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Dialectical Behavior Therapy Program

Dialectical Behavior Therapy (DBT) What is DBT? DBT is a scientifically supported treatment based on a combination of cognitive behavioral therapy and Eastern meditation techniques. It was developed by Dr. Marsha Linehan to initially help individuals with suicidal thoughts/behaviors and self injury but has expanded to include a number of other conditions including eating disorders, substance use, depression, and impulsive

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Neziroglu BDD Presentation Part 5

Acceptance and Commitment Therapy ACT- a form of cognitive-behavioral therapy based on Functional Contextualism (Hayes, 1999), and Relational Frame Theory (Hayes, Barnes-Holmes, & Roche, 2001). Functional Contextualism examines a behavior in its context and examines the function. Different from Cognitive Therapy ACT is different in that it does not attempt to use any strategies to alter thoughts or feelings.

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Neziroglu BDD Presentation Part 4

Behavioral Treatment Steps Step 1: Build A Hierarchy Targeting avoidance. Targeting distressing situations. Question patient about a typical day to elicit hierarchy items. Building a Hierarchy Common Distressing Situations Mirrors/Shiny surfaces Outdoors and bright lighting Crowded situations with little personal space Shopping centers Haircuts Summer time activities Shopping for clothes Classroom environment Sports activities (swimming) Bill’s Hierarchy Watching

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Neziroglu BDD Presentation Part 3

. Understanding Issues that may Interfere with Treatment Overvalued ideation Personality disorders Extent of avoidance behaviors Co-morbidity Severity of Depression Lack of support system Family with psychiatric disorders Readiness for change Social anxiety Family criticism Predictors of Treatment Outcome in BDD Overvalued Ideation OVIS is highly predictive of treatment outcomes for OCD and BDD Personality Disorders Extent of avoidance

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Neziroglu BDD Presentation Part 2

Function of Repetitive Behaviors These behaviors reduce negative feelings of anxiety, shame and disgust Neziroglu et al., 2008 Psychopathology of Mirror Gazing Motivation for Mirror Gazing: Hope that I will look different Need to camouflage self Need to know exactly how I look Compare with ideal or how I used to look Mental cosmetic surgery Feel worse if I

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Nezirolgu BDD Presentation Part 1

Evidence Based Treatment of Complex Body Dysmorphic Disorder Part 1 Fugen Neziroglu, Ph.D ABBP, ABPP, Leah Frenkiel,B.A., Claudio Clavadetscher,B.A, & Douglas Fabian,B.A .1. Body Dysmorphic Disorder (BDD) History: In the late 19th century, Morselli (1891) coined the term dysmorphophobia to refer to the worries and complaints associated with an imagined deformity Dysmorfia – Greek word meaning a bad body or

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Neziroglu Hoarding Presentation – Part 5

Applying the Intervention Technique The proposed Intervention differs from interventions aimed at addressing addictive behaviors: This is more of an opportunity for family members to assertively communicate their feelings and urge the hoarder to participate in treatment The hoarder is not necessarily kept ignorant of the meeting before arriving at it. While boundaries are discussed in this meeting, family members

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Neziroglu Hoarding Presentation – Part 4

ERP for Acquisition Compulsion STEP 1: Construct an Exposure Hierarchy Create hierarchy of anxiety-producing situations Rate items in terms of how much anxiety you anticipate each of them will create (SUDS 1 to 100) STEP 2: Begin with the Lowest SUDS Item Begin with the item at the bottom of the list (lowest SUD) In vivo exposure, resist all urges

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Neziroglu Hoarding Presentation – Part 3

How likely is a Hoarder to Engage in Treatment N=40 9 entered hoarding treatment   (22.5%) 10 came for 5 or less sessions and never engaged in hoarding treatment (25%) 21 came for over 25 sessions but never engaged in hoarding treatment   (52.5%) Number of people engaging increases when hoarding is due to OCD, ADD, Depression.  These individuals improve with treatment.

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Neziroglu Hoarding Presentation – Part 2

Hoarding Behavior vs. Normal Behavior Process of Hoarding Acquire item Use the item Consider discarding the item: evaluate its use Obsessional Thoughts Anxiety Save the item Anxiety Relief Normal Pattern of Use for Disposable Objects Acquire item Use the item Consider discarding the item: evaluate use Discard or save the item Comorbidity 75% of individuals with hoarding disorder have a

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