Dialectical Behavior Therapy (DBT) is a treatment that was developed by Dr. Marsha Linehan at the University of Washington. The therapy was initially designed to treat Borderline Personality Disorder, and substantial research has been done that supports its effectiveness as a treatment for people with difficulties regulating their emotions and for those engaging in suicidal behavior or non-suicidal self injury (self-harm behavior). Since the initial studies, it has also been demonstrated to be helpful for other mental health problems, including eating disorders, mood disorders, and substance use disorders, as well as teens who struggle with self-harm behavior or suicidal thoughts/behaviors. The primary objective of DBT is to help people learn to more skillfully manage their emotions in order to lead more effective and satisfying lives.
DBT was developed for individuals who struggle with intense emotions that can get out of control. DBT may be right for you if you experience some of the following:
Fears of abandonment
Difficulties in relationships
Being uncertain of who you are
Impulsive or risky behaviors (e.g. unsafe sex, substance abuse, binge eating, compulsive shopping)
Intense emotions that are difficult to control
Feelings of emptiness
Intense anger
Intentional self-harm
Thoughts of suicide / suicide attempts
What to Expect in DBT:
DBT focuses on problems you presently face. We'll work together to understand what is getting in the way of having the life you want to have, and then help you change your behavior.
DBT is supportive and collaborative. DBT therapists believe it is essential for therapy for you to feel accepted, validated, and supported within the context of therapy, while working on changing your life.
DBT is time-limited. I recognize that people don’t want to be in therapy for the rest of their lives. DBT is designed to provide you with the skills you need to continue to work independently, outside of therapy. You become your greatest resource to empowering yourself. The typical course of comprehensive DBT is 6-12 months. Some clients elect to continue individual DBT therapy after graduating skills training to work on additional remaining goals.
DBT is active. This is not the kind of therapy where you sit on the couch and I nod and take notes. DBT requires doing work between sessions, outside of therapy, in your life - so that you can reach your goals faster.
What skills are taught in DBT?
Mindfulness
Middle Path (special skills for teens and families)
Distress Tolerance
Emotion Regulation
Interpersonal Effectiveness
Comprehensive DBT includes 4 components:
Individual therapy - usually weekly, at least at the beginning
Skills training - typically done in a group format, but can be done individually as well. For teens, skills training typically involves at least one parent participating. Unlike many psychotherapy groups, DBT Skills Groups are run more like a class or seminar than a traditional therapy group. The group meets for 1.5 hours once a week. Each group begins with a brief mindfulness exercise followed by a review of homework assigned from the previous week. The second half of the group focuses on teaching new DBT skills.
Skills coaching - DBT therapists are available to help clients use skills in their lives. I am available 24/7 for my clients to provide in-the-moment coaching to help you generalize the skills you are learning as you face challenges in between our sessions.
Consultation team - DBT therapists meet on a regular basis together to ensure they are implementing the treatment well and to help support one another.