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By: Christina Landeros

Dialectical Behavioral Therapy (DBT) and Eye Movement Desensitization and Reprocessing (EMDR) treatment modalities have been widely known and accepted as evidence-based and effective therapeutic practices around the world.

Brief Creation History

DBT, which is a modified form of Cognitive Behavioral Therapy, was developed by Dr. Marsha Linehan in the 1970s during a time in her life when she was experiencing problems with her own mental health.

EMDR was developed in the late 1980s by Dr. Francine Shapiro. The idea for EMDR originated a decade prior while she was working on her English literature degree. Her interest in behavior therapy and human psychology continued to develop and in 1987, after a fatal cancer diagnosis, and a chance discovery with eye movement, EMDR was developed.

How Does DBT work?

A trained DBT therapist assists you with learning and implementing skills incorporating 4 main modules: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation. This can be adapted to work with individuals and groups of all ages. DBT has been used to effectively treat issues such as borderline personality disorder, impulsive self-harming behaviors, substance abuse, eating disorders, and others.

How Does EMDR work?

A trained EMDR therapist guides you through a series of 8 Phasesincluding: including history-taking, preparation, assessment, desensitization, installation, body scan, closure, and re-evaluation. EMDR uses bilateral stimulation (eye movement, sound, tapping, etc.) to decrease emotional pain and distress associated with traumatic memories. It is used to treat illnesses such as PTSD, addictions, anxiety, chronic pain, depression, OCD, eating disorders, panic attacks, panic disorder, phobias, and others.

So Why Combine them in Mental Health Treatment?

•Both approaches are modified from behavior therapy, are evidence-based, and have been found to be effective in working with people with mental health disorders.

•Both help with addressing the past, present, and future

•Wise Mind and other DBT skills can be used to support EMDR during the preparation phase.

•Clinicians can process and introduce DBT skills in sessions on treatment days when clients do not have time for EMDR reprocessing.

•DBT skills can be used by clients to help with in-between sessions emotional and affect regulation, stabilization, relaxation, and mindfulness in the present.

•Targeting different parts of the brain, top-down(talk therapy)and bottom-up(EMDR reprocessing)helps with providing comprehensive mental health treatment.

Additional Factors to be Mindful of:

•Medication management and consistent monitoring by the client’s prescriber/ medical provider also enhance treatment effectiveness and improves holistic care.

•It’s important to apply the treatment correctly so they will be effective.

•It’s important for therapists to seek out consultation and additional training as needed.

•Informed consent, a thorough explanation of integrating the approaches, and agreed-upon Treatment Plans between the clinician and client are vital before the start of care.

Koerner, K. (2012). Doing Dialectical Behavior Therapy: A Practical Guide. The Guilford Press.

Shapiro, F. (2018). Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and Procedures (3rded.). The Guilford Press.

Van der Kolk, B., M.D. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books