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DBT Essentials: A Roadmap to Handling Borderline Personality Disorder

By March 13, 2024March 29th, 2024DBT

Dialectical behavior therapy (DBT) is an evidence-based, rigidly structured form of psychotherapy. It was developed by psychologist Marsha M. Linehan in the late 1980s as a treatment method specifically designed for chronically suicidal individuals diagnosed with borderline personality disorder. DBT combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. Here is a roadmap to guide the treatment of BPD using DBT:

  1. Assessment and Diagnosis:
    1. Thorough Assessment: Conduct a comprehensive assessment to understand the individual’s history, symptoms, and challenges.
    2. Collaborative Diagnosis: Work collaboratively with the individual to establish a diagnosis of borderline personality disorder.
  2. Building a Therapeutic Alliance:
    1. Establish Trust: Recognize the importance of trust in the therapeutic relationship. Validate the individual’s emotions and experiences.
    2. Commitment to Treatment: Ensure commitment from both the therapist and the individual to engage in the therapeutic process.
  3. Orientation to DBT:
    1. Educate about DBT: Provide a clear understanding of what DBT is, its goals, and how it can help in managing emotions and behaviors.
    2. Highlight Dialectics: Emphasize the dialectical nature of DBT – balancing acceptance and change.
  4. Individual Therapy:
    1. Target Identification: Collaboratively identify and prioritize specific target behaviors and problems to address in therapy.
    2. Skills Training: Begin teaching skills in distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness.
  5. Group Skills Training:
    1. Structured Modules: Conduct weekly group sessions to teach and practice DBT skills, focusing on the four modules mentioned above.
    2. Homework Assignments: Encourage individuals to practice skills between sessions and discuss their experiences in the group.
  6. Phone Coaching:
    1. Availability: Establish clear guidelines for when and how individuals can contact the therapist for phone coaching between sessions.
    2. Crisis Intervention: Provide guidance and support during moments of crisis, reinforcing the application of DBT skills.
  7. Mindfulness Practice:
    1. Integration: Integrate mindfulness techniques into both individual and group sessions to enhance awareness and reduce impulsivity.
    2. Regular Practice: Encourage regular mindfulness practice as a key component of emotional regulation.
  8. Therapist Consultation Team (TCT):
    1. Supervision: Therapists involved in DBT should meet regularly to discuss cases and receive consultation to ensure adherence to the DBT model.
    2. Problem Solving: Use the TCT for problem-solving challenging cases and maintaining therapist motivation and commitment.
  9. Assessment of Suicidal and High-Risk Behaviors:
    1. Safety Planning: Develop and regularly update a safety plan to address suicidal and self-harming behaviors.
    2. Collaboration with Other Professionals: Coordinate with other healthcare providers involved in the individual’s care to ensure a comprehensive approach.
  10. Termination and Aftercare:
    1. Gradual Termination: Plan a gradual termination process to allow for a smooth transition from therapy.
    2. Aftercare Planning: Develop an aftercare plan that includes ongoing support, continued skill practice, and resources for maintaining progress.
  11. Ongoing Monitoring and Evaluation:
    1. Regular Assessments: Continuously assess progress, adapting treatment goals as needed.
    2. Feedback and Adjustments: Solicit feedback from the individual regarding their experience in therapy and make necessary adjustments to enhance effectiveness.

Implementing DBT for borderline personality disorder requires commitment, patience, and flexibility. Regular supervision and ongoing education for therapists are crucial for maintaining fidelity to the DBT model.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.



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