Dialectical Behavior Therapy (DBT) is an evidence-based treatment designed to help improve overall quality of life through a combination of skill building and cognitive behavioral techniques. It has been proven effective in treating a wide range of problems. The overall goal of DBT is to develop a life worth living. It is operated under the assumption that people are doing the best they can to meet their needs but may not have learned appropriate or effective ways of doing so.
DBT can be used as a treatment for many different things:
· Borderline Personality Disorder
· Eating Disorders
· Substance-Abuse Disorders
· Those at High-Risk of Suicide
· Bipolar Disorder
· Emotional Dysregulation
Comprehensive DBT consists of weekly individual therapy, group skills training, phone coaching, and therapist consultation. While the group skills training is strictly psycho-educational (like a class or workshop), individual therapy “fills in the gaps” by working with you on developing more effective ways of dealing with current issues in your personal life. Phone consultation is limited to 5-10 minutes of skills coaching to help incorporate skills into your everyday life. Therapist consultation means that each week the DBT therapist is consulting with other clinicians who are trained in DBT, so you are being treated not just by one but a team of competent therapists.
Skills training consists of four treatment modules: core mindfulness skills, distress tolerance skills, emotion regulation skills, and interpersonal effectiveness skills. The core mindfulness skills module is repeated in between every module, and each module lasts 2-5 weeks. You will be required to track your emotions, urges, and use of skills daily using a diary card. Each week, following a brief mindfulness exercise, each group member shares what skills they used that week and may discuss what was helpful and where they could improve. After the diary cards are discussed, there will be a short break before a new skill is presented. Because DBT is based on behavior modification principles, DBT holds each participant accountable for doing the work required in order to improve. The diary card is imperative because it helps individuals stay mindful of skills throughout the week, and ultimately leads to behavior change through repetitive practice. Participants are encouraged to utilize phone coaching as needed in order to enhance the generalization of skills.
Mindfulness skills are about developing self-awareness and living in the present moment. Distress tolerance skills help individuals to move through a crisis without making things worse. Emotion regulation skills are about increasing understanding and ability to cope with intense emotions. Interpersonal effectiveness skills help individuals to resolve conflict and communicate feelings and needs in a way that they respect themselves and others equally.
Anyone can benefit from DBT, but it is a big commitment. DBT is much more structured than many traditional talk therapies, but it is effective. Many people feel nervous about joining a new group, but you are not alone. Most group members feel this way in the beginning but develop cohesion over time and really benefit from each other’s support and knowing that they are not alone in their struggles.
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