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Background: Family based Dialectical Behavioral Therapy is a new form of treatment for Bulimia Nervosa in adolescents. The families learn the skills of Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness and walking the middle path, along with the adolescent so they can help each other, with coaching, through the skills acquisition.
What is Bulimia?
A brief overview of Bulimia and factors thought to lead to the development of the problem.
What is Motivational Interviewing?
Discuss the nature of motivation, its importance in the process of change, and the Stages of Change model.
What is Family Based DBT?
Describe the principles of Family Based Dialectical Behavior Therapy, including the central dialectic of acceptance and change, the role of emotion regulation in problem eating, and some of the research conducted on DBT. Review behavioral skills that include: mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance, and walking the middle path.
Understanding the Patterns
Explain the process of behavior analysis, and how it can help to identify patterns of events and behaviors that support and maintain problematic eating.
Breaking the Cycle
Discuss how the behavioral skills can help to break patterns of behavior that lead to disordered eating.
Coping with Relapse
Because relapse is a frequent occurrence with almost any change in behavior, we will discuss learning how to cope with lapses, how to prevent lapses from developing into full blown relapses, and how to get back on track after relapse.
The presentation is didactic in nature with an interactive component if time allows.
The presentation will begin with a short discussion of Bulimia Nervosa, what it is, how one gets it, what are predisposing factors, etc. It will address genetics, personal temperament and the influence of culture (biopsychosocial theory.) There will be a section on alternative treatments (what is useful from those treatments) and how DBT adds something different from CBT and IPT (the two treatments of choice for bulimia). There also would be an integration of theoretical perspectives from DBT, including how dysfunction evolves from emotional sensitivity in transaction with an invalidating environment (which includes family of origin and cultural elements). We will also discuss the need for family involvement when treating adolescents.
We will review motivational interviewing techniques helping patients and their families to commit to treatment. The Stages of Change model would be included to help the audience identify where they or their patients are in the process of behavior change, in order to give them an idea of how to progress through these stages toward desired outcomes.
We would discuss family based DBT, what it is and how one uses it. This would include strategies to understand one’s own behavior, including behavior analysis, as well as skills for increasing acceptance of one’s self, and for changing behavior. We will then help the audience learn how to apply Family based DBT techniques to dealing with issues of bulimia. It will address the need for commitment, mindfulness, Distress tolerance, Emotion regulation, Interpersonal effectiveness, and Walking the Middle Path.
Director of Adolescent and Family Services at Insight Behavioral Health Centers. She is currently affiliated as an Associate Professor in the Department of Psychiatry, UIC Medical Center and Associate Professor, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences Northwestern University. She has over 15 years of clinical and teaching experience in the field of eating disorders. She is a member of the American Psychological Association, and the Academy for Eating Disorders. Astrachan-Fletcher, E. & Maslar, M. (2009). The Dialectical Behavior Therapy Workbook for Bulimia: Using DBT to regain one’s life; Skills for Breaking the Cycle. New Harbinger Publications.
Michael Maslar Psy.D., is a Licensed Clinical Psychologist who is Director of the Mindfulness and Behavior Therapies program at the Family Institute of Northwestern University. He previously coordinated psychology training and Dialectical Behavior Therapy (DBT) services at Northwestern Memorial Hospital’s Outpatient Psychiatric Rehabilitation Program, and has worked with challenging problems in a variety of other outpatient, inpatient, and residential settings. A graduate of the Chicago School of Professional Psychology, he practices mindfulness-based therapies, therapies rooted in “Third Wave” behavioral therapies. He received instruction as a clinician and trainer from the original developers of DBT, Marsha Linehan’s Behavioraltech.
