What Is DBT?

Dialectical Behavior Therapy
(DBT) is an evidence-based treatment for persons struggling with emotion regulation issues (e.g., rapid mood changes, intense and debilitating emotions, etc.).  It was developed by Dr. Marsha Linehan and colleagues at the University of Washington.  Since it's creation in the early 1990's, DBT has been shown to be effective for a broad range of issues from severe suicidal thoughts to problems in maintaining relationships. The standard DBT "program" consists, at minimum, of once weekly individual therapy and once weekly skills training, usually done in a group.  DBT is provided by a team of therapists who meet weekly for consultation on how to improve their skills as therapists and to remain adherent to the treatment principles and protocols.
The overarching goal of DBT is to obtain “a life worth living” by providing skills managing emotions, tolerating distress and improving relationships.   DBT has been shown to be effective in reducing suicidal behaviors, hospitalizations, and problems with anger, depression, and hopelessness.  The key problem that DBT treats is emotion dysregulation, defined as a combination of extreme emotional vulnerability with difficulty in regulating emotions once they are aroused.  DBT clients learn an array of skills to manage their emotions and the impulsive and almost automatic behaviors that often accompany strong emotions.  In individual therapy each client works on a highly personalized plan to reduce the behaviors getting in the way of attaining their goals and to increase their use of skillful behaviors.  Most clients who enter DBT are asked to make a year commitment to attend both individual therapy and skills training.  In one year of treatment and with hard work from both the client and the therapist, most clients can see significant improvement in their lives.

What to expect...

DBT is a therapy which requires a serious commitment from both the client and the therapist. Your therapist will help you clarify your goals and will ask for specific commitments from you, which will help you reach your goals. You and your therapist will develop a collaborative relationship which will seek to reduce any problems that get in the way of your therapy and will also identify behaviors that you most need to change in order to achieve your goals. Individual therapy and skills training will be weekly, and you will have homework for each. You will also have access to between- session coaching contact. DBT is a very active and directed process, where you and your therapist delineate a clear path toward your goals and focus on the steps needed to reach them. Your effort will be a huge factor in your progress.

The first four sessions of DBT will focus on orientation, assessment and commitment. There are formal and informal assessment procedures. During the early sessions you and your therapist will establish your relationship and treatment plan, including making a diary card. Attendance at group usually begins within four to six weeks after entering therapy. The minimum commitment is usually a year and many people stay in DBT for longer than one year.