What is DBT?

Dialectical Behavioral Therapy (DBT) is an evidenced based behavioral treatment, which means there is research to prove its effectiveness. DBT was originally created in the early 90s by Dr. Marsha Linehan as a treatment for suicidal individuals diagnosed with Borderline Personality Disorder. DBT combines elements of Cognitive Behavioral Therapy with Zen principles of mindfulness and compassion.

DBT has since evolved along with the populations treated. Dr. Linehan found that DBT was an effective therapy to treat individuals that had a history of failed therapy, hospitalizations and other treatments. Research and literature on borderline personality disorder has also evolved, in that many clinicians believe BPD is a product of complex posttraumatic stress disorder, or chronic and pervasive invalidation. In other words, difficulty with mood regulation, excessive self criticism or problems related to self image, patterns of unstable relationships, impulsive or self destructive behavior, and trouble with anger-all make sense given certain biological vulnerabilities in addition to an invalidating environment that is unable to meet the needs of the individual. Similarly to changes of the stigma that has been associated with BPD, posttraumatic stress disorder is no longer seen as a disorder only impacting veterans. You or your loved one may be struggling with symptoms and have no understanding as to why; though we believe that given all experiences leading up to now, everything makes sense.

Regardless of the diagnosis, DBT of South Jersey is interested in addressing your symptoms. Unfortunately, you could receive several different diagnoses along the course of your lifetime, and though it can help to point you in the right direction for treatment, labels can also be limiting.

 

How Does DBT Work?

DBT as an evidenced based treatment is designed to run as a comprehensive model that includes four modes:

  • Weekly Individual Therapy Sessions: Start with one of our therapists trained in DBT.
  • Weekly Skills Training Sessions: Group sessions that have a classroom feel, designed to increase your competence in the areas of mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.
  • Phone Coaching: Designed to generalize what is being learned in therapy to your everyday life. Provided by your individual therapist via phone calls or text messages.
  • DBT ConsultationYour therapist meets with other trained therapists to ensure they are giving the best care for you or your family member in accordance with the DBT model.
 
 

Who Can DBT Help?

If you or your loved one is experiencing any of the following, he or she may benefit from receiving comprehensive DBT:

  • Depressed Mood (lack of energy, irritability, lack of self worth, crying spells, loss of interest, over sleeping or sleep depravation, hopelessness etc.)
  •  Anxious Mood (panic attacks, irritability, constant feelings of worry, etc.)
  • Eating Disorder Symptoms (binge eating, restricting, purging, poor body image, emotional eating, etc.)
  • Post Traumatic Stress Symptoms (Avoidance of trauma related stimuli, hypervigilance, hyperstartle, nightmares, reliving the traumatic event through flashbacks or unwanted memories, difficulty trusting others, etc. )
  • Impulsivity (self harming, suicidal thinking, unsafe or risky behaviors such as sexual acting out, over spending or substance abuse)
  • Problems with regulating emotions (you may feel emotions such as anger or fear very quickly, intensely, then it takes awhile before you come back down to your baseline)
  • Relationship chaos (trouble with staying in relationships that are healthy and supportive, difficulty with communication, having all or nothing patterns of thinking that are reflected in relationships, problems with setting limits)
  • Problems in the mind (self doubt, constant worry, racing thoughts, black and white thinking, living in the past or being stuck in “what-if” scenarios)
  • A history of multiple failed treatments/attempts in therapy or hospitalizations
 
 

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DBT Treatment: An Overview

DBT targets various symptoms in stages. Of course, clients may not all come into treatment at stage one, which is why your therapist will meet with you for an assessment in order to recommend the most effective course of treatment for you.

 
 

Stage 1

Goals of stage one are to obtain behavioral control. For clients experiencing life-threatening symptoms such as suicidal thinking, suicidal behavior and self harm, these behaviors are addressed first as they are priority in the hierarchy of symptoms. The second target of stage one treatment is to decrease any behaviors that interfere with therapy working. The third target is behaviors that interfere severely with one’s quality of life. In DBT, behaviors that interfere with making life feel as if it’s worth living, such as substance abuse, depression, anxiety, avoidance, eating disordered symptoms, problems in relationships, impulsivity, financial stressors, employment problems, etc.  The fourth target of stage one is to increase skills that help with tolerating emotional pain and distress, staying in the present moment, making and keeping healthy relationships and understanding their emotions while knowing how to regulate them.
 
 

Stage 2

The main goal of stage two work is to experience emotions and decrease avoidance. This mainly speaks to shutting down that may happen as a result of past trauma or invalidation. Healing from past trauma is the goal in stage two, and at DBT of South Jersey, various techniques from other modalities may be used, such as prolonged exposure, EMDR, compassion focused therapy and sensorimotor therapy.
 
 

Stages 3 & 4

Solving ordinary life problems and addressing feelings of incompleteness. Stages three and four address normal levels of unhappiness that may stem from everyday life. Ultimately, therapists strive to help their clients develop a sense of meaning and connection within the world they live in. Through creating meaning in spiritual growth or making other changes in their lives, clients work towards finding ways to meet their own needs and find a sense of completeness. Again, various modalities can be utilized here such as gestalt therapy, CFT, mindfulness based therapies, among others.