Integrative Chronic Disease Management Programs are being developed to address the growing number of hard to manage chronic diseases and illnesses in the United States. Many of these programs have structural similarities focused on support systems, patient buy-in, lifestyle modification, symptom management, and risk factor reduction. Dialectical Behavior Therapy (DBT) is an integrative program designed to reduce risk factors associated with Borderline Personality Disorder, but is currently used to effectively address a wide range of mental illnesses.
Dialectical Behavior Therapy encompasses many of the core tenets of Integrative Health and Integrative Medicine (12 out of 14), utilizing the necessary methods of integration (all 8) and incorporating the four realms of integration within three specific types of care. Clients are enrolled into a group and individual therapy sessions, must make a commitment towards change, track specific behaviors and risk factors daily through the use of diary cards, and participate in weekly homework assignments. Group sessions focus on four subjects concerning Interpersonal Effectiveness, Mindfulness skills, Distress Tolerance/Crisis Management skills, and Emotional Regulation. Individual sessions are used to reinforce the group session, monitor individual risk factors via the diary card, and provide individualized care on subjects beyond the scope of the group.
Integrative Tenets (12/14)
DBT is inclusive of Mind, Body, and Spirit by utilizing Eastern and Western techniques in patient care. It is personalized and prevention oriented, and embraces wellness care, lifestyle management, and self-care. Mental Health Professionals work in teams to facilitate groups and individual care, and cultivate relationships with clients in order to effectively reduce risk behaviors. This in turn encourages patients to learn about themselves and take responsibility for their own health/wellbeing. It is evidence based, focuses on what works for the client, puts emphasis on the process of care, and ultimately is a valuable cost effective tool with a high rate of success. Most DBT groups are composed of patients with similar family, societal, and cultural factors.
Integrative Methods (8/8)
Due to the nature of small group management combined with individualized sessions, DBT emphasizes the patient as the center of care and is highly personalized. The inclusion of family and love ones in individual sessions is encouraged so that patients have an opportunity to share their new skills and smooth over potential difficulties in application. Individual sessions focus on reinforcing skills learned in group that are effective and offer opportunities to trouble shoot ways to reduce factors preventing skill applications outside the scope of DBT within the patient's environment. A solid base of research behind DBT allows for a focused, evidence-based program. Records are kept for each client consisting of therapist notes, diary cards, and homework. Through the course of the program, patients are encouraged to integrate and utilize all the skills together to build an interdependent network of self-care and positive lifestyle management. Providers refer out and connect patients with resources as needed, so that patients are supported as much as possible through the course of the program in order to achieve positive outcomes.
Realms of Integration (1/4)
There is a vast synthesis of knowledge from a variety of Eastern and Western practices. Providers are also placed in a "lead by example" role, demonstrating use of the skills in their own lives. The extent of administrative integration and provider-system organization and the resulting clinical practice integration depends upon the organization in which DBT Providers practice.
Types of Care
DBT is a Chronic Disease Management Program, a rehabilitation service, and part of Self Care/Wellness & Lifestyle Management.
No comments:
Post a Comment