is objectively safe.
The second is Imaginal exposure. Imaginal exposure and processing involves actively revisiting traumatic memories and retelling them out loud. We will also process the thoughts and emotions that are elicited during this process with the intention of gaining new perspective on the events of the memory. This is process is very effective at decreasing the intensity of trauma related reactions.
Sessions are 90 minutes and they ranges from 8-13 sessions for completion.
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