Carson-Wong, Amanda. The effect of therapist use of validation strategies on change in client emotion in an individual DBT treatment session. Retrieved from https://doi.org/doi:10.7282/T3MP55JQ
DescriptionDialectical behavior therapy (DBT) is a complex psychosocial treatment that was originally developed to treat borderline personality disorder (BPD), a disorder for which emotion dysregulation is central. One of the core DBT treatment strategies designed to target emotion dysregulation is validation. While validation is implicit in many therapies, within DBT there are six explicitly defined treatment strategies called validation levels (VL) that instruct the therapist on how and what to validate in a therapy session. Despite the importance placed on validation in emotion regulation, to date, there have been no studies designed to look at therapist use or impact of specific VLs. The aim of the current study was to explore therapist use of VLs throughout treatment in a DBT training clinic and examine the relationship between specific VLs and change in a client emotion within a DBT treatment session. Video recorded sessions of individual DBT treatment sessions for 35 participants were coded for therapist us of VLs. A repeated measures ANOVA was used to assess for change in therapist use of VLs over time and hierarchical linear modeling was used to correlate therapist use of these strategies with change in client emotion within an individual treatment session. Results indicated there was not a significant change in therapist use of VLs throughout treatment. Additionally, there was not a significant relationship between overall frequency of therapist use of VLs and change in client emotion. An increase in frequency of therapist use of high VLs (i.e., VL 4 through 6) was associated with an increase in positive affect (PA) and a decrease in negative affect (NA) while an increase in frequency of low VLs (i.e., VL 1 through 3) was associated with a decrease in PA and no change in NA. An increase in frequency of VL 4 was associated with an increase in NA. VL 6 was associated with both an increase in PA and a decrease in NA. These findings suggest that specific components of validation strategies may be related to a decrease in emotion dysregulation and suggest possible mechanisms of change that may help to increase treatment efficacy for clients with significant emotional dysregulation.