Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy that was created by Marsha Linehan in the 1980’s. Its main goals are to teach people how to live in the moment, cope healthily with stress, regulate emotions, and improve relationships with others.

It was originally intended for people with borderline personality disorder (BPD) but has since been adapted for other conditions where the client exhibits self-destructive behavior, such as eating disorders and substance abuse. It is also sometimes used to treat post-traumatic stress disorder. DBT is derived from a philosophical process called dialectics. Dialectics is based on the concept that everything is composed of opposites and that change occurs when one opposing force is stronger than the other, or in more academic terms—thesis, antithesis, and synthesis. 

More specifically, dialectics makes three basic assumptions:

  • All things are interconnected.

  • Change is constant and inevitable.

  • Opposites can be integrated to form a closer approximation of the truth.

In DBT, the client and therapist are working to resolve the seeming contradiction between self-acceptance and change in order to bring about positive changes in the client.

Is DBT Right for You?

While the majority of research to date has focused on the effectiveness of DBT for people with borderline personality disorder, as well as co-occurring thoughts of suicide and self-harm, post-traumatic stress disorder, and substance use disorders, DBT has also been shown to work for a variety of mental health conditions including:

  • ADHD

  • Binge eating disorder

  • Bipolar disorder

  • Bulimia

  • Generalized anxiety disorder

  • Major depressive (including treatment-resistant major depression and chronic depression)

  • Post-traumatic stress disorder

  • Substance use disorder

  • Suicidal and self-harming behavior

Researchers have also found that DBT is effective regardless of age, gender, sexual orientation, and race/ethnicity.

(credit: www.verywellmind.com)

What makes treatment “DBT informed” versus full DBT? Full DBT consists of: weekly individual therapy, group skills training, therapist consultation group, and phone coaching. This is the formula that is considered  full or “adherent DBT.” Adherent DBT is great for highly intensive cases that are bordering on requiring inpatient care, or for people who have a history of repeated psychiatric hospitalization. However, the core components of DBT are still highly effective for more moderate cases, without adhering to the pure model. 

The main difference of my “DBT informed” treatment versus full DBT, is no phone coaching. I have found that, in general, it is best for me to be able to disconnect from my work phone when I leave the office. Taking this time for myself to rest and re-charge ensures that I am 100% when I am in the therapy room. Additionally, I am open to working with you to decide on what therapeutic formula works best for you. Perhaps, you would like to attend therapy bi-weekly in addition to DBT skills group. Under the pure DBT model, this would not be permitted. I believe in offering choices to my clients, and figuring out what is best for you and your life. I do not subscribe to a “one size fits all” model. 

What if I need adherent DBT? I hold a select few spots on my caseload for those who truly require adherent DBT. This will be discussed in your intake session.