Accessible DBT

Dialectical Behavior Therapy (DBT)

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What Is DBT?

Dialectical Behavioral Therapy, or DBT, is a type of therapy specifically developed by Marsha Linehan in 1993 to address the following symptoms:

  • Frantic attempts to prevent abandonment
  • Unstable relationships – alternating between “I love you” and “I hate you”
  • Unstable self-image
  • Impulsive behavior such as binge eating, reckless driving, sex, spending , substance use
  • Self-mutilation or suicidal thoughts/behavior
  • Mood swings of intense anxiety, depression, or irritability
  • Chronic feelings of emptiness
  • Anger that is out of control or inappropriate
  • Brief paranoid ideas or severe dissociative symptoms related to stress

DBT skills have also proven effective for anyone going through an emotional crisis such as job loss, relationship loss, etc.

DBT differs from traditional therapies in several ways. Therapists undergo specific adjunct training in the principles and methods of implementing DBT. The therapist becomes more directive with teaching the skills and clients are challenged to practice the skills as they learn them. Be wary of other programs who claim to teach DBT. They may be teaching the skills, which are valuable. However, to be a complete DBT program, clients must participate in both group and individual therapy, complete homework assignments, utilize diary cards, and complete a Behavior Chain Analysis regularly to process unhealthy behavior patterns.

A DBT therapist is your partner on your journey to a Life Worth Living. You decide your goals. Your DBT therapist will ask questions and prompt you to consider things that you never thought of before.

Dialectics

The term “dialectic” refers to opposites. In Dialectical Behavior Therapy, we consider many dialectics (two opposite things that can be true at the same time) with the purpose of finding a middle path. Some commonly discussed dialectics include:

Acceptance vs. Change

Emotion Mind vs. Rational Mind

Fun vs. Responsibility

Assumptions of DBT

A DBT therapist enters into the therapeutic relationship with certain attitudes or “assumptions” about the clients and their role as a therapist:

  1. People are doing the best they can, and they can do better
  2. People want to improve
  3. People need to do better, try harder and be more motivated to change
  4. People may not have caused all their problems, but they need to solve them anyway
  5. The lives of suicidal, depressed, anxious, or angry people are painful as they are currently being lived
  6.  All people must learn new behaviors in different situations in their lives (school, work, home, community)
  7. There is no absolute truth
  8. People cannot fail DBT

The Four Modules of DBT

  • Mindfulness–In the words of Jon Kabat-Zinn, mindfulness is, “Paying attention, on purpose, in the present moment, as if your life depended on it, non-judgmentally.”
  • Distress Tolerance--Getting through a challenging moment without making the situation worse
  • Emotional Regulation— Staying in the “wise mind” and managing emotional reactions/overreactions to stressors
  • Interpersonal Effectiveness–Using assertiveness skills to solve problems and work out conflicts

Each module will be revisited over the course of therapy, and the client will develop a deeper understanding of each component with each repetition.