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.”
Who is DBT for?
You might be struggling with things like
- Feeling like you're on an emotional roller coaster
- Fighting with loved ones
- Feeling numbed out, empty or disconnected
- Not having a sense of self
You might even have turned to things like
- Overspending on things you don't need
- Unhealthy eating patterns
- Thinking about suicide
- Threatening suicide
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:
Borderline Personality Disorder (BPD), is a personality disorder that holds significant potential for successful treatment. Although BPD often suffers from a negative perception, there is an encouraging solution in the form of DBT, which has proven to be highly effective in treating this disorder.
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.
Group is where you’ll learn skills to become more mindful, improve interpersonal effectiveness, tolerate distress, and learn to manage and control our emotions.
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.
Individual DBT helps you recognize patterns that get you stuck and figure out ways to move forward.
The DBT team approach excels at delivering exceptional DBT skills 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.
Where are you located?Our clinicians are located all over, and are licensed to provide services to clients in NY, NJ, FL, MD and Israel. Currently, we offer services via telehealth and in person in Jerusalem. Please call our office 02-376-4719 or 011-972-2-376-4719 to find out more about getting started with therapy.
Do you take insurance?Like many private therapists, we are not in network with any insurance companies. Clients are sometimes able to be reimbursed by their insurance for a portion of the cost or the full cost via out-of-network benefits. We recommend that all clients reach out to their insurance company to find out if they are eligible for any coverage. To do this, call the number on your insurance card and ask what is covered for an out-of-network provider who is providing the services in which you are engaging (individual therapy, family therapy, or group therapy). Remember to ask if you have a deductible and what they consider the maximum allowable reimbursement. All services are billed directly to the client and full payment is expected at the time of service. Each month, you will be provided with a statement (called a superbill) that contains all of the necessary information that is required by insurance companies. You can submit this bill to the insurance company to be compensated through your out-of-network benefits.
What do you mean by "frum"?Frum can mean a lot of things to a lot of people. We mean whatever you mean. If you would call yourself frum and you’re looking for high quality mental health services, you’re in the right place.
What is your cancellation and rescheduling policy?We have a 48-hour cancellation and reschedule policy for all individual appointments. We are happy to be able to be flexible in rescheduling for any reason, and you are held accountable for full payment of your missed session. Groups require a financial commitment to a full module, regardless of missed sessions.
Does treatment address underlying issues?Treatment focuses on what is not working for you right now, which is informed by your learning history until now. We therefore work to make changes that will last. Underlying issues that are impacting your current way of living are targeted to bring about the greatest possible lasting changes.
Can I keep my outside therapist if I do DBT?If your therapist recommends you join our DBT skills group, we are happy to collaborate with them in your treatment. If your therapist does not offer individual DBT therapy, we will need to determine whether or not the current treatment you are receiving would blend well with the addition of skills training and whether or not comprehensive DBT would be more appropriate. If you would benefit from full DBT, you can continue to see your current therapist while you are in the pre-treatment stage, prior to committing. Once we have committed to work together using DBT, we need all hands on deck to make treatment as effective as possible. This means that you may continue to work with your individual therapist after completing DBT, and while you are committed to DBT, you can only sit in one chair.
I want to learn more but I don't know if I want to or need to start therapy right now.Please feel free to reach out for a free phone consultation with our Client Care Coordinator. We can answer your questions and help you determine if we’re the right fit for you at this time. Therapy can be really tough, just like any development – being aware of our flaws and accepting they exist in order to make necessary changes requires courage and strength. Let us share proven methods with you to help you on that journey.
“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.