DBT Prolonged Exposure (DBT PE) By Dr. Arroyo-Carrion

The DBT Prolonged Exposure Protocol (DBT PE) is an evidenced-based treatment for PTSD developed by Melanie Harned, PhD. It combines all the elements of Prolonged Exposure Therapy (PE) with DBT skills to assist with acquiring behavioral control and addressing any presenting difficulties that remain after PE. Treatment is delivered in three stages but overall, it has been started after 20 weeks of DBT and consists of 8-15, 90-minute sessions, usually on a weekly basis.


DBT PE is a trauma-focused therapy developed to assist trauma survivors who in addition experience emotional regulation difficulties. This protocol is intended for adolescents and adults diagnosed with PTSD who require additional services prior participating in trauma work secondary to life-threatening, impulsive, self-damaging behaviors; severe mental health illness in addition to PTSD; difficulty attending, collaborating, and staying engaged in therapy; severe impairment that makes it difficult to fulfill normative social roles.


Stage 1: Standard DBT (approximately 20, 60-minutes sessions, usually on a weekly basis) to assist with emotional regulation difficulties focusing on the areas of mindfulness, emotional  regulation, interpersonal effectiveness, and distress tolerance.

Stage 2: Participation in PE (approximately 8-15, 90-minutes, usually on a weekly basis) to addresstrauma-related symptoms while continuing engagement in standard DBT.

Stage 3: Once PE has been completed, participation in DBT will continue and focus on improving relationships and increasing participation in activities such as work or school. It is estimatedthat completion of standard DBT program will consists of 1-year of weekly psychotherapy appointments.

According to Dr. Harned’s research, remission of PTSD ranged from 71-80% among DBT PE completers. In addition, adding the DBT-PE protocol is likely to decrease the risk of suicidal and self-injurious behaviors.


If you believe that DBT PE is a good fit for you, please contact us to schedule your intake. There are several providers in the practice trained in DBT available for psychotherapy services and consultation until able to progress to DBT PE. For further information about DBT PE please refer to https://dbtpe.org. Dr Arroyo-Carrion is trained in DBT, PE, and DBT PE and available for a consultation.

If you’d like to learn more about this, you can also check out another blog by Dr. Arroyo here:




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