Perspectives on a Stage-Based Treatment for Posttraumatic Stress Disorder Among Dialectical Behavior Therapy Consumers in Public Mental Health Settings

  • Melanie S. HarnedEmail author
  • Sara C. Schmidt
Original Paper


Difficulties with consumer engagement are a common barrier to implementing trauma-focused evidence-based psychotherapies (TF-EBPs). Potential methods of increasing engagement include utilizing a stage-based treatment approach, and involving consumers in implementation efforts. This mixed method study explored consumers’ perspectives on a stage-based TF-EBP, Dialectical Behavior Therapy (DBT) with the DBT Prolonged Exposure (DBT PE) protocol. Nineteen DBT consumers in two public mental health agencies targeted for implementation of DBT + DBT PE participated in focus groups and completed questionnaires assessing treatment preferences and expectancies. Consumers reported positive treatment expectancies and a strong preference for DBT with DBT PE (89.5%) over DBT alone (5.3%) or PE alone (5.3%). This was primarily due to beliefs about the treatment’s efficacy, a perceived need for PTSD treatment, and the stage-based approach. Consumer-focused strategies for increasing uptake and reach of TF-EBPs are discussed.


Consumers PTSD Implementation Dialectical Behavior Therapy Prolonged Exposure 



This work was supported by grant R34MH106598 from the National Institute of Mental Health to the first author. Portions of these data were previously presented at the 2016 conference of the International Society for the Improvement and Teaching of Dialectical Behavior Therapy. We would like to thank the clients and therapists at the agencies where this research was conducted for their contributions to this project. Drs. Harned and Schmidt provide training and consultation in DBT and DBT PE for Behavioral Tech, LLC.

Compliance with Ethical Standards

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of WashingtonSeattleUSA

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