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How Effective Is Dialectical Behavior Therapy

DBT-effective

Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment that combines standard cognitive behavioral therapy (CBT) techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness and attentiveness to current situations and emotional experiences to encourage acceptance. Psychologist Marsha M. Linehan developed DBT in the late 1980s, after the result of her own transformation that occurred in 1967. It is a therapeutic method specifically geared to treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal thoughts and/ or attempts. DBT emphasizes the psychosocial aspects of treatment and promotes the systematic learning of new emotional coping skills.

DBT Basics

Dialectical behavior therapy is a multifaceted, rigidly structured therapeutic approach. It is carried out in three settings: weekly individual psychotherapy sessions, weekly DBT skills training group sessions, and as-needed phone coaching. Within each setting, DBT focuses on the teaching skills in four fundamental areas, known as the four modules, which are:

  • Core mindfulness: focuses on improving an individual’s ability to accept and be present in any given moment. The skills in this module help individuals learn the importance and value of slowing down and taking pause instead of succumbing to intense emotions and acting in destructive ways. 
  • Distress tolerance: focuses on increasing an individual’s tolerance of negative emotion as opposed to attempting to avoid or escape from it. The skills in this module help individuals learn various techniques for handling crisis (e.g., distraction, self-soothing, improving the moment, etc.). 
  • Emotion regulation: focuses on helping an individual identify, name, understand the function of, and regulate their emotions. The skills taught in this module are intended to help an individual learn to decrease the intensity of their emotions, sit with and experience strong emotions that are causing problems in one’s life, without impulsively acting on them. 
  • Interpersonal effectiveness: focuses on increasing an individual’s communication strategies. The skills taught in this module help an individual learn to identify what their own needs are in a relationship and develop assertive and effective communication methods to ensure those needs are met in a healthy, nondestructive way. 

Each module highlights distinct and specific skills that build upon each other and are individually and collectively integral to the success of this therapeutic intervention.

DBT Efficacy

Although it is impossible to postulate the universal effectiveness of DBT because it is used to treat a wide variety of mental health ailments, there are certain studies that indicate its efficacy. According to Behavioral Tech, DBT is works because it “assumes that many of the problems exhibited by clients are caused by skills deficits.” The National Alliance on Mental Illness (NAMI) asserts that DBT is effective in “reducing psychiatric hospitalization, substance use, and suicidal behavior.” Research has also found DBT to significantly reduce hospital stays, self-injurious behaviors, and the severity of borderline personality disorder symptoms. Results from one study showed that 77% of participants no longer met criteria for a BPD diagnosis after undergoing treatment. Still, the controlled and uncontrolled variables make it extremely challenging to measure the collective efficacy of DBT. 

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.

Can Dialectical Behavior Therapy Work For Anxiety?

Can-CBT-Works

Yes, dialectical behavior therapy (DBT) can be an effective method of treatment for anxiety. According to Psychology Today, “anxiety is built into our primate origins as a warning system.” It is the body’s natural response to stress. The Oxford English Dictionary defines anxiety as “a feeling of worry, nervousness, or unease, typically about an imminent event or something with an uncertain outcome.” Anxiety is an unavoidable fact of life, as very individual will experience stress at some point. Still, there is a notable difference between sporadically experiencing anxiety and suffering from an anxiety disorder where one’s anxiety becomes excessively pervasive. 

Anxiety Disorders

According to Johns Hopkins Medicine anxiety disorders affect up to 18% of the population, making it the most common mental health condition in the United States. The National Alliance on Mental Illness (NAMI) asserts: “Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening.” The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) list five distinct types of anxiety disorders, which are generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), and social anxiety disorder (also known as social phobia). There is a variety of treatment approaches, including a wide array of therapeutic modalities, such as DBT, that can help an individual learn effective coping mechanisms and anxiety management strategies to prevent, reduce, and even become more resilient towards anxiety.

