Dialectical Behavior Therapy (DBT) was created by Dr. Marsha Linehan in the 1970s and 1980s for the treatment of borderline personality disorder (BPD) and is one of few evidence-based treatments for BPD. Due to the effectiveness of treating BPD, more research was done for other psychiatric disorders like mood disorders, PTSD, and substance use disorders. DBT has been shown to be an effective form of treatment for a wide range of concerns. DBT is a cognitive behavioral therapy that includes dialectical thinking and zen mindfulness practices that focuses on balancing acceptance and change. The main goal of DBT is to help clients build a life worth living.
What you can expect for comprehensive DBT
DBT consists of 4 main pillars:
- Individual therapy
- Skills group
- Phone coaching
- Team consultation
Individual is your one-on-one time with a therapist where you spend time exploring your goals and what gets in your way of achieving your goals. You and your therapist will use DBT skills to analyze your behavior, figure out what needs to change, and then learn new skills to make changes effectively. If you are part of the comprehensive DBT program, you will meet with your therapist 1x/week for one hour.
Skills group is another weekly commitment as part of the comprehensive DBT program. Skills group is 2 hours where you will be asked to participate in mindfulness activities, share the homework you completed since the previous group, and learn new skills. Skills group is more comparable to a classroom where you learn skills as opposed to a traditional “support group” though you will probably find that the members and leaders are validating and supportive, that’s just not the focus of the group.
Phone coaching is an important part of DBT. Essentially, phone coaching is a free service to those in our comprehensive DBT program. You have access to your therapist 24/7 and can call them to help you use your skills in the moment, while dealing with a difficult situation or before engaging in a harmful behavior.
Finally, team consultation is meant for the therapists in the DBT program to meet and discuss client cases and how the groups are going. These meetings are confidential and are meant to provide additional support to clinicians, problem-solve client concerns, and hold clinicians accountable for practicing DBT adherently.
The four modules of DBT
Mindfulness is the core part of DBT and is revisited frequently between modules. These skills will teach you how to observe, describe, and participate fully in the present moment. These skills will help you become more aware of your actions, behaviors, and impulses. You will also learn how to be nonjudgmental, increase your effectiveness, and focus on one thing at a time. These will help you view yourself and others more realistically and fairly, act with more intention in the moment, and decrease rumination.
Emotion Regulation will help you identify your emotions and label them, thus helping you have more control over them. You will also learn how to change unwanted emotions by challenging your thinking, problem solving, and challenging yourself to change your behaviors. Emotion regulation helps reduce vulnerability to negative emotions by increasing positive emotions, learning new skills, and taking care of your body. Finally, this section will teach skills to manage extreme emotions and decrease your emotional suffering.
Interpersonal Effectiveness will help you develop skills to communicate in healthier and more productive ways. This portion of DBT will help you become more assertive, ask for what you want or need, learn how to say ‘no,’ and how to deal with interpersonal conflict. Interpersonal effectiveness will help you develop meaningful relationships in your life while maintaining your own self-respect.
Distress Tolerance skills will help you when you are experiencing extremely heightened moods. This section does NOT focus on helping you feel better, but rather, this will help you manage your heightened mood without participating in harmful behaviors or making your situation worse. Distress tolerance will teach you crisis skills and acceptance strategies (note: acceptance does not mean approval). These skills will help you increase your emotional tolerance so that your suffering can be more tolerable.
About the Author
Maria Mangione (she/her), M.A., LPCC is a licensed clinical counselor that specializes in dialectical behavior therapy. Maria works to help people develop the tools they need to develop trust in themselves and build their life worth living. Maria believes in having meaningful connections with her clients and believes that therapy and healing can be fun. Click Here to learn more about Maria’s experience and therapeutic style.