Pine Rest Mission Statement
Pine Rest Christian Mental Health Services is called to express the healing ministry of Jesus Christ by providing behavioral health services with professional excellence, Christian integrity and compassion.

Dialectical Behavior Therapy as Treatment of Choice for Self-Harm Behaviors

By Karen Elbert, LMSW
Clinical Social Worker - Pine Rest Wyoming Clinic, DBT Program Coordinator

Dialectical Behavior Therapy, or DBT, was developed by Dr. Marsha Linehan, Professor of Psychology at University of Washington for clients with histories of chronic suicide attempts, suicidal thinking, urges to self harm, and patterns of actual self-harm behaviors. It has at its foundation Cognitive Behavioral Therapy, which is focused on learning new behaviors and creating the changes necessary for a ‘life worth living.’

Who is DBT appropriate for?
Clients who most benefit from this treatment are those who have developed patterns of behaviors to cope with life stresses that, in and of themselves, end up making life even more stressful. These behaviors may include, but are not limited to:

* Chronic suicidal thoughts
* Multiple suicide attempts
* Self-mutilation such as cutting, burning, and piercings for the experience of the piercing
* Disordered eating
* Serial problematic relationships
* Over-spending
* Drug and alcohol abuse (after a solid period of sobriety)

Often these clients report either feeling chronically empty and alone or they are always on an “emotional roller coaster.” Because of these behaviors and experiences, their relationships and self-esteem suffer collateral damage.

Bio-Social Theory
Linehan frames DBT treatment in her “bio-social” theory of why people resort to these extreme means to solve problems in their lives. A key assumption in DBT is self-destructive behaviors are learned techniques for dealing with unbearably intense and negative emotions. Although “negative” emotions like shame, guilt, sadness, fear, and anger are normal parts of life, it seems some people are particularly inclined or ‘hard-wired’ to be more sensitive to stimuli and experience stronger heights of emotional arousal that also seem to last longer. Severe emotional or physical trauma can also cause changes in the brain to make it more vulnerable to intense feeling states. Whether through ‘wiring’ or experience, some people are just more emotionally vulnerable.

Extreme emotional vulnerability is rarely the sole cause of psychological problems. An invalidating environment is also a major contributing factor. Examples of an invalidating environment can range from less than optimally matched personalities of children and parents (e.g., a very shy child growing up in a family of extroverts who don’t understand the level of anxiety present in social interactions) to extremes of physical or emotional abuse. Linehan’s theory is self-destructive behaviors, whatever the form, arise from the transaction between the emotionally vulnerable individual trying to survive in an environment that is not able to meet these vulnerability-based needs.

An Empirically-Based Treatment
Research studies have been done comparing the outcomes of DBT treatment to what is called “treatment as usual.” The results of these studies have found:

1. Clients participating in this treatment for one year had significantly fewer and less severe self-harm behaviors during the treatment year.
2. Clients engaged in DBT treatment had a lower rate of “treatment drop-out” during the treatment year than the group receiving other treatment.
3. Clients in the DBT treatment group had a tendency to enter psychiatric inpatient units less often and had fewer inpatient psychiatric days.

(Excerpted from "Today" magazine's "Understanding and Surviving Self-Harming Behavior" issue. Read the full article at http://www.pinerest.org/education/today/selfharm/dbt.asp)

Karen Elbert, LMSW, has 25 years’ experience in the human services field, with clinical experience in both inpatient and outpatient settings. She received her Master’s degree in social work from Grand Valley State University. She has also received continuing education and training in Cognitive-Behavioral Therapy, Dialectical Behavior Therapy, treatment of traumatic stress, thought field and body based therapies. In addition, she has a certificate in Spiritual Direction.

Watch for Signs of Depression in Those Who Live with Alzheimer's

by Kim Curyto, Ph.D., Center for Senior Care

When loved ones have Alzheimer's disease, it may be difficult to know what they are experiencing. It is hard for persons with dementia to communicate how they feel as their ability to use words declines. Approximately a third of persons with dementia will experience an episode of depression. Instead of relying on your loved one to tell you about symptoms of depression, look for nonverbal signs. For example, is your loved one's facial expression frequently sad? Do they avoid doing usual activities or being with people? Are they refusing to eat, sleeping all the time or not enough? Other signs include crying, being unusually emotional, angry or agitated.

