Dialectical Behavior Therapy
DBT Skills Training Groups
Dialectical Behavior Therapy (DBT) is a variation of cognitive behavioral treatment that was developed by Dr. Marsha Linehan at the University of Washington in the late 1970’s. DBT was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT is recognized as the “gold standard” treatment for individuals with Borderline Personality Disorder and other difficulties related to emotional regulation. Research has shown DBT to be an effective treatment in reducing suicidal behavior and self-harm behaviors (e.g. cutting or actions to cause physical harm to oneself), decreasing psychiatric hospitalizations, reducing treatment dropout, improving social and global functioning, and in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.
Comprehensive DBT has four components: skills training group, individual treatment, DBT phone coaching, and consultation team:
- DBT skills training group is focused on teaching clients behavioral skills related to problem areas in their lives. The group meets weekly and the group leader teaches skills and assigns homework for clients to practice using the skills in their everyday lives. The DBT skills training group teaches mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance skill modules in a 24 week period. Individuals usually receive two rounds of skills training during the 1 year commitment to DBT.
- DBT individual therapy is focused on improving client motivation and assisting clients to apply the skills to specific problem areas in their lives. In the comprehensive DBT model, individual therapy is conducted once a week for the entirety of treatment.
- DBT phone coaching is focused on providing clients with between session support and coaching on how to utilize skills to effectively manage difficult situations client’s experience in their daily lives. Clients can contact their individual therapist for in-the-moment coaching at the times when they are most in need of help.
- DBT therapist consultation team is intended to be support for the therapists in their clinical work with clients who often have severe and complex problems that are difficult to treat. The consultation team is designed to support DBT therapists, provide additional expertise and solutions, and to share responsibility for each therapist’s clinical work.
DBT includes four behavioral skill modules:.
- Mindfulness: the practice of purposeful awareness of one’s internal and external experience in the present moment
- Distress Tolerance: how to tolerate pain in difficult situations and avoid taking impulsive action
- Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
- Emotion Regulation: how to change emotions that you want to change and increase the experience of positive emotions