Why DBT?

So, you might be asking yourself, why DBT?

Dialectical Behavior Therapy (DBT) was founded and developed by Dr. Marsha Linehan, PhD at the University of Washington in the late 80s and early 90s. DBT is considered the leading evidence-based treatment option for people and families struggling with disorders of emotion regulation, high-conflict, and other self-destructive behaviors. Starting a comprehensive DBT program is a significant step and requires adequate research and information.

Comprehensive and adherent DBT has four functions which are: to enhance capabilities, improve motivation, assure generalization to the natural environment, and to enhance the therapist’s capabilities, which are outlined below.

Enhance Capabilities:

Struggling to regulate emotions is not a moral or character deficit or an issue of willpower, it is a behavioral skill deficit. A principle in DBT is that everyone is doing the best that they can, and they may still need to do better. DBT teaches a 6–12-month skills class designed to increase mindfulness, behavioral control during a crisis, emotional regulation skills and skills geared toward having healthy relationships. These skills are designed to treat specific problems common among suicidal adolescents and their families. Learning these skills helps individuals and families manage conflict more effectively, reduce suffering, and increase overall behavioral awareness and control.

Improve Motivation:

DBT therapists use chain analysis, which is a process of assessing the series of events, link by link, that lead from a prompting event to a problem behavior (eg, suicide attempt) --to assess problematic behavior and identify methods of change (DBT skills). Once the behavior has been adequately understood, the therapist and client collaboratively come up with a solutions analysis or a behavior/skills plan moving forward to reduce the likelihood of the reoccurrence of the ineffective behavior. This helps the individual increase awareness of how the problem behavior occurred and what to do in the future instead.

Assure Generalization to the Natural Environment:

Individual therapy is once a week for 45 minutes, and group is once a week for 75 minutes. While this is more time spent committed to therapy sessions than traditional outpatient programs ask, the real work and growth comes outside the therapy room. As DBT therapists, we want out patients to learn to use the skills in their everyday life, in the pursuit of them building a life worth living. An integral part of this treatment is that our clients have access to phone coaching. After-hours phone coaching is targeted towards helping clients generalize skills outside of the therapy office and learn how to ask for help effectively.

Enhance the therapists’ capabilities:

As part of adherent DBT, all DBT clinicians must be on a consultation team. Consultation team serves as therapy for the therapist and helps the clinical team collaborate and coordinate care.

So, why DBT? DBT also helps people build a life worth living, or a life that they don’t want to escape from. DBT is an evidence-based treatment that has been researched and proven to help a variety of disorders, notably BPD, and also including:

1. Substance use

2. Eating disorders (bulimia nervosa and binge eating disorder)

3. PTSD

4. Anxiety

5. Depression

DBT FAQs:

Will DBT help me?

DBT is an empirically-validated treatment that has been researched for the past 30+ years. Our therapists will complete a thorough evaluation with you to understand the reasons you have entered into treatment, along with your therapeutic and overall goals in life. We have each individual enter pre-treatment after our initial intake, which typically lasts for 4 weeks. We use this time to orient you to the treatment and our program, collaborate and agree on treatment goals, and strengthen commitment before beginning group. Each patient is expected to fill out a daily DBT “diary card,” which is used to track emotions, agreed upon behaviors to increase and decrease, as well as skill utilization and generalization.

New York Times recently wrote a fantastic piece (linked below) which discusses DBT in-depth, and recognizes it as “The Best Tool We Have for Self-Harming and Suicidal Adolescents.”

https://www.nytimes.com/2022/08/27/health/dbt-teens-suicide.html