If you think depression may be a problem, discuss your concerns with a physician. They may prescribe antidepressant medication, or may refer to a mental health specialist for further treatment.

Kimberly Curyto, PhD, is a geropsychologist and research scientist in the Center for Senior Care. She addresses clinical issues dealing with dementia, in addition to developing a program of applied research. She has held positions as a pre-doctoral fellow in the University of Pennsylvania’s Department of Geriatric Psychiatry, and as a post-doctoral fellow at the Philadelphia Geriatric Center. Dr. Curyto is a member of the American Psychological Association and the Gerontological Society of America.

Upcoming Events

Classes and Workshops
November 8, 15, 22, 29
Pine Rest Hosts Anger Management Classes
Pine Rest Christian Mental Health Services will be hosting Anger Management classes in September and November 2005. Classes will be led by Jim Bottenhorn, M.A., L.L.P., director of Pine Rest’s Contact Center.

The six-hour classes will be held over the course of four consecutive Thursday evenings in September, and four consecutive Tuesday evenings in November, from 7:00-8:30 p.m. in the Colorado room, located in the northwest corner of the Mulder Center on Pine Rest’s main campus, 300 68th Street SE, Grand Rapids. Classes are geared toward adults and older teens (aged 16 and older), and are open to both men and women.
For more information click here.

General Events
November 15, 2005
Dementia Screening Day
Are you or someone you know experiencing confusion, forgetfulness or uncertainty? On Tuesday, November 15, Pine Rest Christian Mental Health Services and Saint Mary’s Alzheimer’s Disease and Memory Disorder Program are sponsoring the annual Dementia Screening Day. The free and confidential screening can help determine if you or a loved one are at risk for dementia and how to get help. Health care professionals will be available for one-on-one consultations, and free handouts on dementia will be provided as well.
For more information click here.

Family Institute Lectures and Certification Classes
November 8, 9, 10, 11
Family Wellness Training
Four-day training workshop provides certification for facilitators interested in teaching "Survival Skills for Healthy Families." Facilitated by George Doub, M.Div, LMFT, and Florence Creighton, MPH, LCSW of Family Wellness Associates. 8 a.m. to 5 p.m. Cost: $750/person (scholarships available). Sponsored by Pine Rest Family Institute. Call 616/831-2622 for location and registration information.

November 15
Marriage and Family Building Series
The Marriage and Family Building series is designed for pastors and lay leaders. The cost is $5.00 for lunch. It runs from 11:30 am to 1:30 pm. The title of this event is "Assisting Busy Pastors with Marital Preparation" and will be presented by Dr. Mark Eastburg. Call 616/831-2622 for location and registration information.

Professional Lecture Series
November 2
"Designing Effective Interventions for Dementia: Lessons from Montessori and Neuroscience" Featuring Cameron Camp, Ph.D., Director and Senior Research Scientist with the Myers Research Institute, 10 a.m. to 12:15 p.m. at the Van Andel Center Gym on Pine Rest’s main campus, 300 68th St., SE, Grand Rapids. Complimentary admission. Call 616/281-6363, ext. 2298 or
for more information click here.

November 9
"Clinical Updates and Medication Management for Disease of Substance Use" Featuring Thomas Winegarden, M.D. and Bruce Springer, M.D., 1 p.m. until 3:30 p.m. in the Van Andel Center Gym on Pine Rest’s main campus, 300 68th Street SE, in Cutlerville. Registration is required. 2 MERC Credits. 2 MCBAP Contact hours. Call 616.455.6500 or for more information click here.

December 7
"Treatment of Anxiety Disorders: Pharmacological and Psychotherapeutic Approaches" Featuring James Abelson, M.D., Ph.D., Associate Professor for the Department of Psychiatry and Director of the Anxiety Disorders Program at the University of Michigan. Lecture will be held from 9 a.m. to 12:15 p.m. on Pine Rest’s main campus, 300 68th St., SE, Cutlerville. The lecture is free of charge and open to the public. Call 616.455.6500 or for more information click here.

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Disclaimer

Copyright © 2005, Pine Rest Christian Mental Health Services. All rights reserved. The contents of Mental Health News & Information are for informational purposes only. The content is not intended to be a substitute for professional medical or mental health advice, diagnosis, or treatment. It cannot and should not be used as a basis for diagnosis or choice of treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical or mental health condition.