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What is DBT?

Dialectical Behavior Therapy (DBT) is a compassionate type of behavioral therapy that is intended to help people move towards having a life that feels more meaningful and worth living. It is an evidence based treatment that has proved effective for mood disorders, personality disorders, addictive disorders, impulse control disorders and some anxiety disorders. By combining standard cognitive-behavioral techniques for emotion regulation with the concepts of distress tolerance, acceptance and mindfulness, the skills taught by DBT strengthen a person’s ability to handle their emotions without losing control or engaging in destructive behavior.

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Combining several therapeutic approaches, DBT was originally designed for severe mental illness (people engaging in self harm or with chronic suicidal thoughts). Research is finding that DBT can be extremely effective in less severe areas, such as anxiety, mild depression, relationship conflict – in essence: wherever there is a need to regulate emotions. Once learned, these skills can be applied in our everyday lives, including stress related to work, family relationships, and medical conditions. 

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History of DBT

DBT was designed by Marsha Linehan, Ph.D., beginning in the 1970s. Dr. Linehan pulled from effective treatments such as cognitive behavioral therapy, assertiveness training, validation strategies, and Buddhist mindfulness meditations. Dr. Linehan then went on to study DBT in clinical trials, showing that DBT is, in fact, extremely effective in the treatment of patients with chronic suicidal thoughts and is considered the gold standard for the treatment of Borderline Personality Disorder. Other clinicians have furthered her research into other areas.

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Huntsville DBT offers a comprehensive DBT program that is implemented with fidelity to Dr. Linehan’s model.  A comprehensive DBT program includes four elements: individual therapy (weekly), group skills training (weekly), phone coaching (as needed), and consultation team (for therapists only). Four sets of skills are taught in the curriculum: Mindfulness, Emotion Regulation, Distress Tolerance, and Interpersonal Effectiveness. 

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DBT is an evidenced based modality which has been proven effective in helping people:

• Understand and manage overwhelming emotions

• Learn more about themselves and how they think

• Reduce emotional instability and impulsive behaviors

• Learn more effective ways of coping with stress

• Improve relationships and identify effective relationships in their life

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What does DBT treat?

Although DBT was initially developed to treat people who were chronically suicidal and who had borderline personality disorder, DBT teaches skills useful to pretty much everyone. These include skills like learning to accurately recognize emotions in you and others, tolerating difficult emotions, and engaging with others effectively. 

The treatment has been studied in a number of randomized controlled trials, and we now know that DBT is helpful in 

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• high emotional sensitivity (frequent, often rapidly shifting emotions) and reactivity (intense emotions)

• impulsive behaviors that come as a result of difficulty regulating emotions (e.g., suicidal ideation, self-injury, anger management concerns, substance use, impulsive spending, high-risk sexual behaviors)

• experiences of mood disturbance , anxiety and stress , and traumatic experiences , particularly if there are impulsive behaviors that are related to such experiences

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How does DBT differ from standard therapy?

When most people think of therapy, they think of interpersonal therapy, where you talk about your feelings and your past. While DBT employs much of the change process involved in standard Cognitive Behavior Therapy (CBT), the use of validation/acceptance is added. DBT, like most behavioral therapies, meets you where you are in the current moment; focusing on helping you change ineffective ways of coping by learning new, skillful ways to deal with situations. By validating the client, the therapist is able to reinforce the dialectic: the idea that seemingly opposites can coexist and be synthesized. This means weighing out various points of view in any situation by constantly balancing the ideals of acceptance and change, and assists in creating a life worth living for the client By the teaching of skills, DBT relies on specific goals that can realistically be attained. At times DBT is referred to as a "doing" therapy rather than a “talking” therapy. While DBT does ultimately focus on past experiences the first six months to year of treatment are spent ensuring the client is effective in their current daily life. Diary cards are kept to maintain progress and obtain an overview of the client’s week. Additionally, therapists are available for “coaching calls” between sessions so skills can be reinforced in the moment. Finally, all Peachtree DBT therapists are required to participate in a weekly treatment team to assist one another in providing effective and compassionate treatment for all clients.

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We recommend the "What is DBT?" page on Behavioral Tech's website for further reading into the development of and research into Dialectical Behavior Therapy. Behavioral Tech was founded by and collaborates with Dr. Linehan.

 

How does the DBT program work?

The protocol for DBT therapy that has been shown effective in clinical trials has the following components:

• Weekly individual DBT therapy with a trained DBT therapist

• Daily self-monitoring with Diary Cards

• Weekly DBT class to teach skills in a group format

• Phone coaching to reinforce skills as needed

To go through one full round of all the DBT skills (3 modules) takes about 6 months.  The best results have been seen in doing the module twice, for a full year of treatment.  

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However, there are some clients who would like to learn skills and would like to continue to see their outside therapist.  As we are strong believers that DBT skills can benefit anyone, we welcome clients with an outside therapist to our classes.   As the diary cards and phone coaching will not be provided in these instances, this type of therapy is referred to as DBT-informed therapy.  

 

Huntsville DBT currently offers skills classes for Adults, Adolescents (middle school and high school), and Family class (for parents or family members). Huntsville DBT does not require that clients have a mental health diagnosis to enroll in DBT; however, we do require you to be engaged in individual therapy on a weekly basis either with one of our intensively trained clinicians or with another therapist in the community. Those clients enrolled in the Family Skills Class do not have to be enrolled in individual therapy.

For more information, please see:

https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/