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Dialectical Behaviour Therapy - Prolonged Exposure
for Post-Traumatic Stress Disorder

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About DBT-PE for PTSD

Dialectical Behaviour Therapy (DBT) is highly effective for people experiencing difficulties in managing emotions and interpersonal situations. Given that trauma can cause people to experience problems in emotional, social and occupational functioning, DBT can be effective and is increasingly being applied to those with a diagnosis of Post-Traumatic Stress Disorder (PTSD). At DBT Virtual we provide a therapy protocol called DBT-PE (Prolonged Exposure), which is designed to treat those with PTSD or significant PTSD-related symptoms.

What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental health diagnosis that can occur in people who have either directly experienced, witnessed or learned about a traumatic event. This can include events involving actual or threatened sexual violence, death or serious injury. PTSD involves a range of the following symptoms including:

  • Intrusions: nightmares; flashbacks; recurring distressing memories; and emotional or physiological reactions to reminders of the event.

  • Avoidance: avoiding thoughts, feelings and external reminders (i.e. people, places, or objects) related to the event.

  • Changes in Thinking and Mood: strong negative emotions; difficulty experiencing positive emotions; negative thoughts about oneself, others or the world; blaming oneself for the trauma; detachment from others; and a lack of interest in meaningful activities.

  • Arousal and Reactivity: irritability and aggression; reckless behaviours; hypervigilance; heightened startle response; and trouble concentrating and sleeping.

  • Dissociation: feeling detached from oneself or as though your surroundings seem unreal.

Most people after a trauma will exhibit a range of these symptoms. It is only after someone experiences these symptoms for one month or longer that the mental health condition can be diagnosed.

Can DBT-PE help me?

DBT-PE is designed to combine two evidence-based protocols (Dialectical Behaviour Therapy and Prolonged Exposure) to simultaneously treat both PTSD and other coinciding conditions such as depression, anxiety or personality disorders. DBT-PE is designed for people who either have the diagnosis of PTSD or experience PTSD-related symptoms. More specifically, it is intended for people with PTSD that first require support with stabilization of life-threatening, high-risk or impulsive behaviours that would otherwise interfere with trauma therapy (such as self-harm or suicidal behaviours, substance use, aggression, recklessness, disordered eating, or addiction). It can also be helpful for clients who may experience regular difficulties attending or remaining engaged in their therapy, such as those with repeated absences, withdrawal, dissociation or refusal to participate in their therapy tasks.

What can I expect in DBT-PE?

By participating in DBT-PE you will be required to attend our DBT Skills Group and one-on-one DBT prior to beginning trauma therapy, where the aim will be to increase your capacity to use DBT coping skills to help you gain control over severe behaviours and improve your regulation of emotions and crises (approximately 20 sessions). Once stability is achieved and maintained trauma therapy through Prolonged Exposure can begin (approximately 13 sessions), which involves deliberate exposure to situations and memories related to the trauma that the person avoids. Prolonged Exposure is a necessary intervention in DBT-PE since avoidance is what maintains PTSD symptoms and prevents one from recovering. The two ways this occurs is in:

  • Imaginal Exposure: where one revisits the traumatic experience and describes it verbally during therapy.

  • In Vivo Exposure: where one confronts real life situations that are actually safe but are avoided because the trauma has caused you to believe they are dangerous.


Both forms of exposure are deemed to be very effective at reducing fear, avoidance and other trauma-related symptoms.


Want to learn more about the research supporting the efficacy of DBT-PE? Click here.