The application of DBT has recently been broadened from treating people with Borderline Personality Disorder to offering DBT for people with substance use issues, for adolescents, or for couples.  A recent article in the New York Times talks about providing mental stress training for U.S. soldiers. The plan is to teach 1,500 soldiers by next summer in psychological techniques geared towards improving performance and preventing psychological difficulties such as depression or posttraumatic stress disorder. Strictly speaking, the skills mentioned are not based on DBT proper, but on cognitive behavior skills, which DBT can be considered a subtype of.

Along similar lines, my colleague Dr. Christie Jackson, who is an expert in DBT, and her business partner Paul M. Smith, MSW, a former LA Deputy Sheriff, have founded a program for law enforcement personnel called WELLTRAINING. The program offers education and skills training for law enforcement officers, including information on posttraumatic stress disorder, depression, and wellness. Also covered are skills to cope with critical incidents, interpersonal effectiveness and communication skills, and skills that have to do with emotion regulation as well as anger management.  The idea is that it is better to invest in prevention than in treatment, and so law enforcement personnel learn some of the important stress management and self-care techniques that are geared towards heading off later difficulties.

“Policing is one of the most stressful jobs out there.” explains Dr. Jackson, “There is a high incidence of cardiovascular disease in police officers, there is a lot of alcoholism, twice as many divorces as in the general population, and the suicide rate is three times as high as in the general population. In fact, a police officer is much more likely to die of suicide than in the line of duty. In addition, stress from the job can have a huge impact on an officer’s personal life. The often irregular schedule can make it hard to maintain relationships; many are prohibited from talking about their job on the outside, and many do not want to burden their partners and friends, which can be very isolating. Just think about it – even just maintaining healthy eating habits can be enormously difficult if you’re basically spending your entire day in a car. This is the range of topics we address in our program.”

Amongst the typical stressors of law enforcement personnel, Dr. Jackson lists on-the-job-trauma such as shootings and physical assault, dog-bites, or exposure to harmful substances. “However, many police officers feel that dealing with the bureaucracy and the lack of support from administration can cause at least as much stress. And then there’s dealing with the public: Sometimes the media and the public are very respectful and appreciative, but then many times they are not.” says Dr. Jackson. “That is why we promote skills such as teaching people how to communicate effectively.”

Another focus of the WELLTRAINING program is reducing the stigma that is still associated with seeking mental health services. “It can costs as much as 500,000 Dollars to train a police officer, so it is really important for the department to retain their employees.  Many private companies invest more and more in wellness and prevention programs, because we have some data suggesting that these programs can help reduce tardiness and absenteeism.  The problem is that police officers are considered the ones who help other people, not the ones seeking help.“ explains Dr. Jackson, “There is a real sense of vulnerability associated with seeking help. Many times, the department will put officers who admit to difficulties on restricted duty, which can affect income and an officer’s sense of self worth. One officers put it to me this way: ’When I put on my uniform, I become superhuman.’ This illustrates how doing the job means having to put aside all human frailty. This often leads to people not taking care of themselves outside the job, and not seeking help. We try to combat stigma by providing education and information. The main message has to be that help is available, and that it is o.k. to seek help.”