Category Archives: Persistently/severly Mentally Ill

Dialectical Behavior Therapy (DBT)

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Dialectical Behavior Therapy (DBT) is an empirically supported treatment designed to help people manage overwhelming feelings and self-defeating behaviors. These feelings and behaviors may create major challenges in life (such as angry outbursts, violence, depression, immobility and avoidance by suicide attempts, substance abuse, and eating disorders). DBT encompasses core modules of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness skills training. The emphasis is on building and enhancing skills to regulate emotions, deal with the distressing situations, and improve relationships. DBT was invented by Dr. Marsha Linehan, a psychologist, who used her own insights from living successfully with Borderline Personality Disorder to develop this novel therapy. In its standard form, there are four components of DBT: skills training group, individual treatment, DBT phone coaching, and consultation team.

Trauma Center-Justice Resource Institute

The Linehan Institute

DBT Fact Sheet – NAMI

Trauma Empowerment and Recovery Model (TREM)

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TREM and M-TREM are fully manualized group interventions for women (TREM) and men (M-TREM) who are trauma survivors.  These groups are interventions that address a broad range of trauma sequelae among people with severe mental disorders and/or substance abuse problems. Both use cognitive restructuring, psychoeducation, and coping skills training, weaving each of these techniques throughout the intervention, which incorporates a specific recovery topic in each weekly 75-minute session.  TREM is 29 sessions long while M-TREM comprises 24 sessions. TREM groups are for women only with female co-leaders; M-TREM groups are for men and routinely have male co-leaders.  Both groups are designed for 8-10 members.  TREM is organized into three major parts:  empowerment, trauma education, and skill-building.  Discussions cover topics of sexual, physical, emotional, and institutional abuse, and women explore and reframe the connection between abuse experiences and other current difficulties.  M-TREM is similarly organized but differs in the content of the three major parts.  In M-TREM, the first section focuses on emotions and relationships, helping men to develop a shared emotional vocabulary and increased capacities to address relationship dynamics.  The second section is similar to that of TREM, addressing emotional, physical, and sexual abuse directly.  The third part of M-TREM, like TREM, centers most directly on skill-building and problem-solving, but addresses different content issues in a different order than the TREM group.

TREM has been successfully implemented in a wide range of service settings (mental health, substance abuse, criminal justice) and among diverse racial and ethnic populations.

Specifically for women (all ages, all ethnicities) survivors of trauma for whom traditional recovery work has been unavailable or ineffective.

Alternatives to Seclusion and Restraint

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Seclusion and restraint were once perceived as therapeutic practices in the treatment of people with mental and/or substance use disorders. Today, these methods are viewed as traumatizing practices and are only to be used as a last resort when less-restrictive measures have failed and safety is at severe risk.

For more information on alternatives to seclusion and restraint:

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Managing Traumatic Stress Through Art

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Three art therapists have collaborated to produce this unique workbook. Designed especially for trauma survivors, Managing Traumatic Stress Through Art introduces inventive ways to understand, manage, and transform the after effects of trauma. This dynamic workbook consists of carefully structured step-by-step art projects, augmented by tear out images, and writing experiences. The book’s first section, Developing Basic Tools For Managing Stress, is devoted to establishing a safe framework for trauma resolution. The second section, Acknowledging and Regulating Your Emotions, helps the trauma survivor to make sense of overwhelming emotional experiences. The final section, Being and Functioning in the World, focuses on self and relational development, leading into the future.

No specific age/population. Can be used in individual or group therapy. The art experiences are broad enough to be of value to survivors of a wide variety of traumatic experiences, ranging from childhood abuse to accidents to disabling mental illness.

Managing-Traumatic-Stress-Through-Art

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Cognitive Behavioral Therapy (CBT) for PTSD w/ people w/ severe mental illness (SMI)

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For men or women with PTSD; addiction treatment settings, adolescents, survivors of disaster/terrorism, and person’s receiving treatment in primary care settings.