Dialectical Behavior Therapy in College Counseling Centers: Practical Applications and Theoretical Considerations

Abstract

Authors over the last two decades have discussed the myriad of challenges present in managing college students with severe mental health disorders. During the same time period, Marsha Linehan developed dialectical behavior therapy (DBT) as an empirically sound intervention for individuals with suicidal and self-injurious behaviors and this treatment grew to be an evidence-based practice for a range of challenging clinical issues. I argue that one solution to continued increases in college students who present for treatment to their college counseling centers with difficult-to-treat mental health issues, including but not limited to, borderline personality disorder (BPD), is to implement DBT programs on college campuses. As such, the purpose of this dissertation is to address both practical and theoretical issues in the implementation of DBT in college counseling centers. In chapter two, I begin by presenting an overview of DBT as a comprehensive treatment model and a review of the research to date related to DBT in college counseling centers. In chapter three, I offer a detailed account of the program development and implementation process of the DBT program housed in the college counseling center at Florida Gulf Coast University. In chapter four, I present an investigation of current trends and barriers to implementation of DBT in college counseling centers. Finally, in chapter five, I present a qualitative inquiry of the experience of BPD as told by individuals who have been successfully treated with DBT. I argue that understanding client experiences and behaviors in context is critically important if one is to be able to respond empathically and compassionately. In essence, these chapters represent my attempt to synthesize two areas that I believe are required for successful implementation of DBT programs that provide good quality care: 1) Navigating the complexities of implementing DBT in college counseling centers as practice setting and 2) Appropriate management for clinician biases and tendencies to stigmatize BPD clients, which interferes with their ability to provide care that is both effective and compassionate