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Hear them ROAR: Sovereign Health of Chandler creates a milieu of DBT-informed care
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On Jan. 9, 2017, Sovereign Health of Chandler, Arizona, launched “Rebuilding Our Acceptance & Resilience” (ROAR). ROAR offers comprehensive behavioral health treatment to women using dialectical behavior therapy (DBT)-informed as well as trauma-informed care. ROAR is designed to serve women with intense emotional dysregulation and is noteworthy for having all staff members trained in DBT and trauma-informed treatment. All ROAR staff, from clinicians to support staff, house managers and landscapers are trained to respond to highly emotionally charged situations using DBT, motivational interviewing and other trauma-informed interventions. By extending these techniques to all staff who work with our patients, ROAR has created a safe, secure and consistent treatment milieu.

“By launching ROAR, Sovereign Health of Chandler is able to provide a unique form of comprehensive care that gives women the opportunity to rebuild their lives in the strongest way. ROAR gives them back their power,” said Kelly Vickrey, M.A., LISAC, program director at Sovereign Health of Chandler.

What is DBT?

DBT is an evidence-based treatment for reducing self-harm, suicidality, emotional dysregulation and other emotionally driven behaviors associated with borderline personality disorder. It was developed by Marsha Linehan, Ph.D., A.B.P.P., a professor of psychology, adjunct professor of psychiatry and behavioral sciences at University of Washington, and director of the Behavioral Research and Therapy Clinics.

DBT teaches patients the skills they need to improve their relationships, control their emotions and tolerate crisis situations without using alcohol or drugs, self-harming behaviors or other harmful behaviors. Think about the dialectical component of DBT, which takes into account opposing forces like acceptance and change, as being like the devil’s advocate. Looking at alternative viewpoints introduces conflict into the process of decision-making and helps to foster understanding in patients by allowing them to recognize and accept both sides of the truth.

Behavioral skills training in ROAR

ROAR uses the behavioral skills training in DBT to help patients develop stronger relationships, reduce impulsiveness, and decrease their emotional and cognitive dysregulation. With all facility staff members trained in DBT, patients quickly learn new behavioral skills and incorporate them into their daily behavior more quickly and effectively to foster acceptance and change in their lives.

These skills include:

  • In cultivating core mindfulness skills, patients learn to live in the present moment through focused attention. Mindfulness skills may be obtained through the practice of observing and describing emotions, thoughts and bodily sensations, which helps people to cultivate awareness and participate fully in the present moment.
  • Distress tolerance – also referred to as “crisis survival skills” – teaches a person how to accept and tolerate difficult emotions like stress or emotional pain that occur during a crisis situation by using methods like distraction, self-soothing, looking at pros and cons, and reality acceptance, rather than using harmful behaviors that can make the situation worse (e.g., self-harm, using drugs or alcohol, etc.).
  • Emotional regulation is the ability to understand and control one’s feelings and emotions; it involves the development of healthy coping mechanisms to help patients deal and cope with crisis situations and difficult emotions that they feel are intolerable by using problem-solving or other healthy coping mechanisms to thereby improve their emotional resilience.
  • Interpersonal effectiveness helps patients clarify priorities and communicate effectively in relationships and with others, while maintaining their self-respect, (e.g., learning to say no) and to reduce turmoil in their relationships.

What are the benefits of ROAR?

ROAR serves women whose emotional dysregulation often precludes either the acceptance into other treatment programs or their quick discharge from traditional treatment programs. Patients in most treatment programs only receive DBT care from their clinicians, limiting its effectiveness and leaving patients on their own for most of the day to remember and practice the skills they’ve learned.

With ROAR’s milieu treatment environment, however, patients are always surrounded and supported by DBT-informed care. When receiving meals, riding to activities or simply relaxing in the yard, patients have the opportunity to practice and reinforce the lessons they’ve learned in therapy.

This constant reinforcement of DBT in ROAR can help patients:

  • Improve their ability to cope with difficult emotions
  • Tolerate distress
  • Strengthen relationships
  • Overcome unwanted behaviors.

“Women with severe trauma commonly have difficulty in regulating their emotions and self-soothing when they are upset,” said Susanne Drury, Ph.D., consulting psychologist at Sovereign Health of Chandler. “The DBT-informed milieu of ROAR teaches distress tolerance, emotional regulation, mindfulness and interpersonal skills. In combination with our trauma-informed approach, we can give women the resources they need to live a nourishing life.”

Additional components of ROAR

Clinicians and case managers at our Chandler facility also utilize a technique called motivational interviewing, which involves a nonjudgmental and collaborative relationship between patients and clinicians. Rather than being forced to make changes in their lives, patients are gently persuaded and supported through the recovery process.

Patients who receive treatment for mental disorders, including substance use disorders and co-occurring conditions, also benefit from a number of clinical groups that are offered from both DBT- and trauma-informed approaches, including:

  • Trauma and Coping
  • Distress Tolerance
  • Emotion Regulation
  • Interpersonal Effectiveness
  • Mindfulness: Walking the Middle Path
  • DBT and Addiction
  • Expressive Writing
  • DBT and Everyday Problems
  • DBT and Schema Therapy
  • Grief and Loss
  • DBT and Family
  • Stages of Change
  • Mindfulness and Meditation
  • Process Group

At Sovereign Health of Chandler, ROAR empowers women to make appropriate changes in their lives. A DBT-informed milieu is among the most researched method of helping women with trauma, substance use disorders and other mental health conditions learn the skills they need to overcome difficulties in their lives and by helping them overcome behavioral health conditions in a calm, consistent and appropriate therapeutic community.

For more information about ROAR offered to women at Sovereign Health of Chandler, please contact our 24/7 helpline.


About the author

Amanda Habermann is a senior staff writer for Sovereign Health. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. Her master’s thesis was written on “The effect of parental codependency on elementary school children’s social and emotional development,” and her research has been accepted for poster presentations at the Western Psychological Association. She brings to the team her extensive clinical background and skills in psychological testing and assessment, clinical diagnosis, research and treatment, and recovery techniques for patients with mental illness. She is a passionate researcher and enjoys staying up to date on the newest topics in the field. For more information and other inquiries about this article, contact the author at news@sovhealth.com.

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