Dialectical Behavior Therapy

Dialectical behavior therapy is a comprehensive, evidence-based treatment that was originally developed by Marsha M. Linehan, in the late 1980s, to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT was originally developed with a focus on emotion regulation which is closely tied to one’s ability to manage anxiety. It 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. DBT focuses on cultivating therapeutic skills in four main areas, known as the four modules, which are: 

  • Core mindfulness: focuses on improving an individual’s ability to accept and be present in the current moment
  1. Distress tolerance: focuses on increasing an individual’s ability to tolerate pain that may arise from difficult situations, as opposed to trying to change and/ or escape it
  2. Interpersonal effectiveness: focuses on teaching techniques that enable a person to communicate with others in a way that is assertive, maintains self-respect, and simultaneously strengthens relationships
  3. Emotion regulation: focuses on decreasing emotional impulsivity by shifting intense emotion without reacting instinctively to them

This therapeutic intervention utilizes a multifaceted approach that consists of weekly individual psychotherapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching between sessions. DBT offers both the ability to provide personalized therapeutic support through the individual therapy sessions, as well as peer support in DBT skills training group therapy sessions. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD, and its efficacy has also expanded to other ailments. Clinical findings indicate that DBT is increasingly used as an effective approach for managing anxiety and related issues. 

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.

Does DBT Help With Intrusive Thoughts?

dbt help

Dialectical behavior therapy (DBT) is an evidence-based psychotherapeutic modality that 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. It was developed in the late 1980s by Marsha M. Linehan, as a means to more effectively treat individuals diagnosed with borderline personality disorder (BPD) struggling with suicidal ideation. Borderline personality disorder is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic mental health disorder. The Merck Manual explains that BPD is “characterized by a pervasive pattern of instability and hypersensitivity in interpersonal relationships, instability in self-image, extreme mood fluctuations, and impulsivity.” Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses. DBT emphasizes the psychosocial aspect of treatment and is intended help treat individuals exhibiting self-destructive behaviors and/ or struggling with emotional dysregulation, which is why its efficacy has expanded to other mental health disorders.

Intrusive Thoughts

It is natural for an individual to occasionally experience doubts and/ or fears that lead to certain thoughts and/ or behaviors. These are generally fleeting occurrences that are not uncommonly experienced by neurotypical individuals. Intrusive thoughts are defined as unwanted thoughts, images, impulses, or urges that can occur spontaneously or can be triggered by internal and/ or external stimuli. According to the Anxiety and Depression Association of America, intrusive thoughts affect nearly six million Americans. Intrusive thoughts are sometimes associated with a mental health disorder. The National Institute of Mental Health assert that intrusive thoughts are among the symptoms of post-traumatic stress disorder (PTSD), and can also be a feature of anxiety, depression, and obsessive-compulsive disorder (OCD)

Treatment

The most effective method of treatment for individuals with intrusive thoughts is formalized psychotherapy. There are a variety of different types of therapy that can be combined to create the ideal, customized treatment plan. Cognitive behavioral therapy is most used when treating individuals with intrusive thoughts, especially those diagnosed with OCD. Exposure and response prevention (ERP) therapy is another common method of treatment for intrusive thoughts. Through ERP therapy an individual learns techniques to directly confront his or her intrusive thoughts. While DBT can be effective for some problems associated with emotion regulation, it is not the first line treatment for intrusive thoughts. However, in people with personality disorders such as OCD, studies have found that DBT can improve quality of life and self-control as well as reduce hopelessness. Depending on several contributing factors, supplementary treatment methods, such as medication, may be incorporated into a treatment plan. With the proper treatment and support an individual can learn to control his or her symptoms and implement healthy coping strategies for navigating and managing any subsequent recurrences. 

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.

