Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan, Ph.D., as a treatment for individuals with borderline personality disorder or emotional dysregulation problems. DBT is an empirically-based, highly practical, and structured therapy that emphasizes both acceptance and change-oriented skills (dialectic). The word “dialectical” means a synthesis or integration of opposites; for example, as therapists we understand that our clients are doing the best they can and, at the same time, they need to change specific behaviors in order to achieve their life goals. Therefore, clients are helped to move away from rigid and unworkable behaviors to more effective ones.
DBT has shown to be effective with individuals struggling with depression, eating disorders, trauma, substance abuse problems and emotion dysregulation problems in general. For more information about DBT, visit behavioraltech.org.
At the East Bay Behavior Therapy Center we are offering all treatment components and our clinical work is in complete adherence to a full DBT program.
DBT individual therapy
The goal of individual DBT therapy is to help clients create “a life worth living” by addressing safety issues (suicidal thoughts and behaviors, self-injurious thoughts and behaviors), therapy-interfering issues (impulsive behaviors, things that interfere with therapy), quality of life interfering issues and other specific targets/goals. Clients are asked to monitor their ineffective behaviors and how often they are applying DBT skills in their life by completing a diary card on a daily basis. The dairy card is reviewed at the beginning of each individual therapy session.
In addition, clients are taught chain analyses, which is “a detail description of the problematic behaviors.” Chain analyses are completed in session with the therapist and outside of sessions in order to analyze behaviors that the client wants to change and identify skills that could be helpful for dealing with that particular problematic situation.
DBT skills training
DBT Skills are taught on a weekly basis in a 1.5 hour group session. This DBT skill group is not a traditional “process” group where people share feelings, thoughts, opinions and simply discuss about them. Rather, the DBT Skills group is much more like a class on “emotional intelligence.” Certainly sharing can and does happen, and members can be supportive to one another as far as they are comfortable; however, the group is about learning DBT skills in a classroom style format. At our center, every group session starts with a mindfulness exercise followed by homework review, presentation of a new skill, and homework assignment. When presenting a new skill, handouts are given to clients and experiential exercises are conducted as well in order to facilitate the learning process.
The DBT skills training is structured in four specific modules: (1) Mindfulness, (2) Emotion Regulation, (3) Distress Tolerance, (4) Interpersonal Effectiveness. there is an an additional module for adolescents and families called “The middle path.”
The main purpose of this module is to teach clients to be present and pay attention in the moment.
In t his module clients are taught specific stress management skills in order “to survive a crisis without making it worse.”
In this module clients with learn how to skillfully deal with mild to intense emotions in a more effective way by noticing them, learning to tolerating them, and finally deciding how to effectively respond to them.
This module focuses in teaching clients how to deal with others in a more effective way without damaging the relationship, handling interpersonal conflict or assessing whether a relationship is toxic or not.