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What Is Dialectical Behavior Therapy (DBT)?


What Is Dialectical Behavior Therapy (DBT)?

Woman talking with therapistDialectical Behavior Therapy was developed by Marsha Linehan and started to become more widely known to the public around 1993, upon the publication of her book and skills training manual.  DBT is a comprehensive treatment approach that was first developed to help clients that had persistent self-injurious behavior (like cutting, or burning oneself) and/or had a diagnosis of Borderline Personality Disorder.  The treatment includes: 1. having a client participate in individual therapy, 2. Attending skills group, 3. Having access to 24/7 phone coaching, 4. Having ancillary treatment, (as needed, like psychiatry, family therapy), and 5. having the therapeutic professionals involved meet weekly in order to maintain treatment objectives and prevent burnout.  Since DBT first came out there has been, and continues to be, ongoing research on the treatment and efficacy of the approach with a variety of clinical populations.

Although the original intention was for DBT to help clients with Borderline Personality Disorder and parasuicidal behaviors, it’s application and use became widespread to other clinical populationships: such as clients with eating disorders, addiction, mood disorders, trauma and more.  Furthermore, more recent studies have looked at the application of one or more of the five components of the DBT approach on various clinical populations and some research is showing good outcome data to reinforce the benefits of using DBT skills group or individual DBT therapy alone.

The DBT Skills Group teaches four core skills: Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness.  What makes these skills so effective, in my opinion, is how easy they are to understand, remember, and follow.  In addition, they are so practical and apply to so many basic aspects of life, that often people refer to them as “life skills that anyone can benefit from”.

Mindfulness is a foundational skill that enhances your capacity for awareness of what is happening in the moment, moment-to-moment.  The more awareness you have, the better able you are to have choice in deciding how to respond to what is happening in the moment. This includes the ability to decide if there are other skills you may want to use, based on what is happening.  Other prolific writers and spiritual guides refer to the practice and idea of

Mindfulness as “conscious awareness,” or “presence of mind,” or “observer consciousness.”  In DBT the expectation and approach is to help clients learn and practice all skills until mastery in all domains of life.

Distress Tolerance is the skill of staying present in the midst of overwhelming emotions such that you do not react or overreact to the emotions you are feeling in the moment.  Distress Tolerance skills allow you to ‘buy enough time’ and space to decipher what you need to do in order to avoid unwanted outcomes like saying or doing things you regret and that are not in line with your ultimate goals.  There are a variety of skills taught in this module to help you tolerate stressful and overwhelming situations.

Emotion Regulation skills teach you about how emotions work, their function, how to change unwanted emotions and how to handle emotions better as they arise.  There are a variety of skills taught in this module to help you understand and manage emotions more effectively.

Interpersonal Effectiveness skills teach you about how to manage relationships more effectively, how to determine which relationships are worth keeping, how to build and maintain stronger relationships, and how to determine which relationships are worth ending. In addition, Interpersonal Effectiveness skills teach you how to improve your ability to manage and resolve conflict, how to balance relationship demands with personal needs and priorities, and how to ask for things and say no in more effective ways that preserve your self-respect and the respect of others and the relationship.

What sets My Counseling Connections Inc. apart from other local DBT programs is that we offer our skills groups outside of a comprehensive DBT program, as a stand alone service, and work collaboratively with outside individual therapists in the community to support our clients who. are engaged with and want to stay with their primary/individual therapist.  We recognize that not all clients need a comprehensive DBT approach and can still benefit from what the skills alone have to offer.  We offer Skills Groups for Teens, Young Professionals, Parents, and Kids.

Many practitioners are not aware of the full scope and application of comprehensive DBT vs. offering components of the DBT model, which at times may be problematic when a client is a candidate and would only benefit from comprehensive DBT and are offered only components of DBT unbeknownst to them.  During the intake process at My Counseling Connections, we determine the extent to which a client would benefit from “comprehensive DBT” vs. components of DBT, like the Skills Group.  We also determine whether a client would benefit from individual therapy vs. Skills Group alone and make these recommendations accordingly.

We have found that our skills groups are excellent for teens with or without significant mental health issues.  The four core skills help teens address all the new challenges they are beginning to face in the developmental stage of life they are in.  They are fighting for autonomy and independence, and experiencing more intense relationships and emotions than they ever did before.  The more skills they have to enhance their capacity of awareness, to manage relationships, their emotions, and impulses, the better they will do overall.

We hope you consider learning more about the benefits of Dialectical Behavior Therapy Skills Groups for yourself, or your teen and would be happy to set up a complimentary consultation to discuss how DBT might help you.

Be well and stay safe.

Author: Tammy Berman, LMHC, NCC

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My Counseling Connections

Licensed Mental Health Counselors and Marriage & Family Therapy Professionals.
817 South University Drive, Suite 121
Plantation, FL 33324