Dialectical Behavior Therapy
Acceptance and change toward your life worth living
What is DBT?
DBT is a type of CBT, meaning we’ll look at how your thoughts and behaviors are impacting how you feel. DBT adds the nuance of dialectics, the concept that two things that seem opposite can both be true.
Some common dialectics are “therapy is helpful AND it’s hard work”, “I want to do well in school AND it can be hard to focus”, “I am a wonderful parent AND I make mistakes”.
The main dialectic in DBT is acceptance and change:
“I accept myself exactly as I am AND I am working toward change.”
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Who is DBT for?
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If you are experiencing any of the above symptoms, for any reason, we can help.
The common thread for people who benefit from DBT is emotion dysregulation. Emotion regulation is when we are managing, controlling, and influencing our emotions. Emotion dysregulation is the opposite.
A note about borderline personality disorder:
BPD is the most treatable personality disorder. BPD unfortunately doesn’t have the best reputation; DBT is a treatment that works in treating BPD.
However, lots of people who benefit from DBT do not have BPD.
Why was DBT created? What purpose does it fill?
Marsha Linehan, PhD, the developer of DBT, wanted to create a treatment that would actually work for clients who weren’t getting better.
She initially tried behavior therapy, and clients pushed back, saying “you don’t understand how hard it is, how much pain we’re in.”
Then she tried a person-centered, humanistic approach, and still received pushback: “it’s nice to feel validated, and we have real problems and need real help!”
This led to the development of a third set of strategies: dialectical strategies. With the combination of acceptance and change, clients were able to get movement and flow in sessions, and actually reach their life worth living.
What are the parts of DBT that make it work?
Each of the 4 components, or modes, of the treatment directly map onto the problems people come to DBT with.
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Group is where you’ll learn skills to become more mindful, improve interpersonal effectiveness, tolerate distress, and learn to manage and control our emotions.
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Phone coaching moves you from skills in your head to skills in your life. It also gives you a chance to learn to observe, communicate, and respect limits in relationships.
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Individual DBT helps you recognize patterns that get you stuck and figure out ways to move forward.
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DBT team makes sure your therapist doesn’t burn out and does a great job at doing DBT with you.
A note about doing only “part” of DBT
Without all 4 modes, it is NOT comprehensive DBT.
Many times people think they have “done DBT” and have only received one part. This would be called DBT-informed treatment, or therapy that is informed by aspects of DBT.
For people who need full DBT it’s vital that it be done according to the way it was developed and tested because that’s the way we know that it works!
Recent research shows that many people can benefit from DBT skills group alone. This is a decision that is made together with your individual therapist and is not appropriate for everyone.
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To get started with our Client Care Coordinator
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Call, Text or WhatsApp: 201-688-0722
Call: 02-376-4719
I’d like to join your next DBT skills group - how do I do that?
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You would need to have an intake prior to start a DBT group. That’s a 90-minute session for us to get to know you and decide with you what your goals are and whether this is an appropriate addition to your current treatment.
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We speak to your current therapist and decide together with our team about taking you for group only, or whether we’re only comfortable having you for full DBT (which, as mentioned above, would be group, individual therapy, and phone coaching).
If you’re ready to start, you can click here to schedule with our client care coordinator or call us at 201-688-0722 (US) or 02-376-4719 (Israel).
What is the difference between CBT and DBT?
CBT is a general umbrella term for cognitive behavioral therapies, meaning treatments that target thoughts and behaviors to affect how people feel. There are many types of CBT treatments – DBT is one of them.
What exactly does Borderline Personality Disorder mean?
Borderline Personality Disorder (BPD) is a personality disorder, which means that the problems are chronic, as opposed to other mental health conditions, where the problems change or fluctuate. BPD had 9 criteria – people who meet at least five “qualify” for the diagnosis:
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Chaotic relationships
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Fear of abadonment
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Frequent mood swings
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Anger outbursts
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Impulsivity and risky behiviors in areas such as gambling or food
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Suicidality or nonsuicidal self-harm
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Lack of sense of self
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Feeling empty
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Dissociation or paranoia
In DBT we don’t focus much on the diagnosis. Instead we focus on helping the person with their emotional dysregulation which a lot of these symptoms stem from. That being said, since DBT is such an effective treatment for BPD (see note above on BPD and DBT), we wanted to clear up confusion around this disorder.
Is there such a thing as a DBT approach to parenting?
DBT-C is a combination of parent management training and DBT; see our DBT-C page to learn more!
Can I take my medication while I am in therapy?
If you are already working with a prescriber and taking medication for your symptoms, we’d like you to continue with that treatment exactly until you start to feel better from your work with us.
Once you start feeling better or having symptom relief in therapy, we may have a conversation together with your prescriber about lowering your dosage or going off medication entirely, depending on your preference and your current level of symptoms.
Many of our clients do choose to go off medication once they have eliminated their diagnosis and find that they don’t need it anymore.
There is one important exception to the above policy:
If you are taking an as-needed anxiety medication, you might find that it will interfere with treatment. We actually WANT you to feel all the feelings fully in this moment. So medication that interrupts those feelings is going to teach your brain the things we’re trying to undo. Because of this we would likely discuss with you and your prescriber not taking that medication on treatment days or during the treatment period.
Again, that would be in discussion with both you and the prescriber, and any decision we would come to would be together for your best long-term success.
FAQs
“No one knows how many people with severe mental illness live what appear to be normal, successful lives, because such people are not in the habit of announcing themselves. They are too busy juggling responsibilities, paying the bills, studying, raising families — all while weathering gusts of dark emotions or delusions that would quickly overwhelm almost anyone else.”
— Marsha Linehan, 2011
DBT for Teens
DBT was adapted to meet the needs of teens. DBT for teens is similar to DBT for adults, except that skills group includes family members (at least one parent required to attend as consistently as the teen) and an additional skills module – Walking the Middle Path – which are skills for navigating family conflict.
DBT for teens was developed by Drs. Alec Miller and Jill Rathus to meet the needs of teens struggling with multiple problems and emotion dysregulation.
Parent and family sessions are incorporated as needed, and we encourage the teen to take charge of their treatment. You can read more about our DBT-A program here.
DBT for Children
DBT for children (DBT-C) is a very different and unique treatment approach for children with severe emotional and behavioral dysregulation. Parents play a huge part in the treatment and skills are often taught individually rather than in the group format. Phone coaching is included, and is reserved for parents so that children learn to come to their parents when needed.
We work with parents to develop a change-ready environment for the child. The parenting component relies heavily on learning validation and behavior change techniques, in line with the dialectical balance of acceptance and change. Children and parents learn emotion regulation strategies from DBT in a child-friendly format.
This is an excellent treatment choice for children who need it and who have parents who are committed to helping their child in the long-term. DBT for children was developed by Dr. Francheska Perepletchikova to serve children struggling with severe emotional and behavioral challenges. You can read more about our DBT-C program here.