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CLINICAL SERVICES
DBT Standard Program: Path to Effective Living
Standard programs are available for adults and young adults. The program lasts approximately six months and includes weekly individual therapy, a skills training group (2 hours), as needed phone coaching, and a therapist consultation group. Other treatment components as listed under Services to Family and Friends and medication management are added as needed.
Individual Therapy: Through a combination of dialectical, validation, and problem-solving strategies, individual therapy helps clients to reduce maladaptive, mood-dependent behaviors and replace them with more skillful responses.
Skills Training: A skills training group combines lecture, discussion and practice exercises to develop and refine skills in non-judgmental, present moment awareness and acceptance, distress tolerance, emotion regulation, interpersonal effectiveness, problem-solving, and relapse prevention.
Telephone Coaching: Phone coaching is designed to promote skills use where it matters most — in the real world. Coaching can be especially helpful to clients when they find themselves in difficult situations and need assistance in putting the skills to work.
Consultation Group: Consultation group is for DBT practitioners. In a non-judgmental and validating environment, therapists’ problem-solve difficulties that interfere with clients' progress in treatment and help keep each other within a dialectical framework.
DBT Teen Program
Dialectical Behavior Therapy (DBT) adapted for teens was developed by Dr. Alec Miller and his colleagues at Montefiore Medical Center/Albert Einstein College of Medicine. While most other empirically supported treatments for adolescents deal with one major problem at a time, DBT focuses on the complex, difficult-to-treat teen engaging in, or at risk for, suicidal behavior. The teen program lasts approximately 16 weeks and includes all the components of standard DBT plus a Parent Education and Support Group. Other treatment components as listed under Services to Family and Friends and medication management are added as needed.
DBT Eating Disorders Program: Path to Mindful Eating
We offer both Outpatient DBT Eating Disorder and Intensive Outpatient Eating Disorder Programs for adults and adolescents. Treatment targets include anorexia, bulimia, binge-eating disorder and other problematic eating behavior, as well as disturbances of body weight and shape.
OUTPATIENT DBT-ED PROGRAM
Our Outpatient DBT Program for Eating Disorders is based on the research-supported DBT modifications of Dr. Christine Telch at Stanford University and Dr. Lucene Wisniewski of the Cleveland Center for Eating Disorders. The program lasts approximately six months and includes all the components of standard DBT. Other treatment components as listed under Services to Family and Friends and medication management are added as needed. Ancillary ED services include:
Maudsley Family Therapy: Maudsley family therapy is an evidence-based practice shown to be superior over individual therapy in the treatment of eating disorders in adolescents. The model views the eating disorder, particularly Anorexia, as a serious medical illness. The approach involves significant family involvement throughout treatment; empowering the family to take over re-feeding the client for nourishment to restore health. Maudsley family therapy sessions may include therapeutic meals for families who need help problem-solving obstacles that get in the way of effectively using the method at home.
Nutrition Therapy: Nutrition therapy is essential in the treatment of eating disorders to restore clients’ overall health and help them develop a positive relationship with food and eating. At Portland DBT we subscribe to a client-centered, collaborative approach as we plan for meeting nutritional needs. Support for eating well can reduce urges to engage in eating disorder behavior which, in turn, compliment other ED services offered. All nutrition therapy services are provided by a licensed dietician who specializes in nutrition and eating disorders.
Medical Evaluation/Management: Offered by affiliated medical providers.
INTENSIVE OUTPATIENT ED PROGRAM
Our Intensive Outpatient Program (IOP) for Eating Disorders integrates components of a number of research supported treatments including DBT, cognitive behavior therapy (CBT), and the Maudsley approach. We offer programs for both adults and teens, designed for individuals who need more structure and support than can be offered in a general outpatient setting, but who do not require the intensity of hospital or day treatment. Our programs can serve as a “step up” for clients who require more than once a week outpatient treatment or as a “step down” for those transitioning to a lower level of care.
Programs are structured so that clients can continue in work or school while attending treatment. This arrangement is less disruptive to clients’ schedules and provides intervention and support when needed most-in the evening and after school. Services are provided by a multidisciplinary team of professionals who work in concert to implement a well coordinated and seamless system of care. Treatment plans are individualized based on client need and revised as necessary to accommodate progress as well as setbacks. Of utmost importance is developing a thoughtful aftercare plan where maintenance of gains is the primary target of treatment.
Both adult and teen IOP’s offer nine hours of group therapy per week including:
- CBT for Eating Disorders
- Problem-solving and Relapse Prevention
- Mindful Movement
- Health and Wellness Education
- Weekend Planning and Review
- Therapeutic Meal/Snack
Additional services are scheduled as warranted and include:
- Medical Monitoring
- Nutrition Therapy
- Individual/Family Therapy
- Medication Management
DBT for Substance Abuse Program: Path to Clear Mind
DBT-S (“Path to Clear Mind”) is a modification of standard DBT developed by Dr. Linda Dimeff of the Behavioral Technology Transfer Group with emphasis on the treatment of substance abuse/dependence. Research data on this DBT adaptation suggests that DBT-S is an effective treatment for individuals with mental health and substance abuse problems. This program is ideal for people who have attempted to stop using alcohol or drugs several times, with little long term success. Among the goals of DBT-S are to:
- Increase motivation to stop abusing alcohol or drugs
- Become more aware of urges to drink or use and tolerate or reduce them
- Manage negative emotions such as anxiety, depression, and anger without alcohol or drugs
- Interact effectively with others without relying on alcohol or drugs to bolster self-confidence
- Structure one's environment to support substance-free living
The Portland DBT-S Program lasts approximately six months. It is an abstinence-based program that utilizes all the components of standard DBT and adds interventions specific to substance abuse treatment like urianalysis and relapse prevention skills. Other treatment components as listed under Services to Family and Friends and medication management are added as needed.
