Dialectical Behavior Therapy (DBT) is an evidence-based, psychotherapy approach developed 

by Marsha Linehan, PhD in the 1970’s to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD).  DBT has evolved and is now recognized as the gold standard psychological treatment for borderline personality disorder.  Based on Cognitive Behavioral Therapy (CBT), DBT incorporates behavioral therapy, dialectical philosophy, and Zen practice, and was specially adapted to assist individuals in: 

·    Comprehending and coping with overwhelming and intense emotions

·    Self-discovery and mastery of the mind

·    Cultivating and maintaining effective relationships

·    Reducing emotional instability and impulsive behaviors

·    Learning more effective ways of coping with everyday life and stressors. 

The principles of DBT techniques are built on a few fundamental ideals. First, it was developed on the foundations of both science and philosophy. The first two core beliefs of DBT are “I am doing the best that I can” and “I need to learn new ways to do better and try harder.” Finally, a major thought in DBT is that everything in life is connected. The only stable, constant thing we can trust or rely on is that change is inevitable.  When applied, DBT techniques, will teach you to first identify, then change destructive behaviors that cause pain, discomfort, or an inability to effectively function in relationships and daily life.  Research has shown that DBT is effective in treating a wide range of other psychological disorders, from depression and anxiety to Post-Traumatic Stress Disorder (PTSD) and eating disorders. 

 

Proven to help individuals better cope with intense emotions caused by stress, trauma, anxiety, etc., DBT is used in individual therapy, group therapy, and in the growing-in-popularity internet-based online dialectical behavior therapy or phone therapy.

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1.   DBT Skills Training Group  

Not to be confused with a process or support group, DBT Skills Training Groups are highly structured, classroom-like formatted groups designed to teach powerful skills for maintaining mental and emotional well-being. Homework is assigned weekly to practice the skills in real life. Groups meet on a weekly basis for 2 hours for 24 weeks, and focus on the four pillars of DBT, which include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).

• Mindfulness: Highlighted at the beginning of each skill taught, mindfulness is at the core of DBT skills training.  Derived from Eastern spiritual training, the skills are psychological and behavioral styles of meditation practices.  Core mindfulness focuses on being fully aware and focused on the present instead of worrying about the past or future.  Mindfulness skills will help you connect to the present moment, fully and nonjudgmentally. You will learn to disconnect from unhealthy thinking patterns to more skillfully and fully deal with the here and now. 

• Distress Tolerance: Concerned with tolerating and surviving crises, distress tolerance involves understanding and managing your emotions in difficult or stressful situations without responding with harmful behaviors. Distress tolerance skills are intended to assist you in overcoming urges, addictions, and other forms of compulsive behavior. Distress tolerance is fundamentally about developing the ability to act wisely in the face of unpleasant feelings and mental states without becoming ensnared by the struggle people ordinarily engage in with these emotions and urges. 

• Interpersonal Effectiveness: Focused on creating and maintain balance in relationships, interpersonal effectiveness teaches how to set boundaries while maintaining respect for self and others.  This skill teaches how to ask for what you want, refuse an offer, and cope with conflicts in healthy, effective ways. Interpersonal effectiveness skills help you improve the quality of your relationships and build fulfilling relationships while ending destructive ones. 

• Emotional Regulation: Goals include identifying and comprehending one’s own emotions, decreasing the frequency of unpleasant emotions, decreasing vulnerability to emotions, and decreasing emotional suffering.  Emotional regulation skills teach you ways to modulate your emotions more effectively, reduce the frequency of unwanted emotions and identify factors that increase physiological vulnerability to intense negative emotions.

When practiced and applied consistently, these four skills can help an individual live a balanced life with healthy relationships with self and others.

 

2.   DBT Individual Therapy 

DBT Individual therapy focuses on enhancing client motivation and helping clients apply the techniques learned during DBT Skills Training Groups to specific challenges, events, and areas in their lives.   You will work collaboratively with your therapist to figure out what is getting in the way of your ‘life worth living.’ Those problems are targeted to decrease while simultaneously increasing functional behaviors. Individual therapy takes place once a week for approximately 60 minutes and runs concurrently with DBT skills training groups.

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3.   DBT Phone Coaching

Focused on providing clients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives. Clients can call their individual therapist between sessions to receive coaching at the times when they need help the most.

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Dialectical Behavior Therapy is divided into four stages. During the first stage, any behaviors and thought processes that are harmful such as self-injury or suicidal thoughts and behaviors, are addressed. Stage 2 is aimed at improving interpersonal effectiveness, emotional regulation skills, the ability to tolerate distress. Building self-confidence as well as healthy relationships with friends, family, partners, and acquaintances is the focus during stage three. By stage 4, you will be prepared to focus on your life's purpose. You will carefully consider what makes you happy at this time and decide what objectives you want to accomplish in life.

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Here at A Life In Balance, we are dedicated to helping you through each stage of DBT. Reach out to us for more information and embark on your journey to serenity and happiness.