Dialectical Behavior Therapy
Dialectical behavior therapy (DBT) is an evidenced-based treatment that helps people gain greater control over their behaviors or, as I say a lot, do what works.* Ultimately, we are laying down the foundation to build the life you want to live.
It is called dialectical behavior therapy because it is based on dialectics, the idea that two seemingly opposite things can both be true at the same time. The main dialectic is one of acceptance and change. In order to make any real moves towards change, we need to first accept where we really are (and not where we think we are or where we hope we are). This awareness can be painful and also necessary if we want to do something about it.
Comprehensive or full-fidelity DBT includes 4 components:
- Individual therapy with a DBT trained therapist
- DBT Skills Training, usually in a group
- 24/7 phone coaching
- Therapist participates in weekly DBT Consultation Team meeting
I have completed over 100 hours of DBT training, however, I no longer offer phone coaching or participate in a DBT-specific Consultation group. The therapy that I provide is informed by DBT and not full-fidelity.
What are the skills?
The skills are divided into four parts, with mindfulness as the foundation of all skills:
- Mindfulness – Mindfulness skills break mindfulness down into simpler, functional actions. When put together, these skills help you become more mindful and present in the current moment.
- Distress Tolerance – Divided into Crisis Survival and Reality Acceptance skills, Distress Tolerance is about tolerating and accepting the distress in life that is unavoidable. Non-acceptance of this fact leads to increased pain and suffering. Increased distress tolerance will lead to moving through crises skillfully and accepting life just as it is in each moment.
- Emotion Regulation – Divided into skills focused on understanding emotions, changing emotions, reducing vulnerability to intense emotions, and managing extreme emotions. These skills will help you work with your emotions and not against them.
- Interpersonal Effectiveness – Skills to clarify what you want; to communicate to (more likely) get what you want; to start, grow, and maintain important relationships; and to end unhealthy ones. All of this while balancing your priorities (self-respect, needs) with those of others.
*Credit for most of this language goes to Marsha Linehan, the creator of DBT.
If you are looking for a full-fidelity DBT program, you can search via the Behavioral Tech (BTECH) directory for teams that have completed DBT Intensive or Foundational training.