Treatment of Problematic Sexual Behaviors without Shame: Using Dialectical Behavior Therapy (DBT) Strategies and Skills

Description:

Problematic sexual behaviors (PSB) are a growing area of clinical concern leaving clinicians struggling to find ways to effectively treat it.  The scarcity of empirically supported treatment options makes it difficult to know where to turn to provide clients with the relief they desperately desire. The clinical picture is often further complicated when clients seek help after conducting their own internet research, leaving them with increased feelings of guilt, shame, fear, and adopting an “I am an addict” identity. Dialectical behavior therapy (DBT) offers a non-judgmental approach which assumes that people are doing the best they can and that any behavior makes sense provided the proper context. This allows clients a way forward that reduces feelings of shame and guilt and provides the clinician with a judgement free framework to collaborate with the client and meet them where they are. Early clinical DBT applications with sex offender programs provide some evidence that the approach may also be effective in non-forensic settings.  Problematic sexual behavior is a heterogenous issue which often adds an additional layer of complexity in clients suffering in several areas simultaneously. DBT provides empirically based strategies and skills to help clients with  each of the many areas of difficulties they may be facing.

This presentation will discuss common struggles related to problematic sexual behaviors and discuss how specific DBT strategies and skills can be utilized to provide effective treatment for each of these. Participants will learn how to formulate and adapt an effective treatment plan using Chain Analysis and DBT for addressing problematic sexual behavior.

Attendees will be eligible for obtaining three APA or AASECT continuing education units. Additional fees apply for CE credits.

About The Speaker:

Dr. Keri Clark, PhD, Licensed Clinical Psychologist, Olsen Institute Distinguished Fellow

Dr. Keri Clark is a recognized expert in helping clients heal from painful life events and behavioral struggles using Dialectical Behavior Therapy (DBT), Cognitive Processing Therapy, Prolonged Exposure Therapy and 12-Step Facilitation.  He leverages DBT theory and skills to help clients reveal and process traumatic events and struggles in behavior modification.  Dr. Clark worked to help implement a DBT based milieu treatment programs and train staff in a juvenile correctional and inpatient psychiatric settings.  He draws on 20 years of experience running DBT Skills groups and training others to utilize these skills in treatment for a wide variety of issues.  For that same time period, he has used DBT Strategies and skills to help clients replace a wide variety of severely problematic behaviors with more skillful behavior and build a life worth living.  His experience delivering high quality care in the most austere of settings has strengthened his belief that a therapist can understand and effectively treat nearly any behavior.  Dr. Clark has provided and supervised care to clients of nearly every age for an extremely wide variety of concerns.  Moreover, he has developed and run highly successful inpatient and outpatient programs, including one of the first embedded behavioral health clinic on Joint Base Lewis-McChord, as well as an adolescent inpatient unit treating adolescents with severe mental illness and problematic behavior at the Washington Child Study and Treatment Center in the state of Washington.

Learning Objectives:

At the end of this presentation, the learner will be able to:

1. Recite core DBT Treatment Strategies and Skills.

2. Describe how DBT Skills can be used to effectively treat the issues related to a client’s problematic sexual behavior.

3. Design and adapt an effective treatment plan using Chain Analysis and specific DBT skills for a variety of problematic sexual behaviors.

References:

Marco Cavicchioli, Pietro Ramella, Giulia Vassena, Giulia Simone, Francesca Prudenziati, Federica Sirtori, Mariagrazia Movalli & Cesare Maffei (2020) Dialectical behaviour therapy skills training for the treatment of addictive behaviours among individuals with alcohol use disorder: the effect of emotion regulation and experiential avoidance, The American Journal of Drug and Alcohol Abuse, 46:3, 368-384, DOI: 10.1080/00952990.2020.1712411

Coleman, E., Dickenson, J. A., Girard, G., Rider, N., Candelario-Perez, L. E., Becker-Warner, R., Kovic, A. G., Munns, R. (2018). An integrative biopsychosocial and sex positive model of understanding and treatment of impulsive/compulsive sexual behavior. Sexual Addiction & Compulsivity, 25(2-3) 125-152. https://doi.org/10.1080/10720162.2018.1515050

Joseph Allan Sakdalan & Rajan Gupta (2014) Wise mind—risky mind: A reconceptualisation of dialectical behaviour therapy concepts and its application to sexual offender treatment, Journal of Sexual Aggression, 20:1, 110-120, DOI: 10.1080/13552600.2012.724457

Steil, R., Schneider, A. & Schwartzkopff, L. How to Treat Childhood Sexual Abuse Related PTSD Accompanied by Risky Sexual Behavior: A Case Study on the Use of Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD). Journ Child Adol Trauma 15, 471–478 (2022). https://doi.org/10.1007/s40653-021-00421-6