DBT Interventions for High-Risk Clients: Ensuring Safety and Effectiveness in Trauma Treatment

Clinicians often shy away from targeting/treating trauma and PTSD when clients present with high-risk behaviours, including non-suicidal self-injury and suicidal behaviours. This is often true even for clinicians with significant expertise in treating trauma. Unfortunately, a majority of clients who engage in high-risk behaviours have also experienced significant trauma or meet criteria for PTSD, and their trauma-related symptoms often prompt suicidal and self-injurious behaviours.

Many clients find themselves stuck in a catch-22; their trauma-related symptoms cause severe emotional distress that makes NSSI and suicidal behaviours more likely to occur, and these behaviours, in turn, render them ineligible for many treatments that would address their trauma.

On the other hand, clients without the ability to regulate and tolerate intense emotions and distress can be overwhelmed by trauma treatment, and treatment can actually be harmful or dangerous to them.

Dialectical Behaviour Therapy, a treatment approach that was initially developed to help people with frequent and intense suicidal behaviour who often had histories of trauma, offers tools and structures that help to resolve these very conundrums.

In this talk, attendees can expect to get a brief overview of strategies, tools and lessons learned in the context of DBT that will help them support clients who engage in suicidal behaviours. Clinicians will leave this talk with a few helpful guidelines and tools from DBT that may change their approach and comfort level working with trauma in a safe and effective manner when high-risk behaviours are a consideration.