Dialectical Behavioral Therapy (DBT) is a combination of behavioral and cognitive therapies. The main goal of DBT is to transform negative thought patterns and destructive behaviors into positive outcomes. Although DBT was originally developed to treat individuals diagnosed with borderline personality disorder (BPD), it is now often used to treat individuals with suicidal ideations and/ or other self-destructive behaviors as well as other mental health conditions such as depression, post-traumatic stress disorder (PTSD), substance use disorder (SUD), and more. Additionally, it is highly common to integrate DBT into a treatment plan for an individual struggling with an eating disorder. Research has found that DBT has been shown to help with emotional regulation, building self-management skills, reducing anxiety, lowering stress and learning to effectively control destructive eating behaviors.  

How DBT Works

DBT treatment is generally a combination of individual therapy sessions and DBT skills group sessions. An individual will engage in one-on-one psychotherapeutic sessions with a trained therapist to address all the individual’s nuanced mental health needs, as well as help to encourage the individual to remain motivated to address obstacles that arise throughout the course of treatment, and apply the DBT skills learned in group sessions to his or her daily life. The DBT skills group sessions provide a forum and an emotionally safe environment for participants to learn and practice the DBT skills with other individuals going through the same experience. In the DBT skills group sessions a trained therapist introduces and teaches the DBT skills to the participants as well as facilitates relevant therapeutic exercises. Group members are assigned homework (i.e. practicing mindfulness exercises) to reinforce the lessons from the previous DBT skills session. Each DBT group skills session usually lasts about two hours, and the DBT skills group meetings are generally held once a week for about six months. 

The needs of the group members can increase or decrease the duration, greater or shorter than six months, of the DBT group skills sessions. Additionally, the format can change, as it will be tailored to the unique needs of the individual in treatment. For example, depending on the individual, some may benefit from the one-on-one therapy sessions without attending the weekly DBT skills group sessions, while others may benefit from participating in the weekly DBT skills group sessions without attending a regularly scheduled one-on-one therapy session. 

A fundamental component of DBT is the assumption that effective treatment, which includes the group skills training sessions, must place equal focus on the behavior and experience of the mental health provider working with the individual in treatment as it does to the behaviors and experiences of the individual in treatment. Hence, most mental health clinicians that offer DBT often practice the skills themselves. This helps the mental health clinician providing DBT reinforce his or her knowledge of basic behavior techniques as well as remain current with all DBT treatment strategies.

Insurance Coverage

At one point in time, the need for mental health treatment was stigmatized and health insurance companies did not prioritize this component of healthcare coverage. Fortunately, this has shifted as many mental health ailments are recognized as potentially equally debilitating as other physical health ailments (i.e. diabetes, physical disabilities…etc.) and are included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). While the details of mental health coverage will vary and the out-of-pocket responsibility will depend on the specific type of health insurance coverage, all health insurance companies are required to provide partial or full coverage for mental health treatment, including DBT carried out by a registered, certified mental health clinician. 

It is important to note that in America, there are a plethora of different types of healthcare insurance coverage options, including the array of health insurance companies and the variety of tiered health insurance coverage plans offered by each company. The health insurance premiums can range from $30 a month to over $1,900 a month depending on the insurance company selected and type of plan selected. Some plans will offer coverage only for services rendered by in-network providers, while others may offer full or partial coverage for services provided by out-of-network providers. The out-of-pocket responsibility will be wholly dependent upon one’s elected health insurance plan. In order to avoid any surprise healthcare bills it is essential to fully understand the intricacies of one’s health insurance plan. Make sure to call customer support on the backside of the health insurance card and inquire about coverage, out-of-pocket responsibility and/ or the need for any referrals and/or preauthorization requirements.