Dialectical Behavior Therapy (DBT) is a research-based cognitive behavioral treatment model that was originally developed by Dr. Marsha Linehan in the 1990’s to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT is recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other psychological problems such as eating disorders (specifically bulimia nervosa and binge eating disorder), suicidal and self-harm behavior, substance abuse, depression, and post-traumatic stress disorder (PTSD). DBT addresses problems with emotion regulation, managing behaviors, and challenging and changing certain thought patterns that can lead to emotional reactivity and interfere with relationships and our ability to build a Life Worth Living.
DBT maintains that some people have strong reactions to stimuli and experience high levels of arousal that need more time to return to baseline after these events occur. Learning DBT skills helps us manage feelings of having constant ‘crises’ and/or experiencing extreme emotions.
The dialectical nature of this approach means that treatment will include teaching you acceptance and change strategies to help you build the life you want.
WHAT ARE THE COMPONENTS OF DBT?
There are four major components of a DBT program: skills training group, individual treatment, DBT phone coaching, and consultation team.
- Skills training group covers four modules: Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness. Our adolescent skills training group includes an additional module “Walking the Middle Path”. Skills training group focuses on enhancing clients’ capabilities by teaching them behavioral skills. The group is run like a class where the group leader teaches the skills and assigns homework for clients to practice skill application in their everyday lives.
- Weekly individual sessions are offered that focus on enhancing motivation and helping patients apply skills to specific challenges and events in their lives. The reduction of maladaptive behaviors impacting the patient’s life in a negative way is discussed and a target hierarchy is developed to build greater awareness of triggers, emotions, thoughts, and actions. This is done through the completion of diary cards and behavior chain analysis.
- DBT phone coaching is focused on providing patients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives. Patients can call their individual therapist between sessions to receive coaching at the times when they need help the most.
- DBT therapist consultation team is intended to be therapy for the therapists and to support them in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help therapists stay motivated and competent so they can provide the best treatment possible. Our team meets weekly and is composed of individual therapists and group leaders who share responsibility for each patient’s care.
There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.
What skills are taught in DBT?
- Mindfulness: The practice of being fully aware and present in our lives.
- Distress Tolerance: How to tolerate discomfort in painful and difficult situations.
- Interpersonal Effectiveness: How to ask for what you want and say “No” while maintaining self-respect and relationships with others.
- Emotion Regulation: How to understand and regulate emotions.
You can learn more about the development and research of DBT at www.behavioraltech.com.