Hybrid Dialectical Behavior Therapy for Veterans to Further Reduce Emotion Regulation Problems and Trauma Symptoms

REfreshment of Dialectical Behaviour Therapy for Veterans to Further Reduce Symptoms and Prevent Relapse of Post-traumatic Stress Disorder and Emotion Regulation Symptoms by Guided Self-Help

Around 10% of post-active veterans experience post-traumatic stress disorder (PTSD) many years post-mission. PTSD in veterans is frequently associated with challenges in emotion regulation, aggression, suicidality, and financial and psychosocial stress. In 2018, a 12-week clinical treatment programme, the Veterans Intensive Treatment Unit (VIBU), was developed for veterans experiencing these psychiatric symptoms, for whom conventional treatments had proven ineffective. The VIBU provides patients with trauma-focused and dialectical behaviour therapy (DBT). A recent study revealed that the VIBU was effective in reducing psychiatric symptoms. However, a recurrence of symptoms was observed in patients a few months after discharge. Consequently, an aftercare programme consisting of hybrid DBT is offered to consolidate and repeat the DBT skills and apply them in daily life.

Inclusion Criteria:

• Adult veteran (18 years or older), treated at Sinai Center, with knowledge of DBT
• Primairy diagnosis of PTSD, determined with CAPS-5, resulting from war-related traumas
• Stable for four weeks on their medication (type and doses)
• Able to to do online homework assignments and communicate with their therapist via an eHealth platform
• Dutch speaking

Exclusion Criteria:

• Chronic psychosis (psychotic features as comorbidity from PTSD is allowed) or bipolar disorder type 1
• IQ below 80 or cognitive disorders
• Severe self-harming behaviour, such as auto-mutilation or suicidal ideations as main problem
• Following day treatments or other intensive treatment for residual symptoms