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1. Analyze the Biosocial Theory and the role of invalidation in driving trauma-related symptoms.
2. Integrate DBT with neuroscience to optimize clinical interventions.
3. Build therapeutic alliance with traumatized clients by balancing acceptance strategies with change strategies.
4. Demonstrate mindfulness skills to treat trauma-related dissociative symptoms.
5. Apply distress tolerance skills to cope with trauma-related triggers and reminders.
6. Practice affect regulation skills to stabilize emotions which have become dysregulated by trauma.
7. Employ dialectical thinking to recalibrate trauma-related thought patterns.
8. Develop interpersonal skills to restore relationships affected by trauma.
9. Integrate DBT with brain science and other models to optimize trauma work.
10. Analyze trauma memories utilizing radical acceptance, dialectics, and meaning-making.
11. Apply Wise Mind state to replace reactive, addictive, and self-injurious behaviors.
12. Formulate how to help clients find the middle path between over- versus under-thinking/feeling/acting.

Foundations of DBT:

• The Bio-Social Theory and its role in treatment
• What are dialectics?
• Trauma is invalidating / Invalidation is traumatizing
• Why DBT has moved beyond personality disorders
• Acceptance v. change – the overarching dialectic

DBT, Trauma, and the Brain

• Healthy Brain v Traumatized Brain
• Malleability, plasticity, and post-traumatic growth
• How DBT interventions impact neurobiology
• Fight, flight, freeze as it relates to trauma survival

Integrating Trauma-Informed Care into DBT Core Skills

• How to sequence DBT in a trauma-informed manner
• The role of dialectics in trauma recovery
• Application of DBT to other trauma-related symptoms and disorders
• Integration of DBT with other trauma-focused modalities

Dialectical Thinking

• Common thinking errors among traumatized clients
• Teaching clients to find the “both/and” in their lives
• The role of dialectics in trauma recovery
• Skills: DBT House; TEA – Thoughts, Emotions, Actions; TOM – Thoughts, Opposite, Middle; Cognitive Defusion; Socratic Questioning

Mindfulness: Reactivity v. Dissociation

• How trauma forces awareness to the extremes
• Replace dissociation and hypervigilance with mindful tools
• Mindfulness skills to combat flashbacks and insomnia
• Skills: 3 A’s – Awareness, acceptance, action; RAIN Dance; Mindfulness Action Plan; Somatic Awareness

 Distress Tolerance: Overreaction v. Paralysis

• Radical acceptance through the lens of trauma
• Coping with triggers, nightmares, and intrusive thoughts
• Finding meaning in suffering
• Increasing willingness to try new behavior
• Skills: Diary cards; chain analysis, DBT House

Emotion Regulation: Impulsivity v. Paralyzing Worry

• How traumatic experiences escalate the frequency, severity, and intensity of emotions
• Common emotional myths caused by trauma
• Distinguish between feelings and “action urges”
• Replace reactivity with problem-solving
• Skills: “Act opposite”, SEEDS - Symptoms, Eating, Exercise, Drugs, Sleep

Interpersonal Effectiveness: Over-Reliance v. Burning Bridges

• Trauma’s effect on attachments and relational styles
• Assertiveness, boundaries, and coping with conflict
• Decrease social isolation and mistrust of others
• Skills: DEAR Adult: Assert, appreciate, apologize; Escaping the drama cycle; Appearing confident; Dealing with crisis

Develop a Trauma-Informed Treatment Program

• Skills groups and skills coaching
• Levels of validation
• Adherence v. adaptation
• Priorities and stages of treatment

Clinical Considerations

• Crisis intervention for suicidality, self-injury
• Co-morbidities: Personality disorders, substance abuse
• Diversity and multicultural factors
• Limitations of the research and potential risks

Kirby Reutter, DBTC, LMHC, CADAC, MAC is a bilingual psychologist and leading trauma specialist. Dr. Reutter has presented on a variety of mental health topics in over 80 locations throughout the United States, including Alaska and Hawaii. In addition, Dr. Reutter has presented original research at MIT, provided trainings for the US military, spoken at the International Conference on Human Trafficking, and has appeared multiple times on live Spanish radio. In 2018, Dr. Reutter delivered a TEDx Talk regarding the effects of human trafficking on both brain development and society. Thus far to date, Dr. Reutter has authored 3 books, 1 book chapter, and 6 journal articles. Dr. Reutter’s most recent publication is entitled: DBT Skills Workbook for PTSD: Practical Exercises for Overcoming Trauma and Post-Traumatic Stress Disorder. Dr. Reutter currently contracts with the Department of Homeland Security to provide treatment services for refugees seeking political asylum.
Dr. Kirby Reutter is not affiliated or associated with Marsha M. Linehan, PhD, ABPP, or her organization.

Speaker Disclosures:
Financial: Dr. Kirby Reutter maintains a private practice and receives compensation as a consultant. He receives royalties as a published author. Dr. Reutter receives a speaking honorarium, recording, and book royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Kirby Reutter has no relevant non-financial relationships.

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CE Information Coming Soon
Continuing education credit information is coming soon for this non-interactive self-study package.

CEs may be available for select professions, as listed in the target audience. Hours will be dependent on the actual recording time. Please check with your state licensing board or organization for specific requirements.

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**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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