Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic.

The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians' recommendations for providing DBT via telehealth. Participants included N = 99 DBT practitioners (79.8% female; 20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians' attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.

Emotion Dysregulation in Personality Disorders.

PURPOSE OF REVIEW: This manuscript aims to take stock of emotion dysregulation and personality disorder (PD) research, review key findings, and highlight future directions. RECENT FINDINGS: Most emotion dysregulation research in PDs has focused on borderline personality disorder (BPD). BPD is characterized by high baseline negative emotion and the use of maladaptive emotion regulation strategies, but several other emotion dysregulation components may not be pervasively evident in the disorder. Trends in the BPD field that add nuance to the study of emotion dysregulation suggest that BPD may involve problems in the flexible, contextually based selection/implementation of emotion regulation strategies, as well as the development of appropriate emotion regulatory goals. Furthermore, relational stressors may elicit and maintain emotion dysregulation in BPD. Less research has examined emotion dysregulation in other PDs, but several PDs may involve deficits in emotional processes (e.g., lower behavioral inhibition and resistance of emotion-related impulses), particularly in interpersonal contexts. Emotion dysregulation is a nuanced and contextual problem which, for some PDs, may be particularly nested within interpersonal contexts. The BPD field and the increasing nuance of the study of emotion dysregulation within it points to key future research directions for the broader PD field.