DBT Trauma Recovery Program: Path to Calm Awareness
Portland DBT’s Trauma Recovery Program is designed for individuals who have experienced traumatic events in their lives-often, but not exclusively, during childhood and usually in the context of relationships. The research based services that comprise this program target problems with hyperarousal, as well as the re-living and avoidance cycle commonly experienced by trauma survivors. The program is eight weeks in duration with an option of continued renewal until problems have abated.
Introductory Education Group:
This psychoeducation group covers common reactions to trauma, the impact of traumatic events on the brain and body, information about post traumatic stress disorder (PTSD) including a variant of the disorder called complex PTSD, and a research-based approach to treatment that targets both biology and learning.
Down-Regulation/Grounding Group:
Participants in this group are led through a progression of breathing and relaxation exercises to better manage hyperarousal symptoms and other forms of trauma related distress. Also covered are grounding exercises to help clients reorient their minds and bodies to the present moment. This group is experiential in nature, with a strong emphasis on both in-group and out-of-group practice.
Therapeutic Yoga Group:
Therapeutic yoga involves leading participants through a progression of breathing exercises and body movements while seated in chairs. These exercises are designed to increase awareness of the mind-body connection, reduce stress, and calm the mind through a gradual release of body tension.
Individual Exposure Therapy:
Individual therapy is focused on the reduction of PTSD and related symptoms through formal exposure therapy. Exposure therapy involves gradated and repeated presentation of trauma related material with goals of decreasing avoidance, psychologically “digesting” traumatic memories, and reducing the emotional distress elicited by a variety of conditioned cues.
Ancillary program services include:
Dialectical Behavior Therapy
Trauma Recovery Program participants can also enroll in our standard DBT program which consists of weekly individual therapy, a skills training group, as needed telephone coaching, and team consultation group. We also offer a group-only option for individuals who do not require the full program but could benefit from DBT-influenced skills training.
Advanced Process Group
This group is designed for individuals who have completed basic recovery work and possess good communication and coping skills. Through a process of sharing and feedback, clients explore how past traumatic events have affected them today with the goal of establishing an integrated and more balanced perspective regarding the past, present, self and others.
Family/Couples Therapy
Family/couples therapy is available to address the impact traumatic experiences have on the family system and intimate relationships. Psychoeducation, acceptance-change based interventions, skills training, and exposure principles inform these services.
ACES Group
ACES (Acceptance and Change through Education and Support) is a 12-week psychoeducational group. Through lecture, discussion, and practice exercises, clients acquire skills in self-awareness and acceptance, stress management, balancing expression of emotions with emotional control, and effective communication. The group is designed for individuals who would like to improve their quality of life by addressing the following problem areas: low self-esteem & lack of confidence, mild to moderate problems with depression and anxiety, and difficulty dealing with stressful situations including relationship conflict. Other components of DBT as listed under the Standard Program, Services to Family and Friends and medication management are added as needed.
Medication Management Services
Clients can integrate medications into their overall DBT treatment plan. Our medical providers place an emphasis on educating clients in understanding how medications work, the benefits and possible side effects, and targets for improvement. Medications are part of the entire treatment process and represent a biosocial approach. Medication management services include:
- Initial medication evaluation
- On-going medication management
- Consultation with primary care provider
- Facilitation of related care such as laboratory testing
Services to Family and Friends
Family and Friends Orientation Workshop: This three-hour workshop provides basic information regarding Dialectical Behavior Therapy (DBT), Borderline Personality Disorder, and staff and services offered at Portland DBT to family and friends of program clients.
Parents’ Group and Partners’ Group: These 16-week groups are designed to help parents/partners facilitate the progress of their family member in the program. The goals of each group are to:
- Explain the biosocial model of development and maintenance of clients’ issues and problems
- Teach some of the basic DBT ideas and skills that clients are learning in the program
- Explore ways to provide an environment for clients that balances validation (where the focus is on acceptance) and problem-solving (where the focus is on change)
- Facilitate mutual support and problem-solving between group members as their family member advances through the program
DBT-Informed Family Therapy and Couples Therapy: An individually tailored treatment plan is developed based on your family’s specific needs. Common areas of intervention include reducing patterns of harmful conflict and polarization, as well as strengthening relationship-enhancing behaviors such as accurate expression and validation.
Family Consultation Services: Individual consultation sessions are available for family members to share concerns about their loved one, gain a better understanding of their current situation, and to discuss treatment options.
Client Workshops
There are no client workshops being offered at the current time.
For fee information on any of the above services or to make a referral, please contact the referral line at (503) 290-3291. Most insurance accepted. VISA and MasterCard accepted. Reduced rates may be available for clients in a financial hardship situation.
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