Preparing for DBT PE: Client Readiness for PTSD Therapy

Criteria for Assessing Readiness for DBT PE

Key Readiness Criteria

1. No imminent risk of suicide: Clients must not be at imminent risk of suicide, which Adriana met by the targeted start date.
2. Absence of suicidal/self-injurious behavior: There should be no suicidal or self-injurious behavior for at least two months before starting DBT PE.
3. Control over suicidal/self-injurious urges: Clients must demonstrate the ability to control urges for suicidal or self-injurious behavior in the presence of cues.
4. No serious therapy-interfering behavior: Clients should not engage in significant therapy-interfering behaviors, as consistent participation is crucial for DBT PE efficacy.
5. PTSD as the highest priority goal: Treating PTSD needs to be the client’s highest priority goal.
6. Ability to tolerate intense emotions: Clients must show the capacity to tolerate intense emotions without resorting to escape strategies.

Adriana’s Progress and Challenges

Adriana met several of these criteria, such as the absence of suicidal behavior for the required period and showing control over her urges in the presence of cues. She also recognized PTSD as her highest priority goal. However, her ability to tolerate intense emotions fluctuated, particularly in times of high vulnerability.

Continuous Skill Development and Application

The therapist focused on helping Adriana practice mindfulness to current emotions and learn to manage her emotional responses adaptively. Assignments targeted both in-session and out-of-session activities, aimed at strengthening her emotional resilience and preparing her for the intense emotional work in DBT PE.

Looking for practical everyday tools? This print-friendly handout is just what you need. Click on the following link to download the PDF:

DBT PE Readiness Criteria for PTSD-focused Treatment

This handout is designed to assist therapists in evaluating client readiness for PTSD-focused treatment, suitable for DBT prolonged exposure and other trauma treatment models. It details essential readiness criteria that combine objective and subjective assessments, ensuring comprehensive evaluation of a client’s psychological stability and appropriateness for exposure-based and other trauma therapies. The document features in-depth descriptions of each criterion alongside spaces for therapists to document observations and decisions, enhancing the therapeutic decision-making process. This structured approach supports therapists in making informed judgments essential for managing and preparing clients for effective trauma treatment.

Instructions

To effectively use this handout, begin by reviewing each readiness criterion presented, reflecting on its application to your client’s current state and therapy progress. As you assess each criterion, utilize the provided space to note specific observations, concerns, or decisions related to your client’s readiness for PTSD-focused treatment. These notes will serve as a valuable reference for ongoing assessments and discussions within your therapeutic team or consultations. Regularly updating these notes is recommended as your client’s treatment progresses, ensuring that all decisions are based on the most current and comprehensive client data. This approach will enhance your clinical judgments and support successful therapy outcomes.