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Dialectical Behavior Therapy (DBT), is a modification of standard cognitive behavioral therapy (CBT). In the development of DBT, Marsha Linehan, Ph.D. found that using standard CBT was ineffective in helping many individuals with intense emotion dysregulation to make changes in their lives.
While CBT was helpful for some individuals, others became frustrated with the constant focus on change. In the development of DBT, Linehan added many acceptance-based strategies such as mindfulness and validation to the standard change strategies of CBT. She did this to aid individuals in understanding the part of their experience that was valid and made sense.
In DBT, we work hard to balance the technology of change with acceptance of the current situation as it is.
In this way, DBT teaches a “dialectical” way of thinking. Linehan uses an image to describe what is meant by “dialectical” as it relates to DBT. She describes a teeter-totter, in which the therapist is on one end and the patient is on the other. Both the therapist and the patient need to work towards creating conditions in which therapist and patient can work together to foster both acceptance and change at the same time. Acceptance on one end of the teeter-totter, and change at the other. In this way, they come together at the middle of the teeter-totter, and this allows movement forward toward the patient’s goals.
DBT can be especially useful for managing painful emotions that seem to be unbearable, quickly changing emotions and moods, emotions that control your life and lead to impulsive behavior, intense self-hatred and shame, intense feelings of emptiness, loneliness or numbness, relationship problems due to a fear of abandonment, intense sensitivity to criticism, and vulnerability to irritability or anger.
DBT is also exceptionally helpful for learning how to manage behavioral struggles such as self-harming or suicidal behaviors, food issues such as bulimia, or binge eating disorder as well as substance use disorders and other behaviors that serve the function of regulating emotions.
How do I know if DBT is right for me?
We will determine whether or not you are in need of comprehensive DBT during the intake process. If you are interested and it is determined that you are appropriate for comprehensive DBT, you will be invited to take a vacation from your current therapy, make a time commitment to DBT, and fully invest yourself in the treatment so that you can make optimal change in your life. DBT is a voluntary treatment, so it is only with your voluntary consent and commitment that you will be accepted into the program.I'm only interested in joining a group. Do I still need a therapist?
If you are only interested in joining one of our skills groups, you are welcome to do that as well. Individuals who are not in need of comprehensive DBT often opt to do this. Sometimes they have an individual therapist with whom they are working and they really trust, and just want to learn the skills as an adjunct to their current work.In this case, we encourage the individual to stay with their therapist, invite them to join our groups, and require the individual therapist to take on phone coaching and learning about the skills and talking about them in sessions. It is a prerequisite that individuals who join skills groups must be in some form of ongoing, weekly, individual therapy during the course of the group commitment; however, it is not required that the therapist be a DBT therapist. This is not standard DBT…but DBT informed treatment.
I'm only interested in individual therapy. Do I still need to join in on group sessions?
Rarely, but occasionally, folks come to us with no interest in skills at all and only want individual therapy. This option is up to the individual therapist and the client. Often the client does not want skills group because of worries or concerns about being with others, NOT because the skills aren’t needed. In this case, we often take some time to help the client learn the necessary skills or behaviors to join the group, as this is a critical component of DBT.While in comprehensive DBT, we are working with you to learn the new strategies (skills acquisition) as well as strengthen and generalize these skills to all relevant contexts. In the service of that, we will also provide out of session coaching to you so that you can learn how and when to utilize what you are learning outside the therapy room.
In addition, each therapist providing DBT for you is required to participate in a weekly DBT consultation team with other DBT providers. This is an essential component of treatment since it helps our DBT therapists provide the most effective, highly competent DBT services to you and you receive the expertise and experience of the entire group, not just your individual therapist.