Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) is an empirically validated treatment model designed to address problems of extreme emotion dysregulation, parasuicidal and suicidal behaviors. DBT was developed by Marsha Linehan in the late 1980’s after other treatment protocols were unsuccessful in decreasing the chronic behaviors of a specific diagnostic group.
DBT is best described as a synthesis of mindfulness, behavioral science, and dialectical philosophy. Together these elements are used to decrease severely dysfunctional behaviors and increase skillful living.
DBT reframes dysfunctional behaviors as part of an individuals learned problem solving. Therapy emphasizes active problem solving techniques, skills training, and validation.
In my practice individual sessions focus on skills training, diary card mechanics, and homework. Once review of homework is completed, the remaining time is spent on skills training using the four modules plus a fifth one which I added.
Dialectical behavior therapy (DBT) offers individuals comprehensive skills to manage painful memories and emotions and decrease conflicts in their relationships. This modality focuses on five specific areas of therapeutic skills. These are:
- Mindfulness – Teaches how to stay present, aware, and int he moment without judgment. These skills reduce emotional reactivity, increase clarity, and support wise decision making.
- Distress tolerance – Learning how to cope with intense emotions. These skills focus on surviving emotional crises, accepting reality, and reducing harmful behaviors.
- Emotion regulation – Learning how to manage, and change intense emotions in healthy and effective ways. These skills build emotional awareness, reduce emotional dysregulation, and increase the ability to experience emotions without feeling overwhelmed.
- Interpersonal effectiveness – Teach how to communicate clearly, maintain healthy relationships, and honor their own needs while respecting others.
- Self compassion - Treating oneself with the same kindness, understanding, and support you would offer a friend, especially during times of stress. There is strong evidence to support that as self-compassion increases, shame decreases.
If you are interested in exploring DBT therapy, you should look for a therapist with specialized training and experience in DBT strategies.
I was intensively trained in DBT in 1997 through Marsha Linehan's group in Washington. I have utilized DBT in both inpatient and outpatient settings over the past 28 years.
If you believe you may benefit from dialectic behavioral therapy, please get in touch with me. I would be happy to discuss how I may be able to help.