• Dialectical Behavior Therapy

    Dialectical Behavior Therapy

    Dialectical Behavior Therapy (DBT)

    Dialectical Behavior Therapy (DBT) is an adaptation of Cognitive Behavior Therapy (CBT); both are evidence-supported treatments for the following populations/diagnostic groups:

    • Borderline personality disorder
    • Chronic suicidality
    • Non-suicidal self-injury
    • Major depressive disorder
    • Bipolar Disorder
    • Eating disorders (binge eating and bulimia nervosa)

     

    DBT is designed to assist clients with multiple, complex, or severe problems and that are potentially life-threatening.  It is assumed that difficulty managing strong emotion is the core vulnerability.  DBT is an option to consider for emotionally-dysregulated clients who have failed to respond to other treatments.  DBT aims to help clients create a ‘life worth living’ by addressing problems in an orderly fashion, starting with the most serious:

    • Problems that interfere with staying alive (life-threatening behaviors or suicide ideation)
    • Self-injurious behaviors
    • Behaviors that interfere with treatment
    • Other problems that interfere with quality of life (depression, anxiety, body dissatisfaction, etc.)
    • Problems with creating meaning and joy in life

     

    DBT is more intensive than traditional outpatient therapy. A participant is expected to meet weekly with an individual DBT therapist and also attend a weekly skills training group.  Telephone “coaching calls” are part of treatment as well.  Coaching calls are not therapy over the phone, but do provide clients with assistance in applying the skills they are learning in ‘real life’ situations as they occur.  The skills training group takes approximately six months to cover skills for emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness.

    More is expected of clients in DBT.  They commit voluntarily to staying alive for the duration of treatment, work towards eliminating self-injury, self-monitor their behaviors and emotions, and attend all components of treatment.  Thus, they participate in a commitment process with their individual therapist to ensure the necessary ingredients for successful treatment are in place.