This book was an outstanding explanation of how to apply DBT specifically to self-harm, written by an expert in the field, Dr. Hollander. Dr. Michael Hollander has been working with adolescents and their families for over 40 years, helped found McLean Hospital’s DBT program, and now serves as Director of Training and Consultation at Boston Child Study Center.
What struck me most was how clearly he explains DBT and its application with adolescents. I had always known DBT was evidence-based for self-harm and borderline personality disorder, but I didn’t realize how structured and disciplined it is in its true form.
Dr. Hollander lays out some key concepts I found interesting: commitment to safety (taking self-harm “off the table”), the balance between privacy and parental involvement, and the requirement that patients can reach their therapist 24/7 during crises ("The mistro must show up to the performance").
The skills themselves are deceptively simple but seem to make sense. Concepts like practicing distress tolerance in non-crisis situations, removing self-harm temptations, validating effectively (attentive listening, active reflection, and “giving voice to the unspoken”), and using the “GIVE” skill (Gentle, Interested, Validate, Easy manner) to repair relationships are explained so well. Hollander emphasizes the “three Ps”, practice, patience, and perseverance, and encourages allowing natural consequences, using pros and cons for both short- and long-term decisions, and applying “opposite action” to shift intense emotions.
As a provider, I found this book invaluable. It deepened my understanding of DBT far beyond the bullet points we usually see in trainings and articles. It also highlighted how few practitioners are able to deliver DBT in its full, rigorous form.
Reading this gave me a renewed respect for therapists certified in DBT and inspired me to incorporate these evidence-based strategies more intentionally into my own work.