Treating Trauma in Dialectical Behavior Therapy The DBT Prolonged Exposure Protocol (DBT PE)


SKU: 9781462549122 Categories: , , ,

Many DBT clients suffer from posttraumatic stress disorder (PTSD), but until now the field has lacked a formal, tested protocol for exactly when and how to treat trauma within DBT. Combining the power of two leading evidence-based therapies—and designed to meet the needs of high-risk, severely impaired clients—this ground-breaking manual integrates DBT with an adapted version of prolonged exposure (PE) therapy for PTSD. Melanie S. Harned shows how to implement the DBT PE protocol with DBT clients who have achieved the safety and stability needed to engage in trauma-focused treatment. In a convenient large-size format, the book includes session-by-session guidelines, rich case examples, clinical tips, and 35 reproducible handouts and forms that can be downloaded and printed for repeated use.


  • I. Background
  • 1. The Development and Foundations of DBT PE sample
  • 2. The Target Population
  • II. Stabilization and Preparation
  • 3. Setting the Stage for DBT PE in Pretreatment
  • 4. Achieving Safety, Stability, and Skills in Stage 1
  • 5. Building Motivation for DBT PE
  • 6. Determining Readiness for DBT PE
  • 7. Preparing to Start DBT PE
  • III. The DBT PE Protocol
  • 8. Session 1
  • 9. Session 2
  • 10. Joint and Family Sessions
  • 11. Session 3
  • 12. Intermediate Sessions (Sessions 4+)
  • 13. The Final Session
  • IV. Troubleshooting and Tailoring Treatment
  • 14. Troubleshooting Problems
  • 15. Targeting Specific Trauma-Related Emotions
  • 16. Working with Different Trauma Types
  • 17. Treating Diverse Populations
  • V. Next Steps
  • 18. Stage 3 and Beyond
  • Appendix A. DBT PE Client Handouts
  • Appendix B. Therapist Forms
  • Appendix C. Session Checklists
  • Appendix D. Measures
  • References
  • Index

Author Bio:

Melanie S. Harned, PhD, ABPP, is Coordinator of the DBT Program at the VA Puget Sound Health Care System and Associate Professor in the Department of Psychiatry and Behavioural Science and Adjunct Associate Professor in the Department of Psychology at the University of Washington. Dr. Harned previously served as Research Director of the Behavioural Research and Therapy Clinics at the University of Washington, Director of Research and Development for Behavioural Tech, and Director of Behavioural Tech Research. Her research focuses on the development and evaluation of the DBT Prolonged Exposure protocol (DBT PE), as well as methods of disseminating and implementing this and other evidence-based treatments in clinical practice. She regularly provides training and consultation nationally and internationally in DBT and DBT PE, and has published numerous articles and book chapters.


“A well-organized, pragmatic, and user-friendly clinical handbook that takes the reader step by step from pre-treatment considerations to post-treatment next steps, providing detailed descriptions of each stage of treatment delivery. Treatment components, which clearly derive from evidence-based principles, are thoroughly explained, well supported, and practically illustrated with realistic clinical examples….This book is a useful clinical manual for psychotherapists who work with high-risk clients suffering from severe co-occurring emotion regulation and PTSD-related difficulties….The manual is engaging, encouraging, easy to understand, and solidly rooted in a strong evidence base. This manual will be found useful and appropriate for seasoned masters- and PhD-level clinicians, as well as graduate student trainees, who possess both interest in and familiarity with the sometimes challenging-to-treat population of clients with co-occurring emotion/behavioural dysregulation and PTSD.” – Journal of Contemporary Psychotherapy