Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy is a research-based, cognitive-behavioral treatment originally developed by Marsha Linehan at the University of Washington, to help clients with the suicidal and self-harm behaviors often seen in Borderline Personality Disorder.

DBT has since then been modified as a treatment for other complex and challenging mental disorders that involve emotional dysregulation, such as dual diagnoses, PTSD, eating disorders and severe mood disorders. Clients with these disorders often have great difficulty managing the emotional and relational crises of their lives because they lack the needed behavioral coping skills.

Using both acceptance and change strategies, DBT asks both patient and therapist to find a balance between accepting reality as it is, and maintaining a strong commitment to change. Such treatment is ideally offered in an environment that is warm and validating, while attempting to offer enough challenge and guidance to effect behavioral change and reduction of harmful behaviors. The goal is to help clients create “a life worth living.”

Research has shown that DBT treatment is most effective when it includes 1. individual therapy, 2. a weekly skills training group and 3. help with skills application by phone with the individual therapist between sessions. At MTA, we offer all three components. For information about individual DBT therapy or skills application and coaching, please contact us.

Weekly DBT skills training groups are didactic groups that use a step-by-step format to teach four sets of skills: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.

  • Mindfulness: The ability to take control of your mind instead of having your mind control you. Mindfulness helps direct your attention through the process of observing, describing and participating from a nonjudgmental perspective. This allows for more objective, effective, and meaningful experiences in the here and now.
  • Interpersonal Effectiveness: The ability to communicate and express yourself effectively while maintaining an understanding and a commitment to your objectives, your relationship to the person(s) and your self-respect.
  • Emotion Regulation: The ability to regulate your emotions by understanding the relationship between thoughts, feelings, body sensations and behaviors. As well as, being aware of vulnerability factors related to emotional states such as; adequate sleep, balanced eating, appropriate medication usage, self-care, exercise and incorporating positive experiences in your daily life.
  • Distress Tolerance: The ability to get through an already difficult time without making it worse. Self-destructive behaviors are often a result of ineffective ways of dealing with painful emotions. Distress tolerance teaches the use of distraction, radical acceptance and pros/cons as alternatives.

These topics are covered through leader presentation, group discussion, handout materials, structured homework and homework review. For more information about DBT please see www.behavioraltech.com.