Best Options For Child DBT In Los Angeles

child receiving DBT treatment

Adolescence is a time in one’s life that is filled with difficult lessons, emotional growth, physical and emotional maturation, surging hormones, and a newfound need for autonomy. Children are faced with countless trials and tribulations, many of which they are ill equipped to effectively navigate without support. An adolescent’s brain is not yet fully developed, and though some young people may appear as adults externally, internally they are operating with an underdeveloped pre-frontal cortex. This is the area of the brain that reins rational thought, impulse control, executive planning, and more. Instead, adolescents using the amygdala (area of the brain that governs one’s emotions, impulsivity, emotional behavior, and motivation) instinctively process external stimuli. The fact that young people are often viewed, as hypersensitive, impulsive, wildly emotional beings should come as no surprise. Hence, it is often difficult to distinguish between typical adolescent behavior and child behaviors that may be indicative of larger issues and could benefit from professional guidance. 

What Is DBT

Dialectical behavior therapy (DBT) is a psychotherapy that is based off of the principals of cognitive behavioral therapy (CBT). In the late 1980s, Psychologist Marsha M. Linehan developed DBT to help better treat individuals with borderline personality disorder (BPD). It has since been rendered an effective method of treatment for many other mental health conditions (e.g. depression, bulimia, binge-eating disorder, bipolar disorder, post-traumatic stress disorder, substance use disorder, etc.). Further, it is helpful in treating issues related to emotional dysregulation. Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses. DBT focuses on teaching four core skills: mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation. 

Next Steps

Being charged with the responsibility to safeguard your child’s mental wellbeing could feel incredibly overwhelming, especially when it becomes evident that they are in need of professional support. Fortunately, there are an abundance of highly qualified DBT providers in Los Angeles, California that specialize in treating children. In order to narrow down your options consider the following tips:

  • Ask your child’s pediatrician: request recommendations from your child’s pediatrician.
  • Check out some online sources: many mental health providers have websites available for potential clients to review and/ or are included in an online compilation of reputable mental health professionals, such as:
  • Ask your network of trusted family and friends for references: chances are more people than you are aware of within your network are connected to mental health professionals—tap in and see if anyone can refer you to someone in his or her professional network to work with your child.

Each mental health clinician renders services that are directly informed by his or her personal and professional experiences, education, and personality. Be sure to interview any potential provider prior to making any commitment, as it is essential to make an informed decision. It is important to bear in mind that every young person is unique and will respond distinctly not only to the array of therapeutic modalities available, but also to the variety of mental health providers. 

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

DBT Therapy In Los Angeles

Los Angeles freeway

Dialectical behavior therapy (DBT) was originally developed to treat chronically suicidal individuals with Borderline Personality Disorder (BPD). Since Marsha M. Linehan developed DBT in the late 1980s, it has become not only the gold standard form of treatment for individuals with BPD, but also has shown efficacy in treating other mental health ailments (e.g. substance use disorder, bulimia, bipolar disorder, attention-deficit hyperactivity disorder, etc.), Dialectical behavior therapy is based on the cognitive behavioral therapy (CBT) approach, but DBT places greater emphasis on the psychosocial aspect of therapy. Dialectical behavior therapy includes three distinct therapeutic settings: weekly individual psychotherapy sessions, weekly group DBT skills training sessions, and intermittent phone coaching. DBT focuses on providing therapeutic skills in four primary areas, which are: 

  • Core mindfulness: the practice of being completely present and aware in the moment 
  • Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it
  • Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions   
  • Interpersonal effectiveness: authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging

Within each therapeutic setting the four DBT modules are reinforced. Six weeks are typically allocated to learning skills specifically related to each of the four modules, respectively. Hence, it generally takes about six months to complete the entire DBT program. 

DBT In Los Angeles

Every individual is different and is likely to have a distinct response to the different options of therapeutic treatment modalities available. Prior to committing to DBT, it is helpful to make sure the mental health provider is a good match. Fortunately, there is a plethora of highly qualified and exceptional mental health providers that offer dialectical behavior therapy services in Los Angeles, California. Due to the vast number of potential DBT providers in Los Angeles, beginning the search for DBT therapy can seem overwhelming. Consulting your primary care physician (PCP) can be an excellent start to your search. Often PCPs are able to provide recommendations for DBT therapists, and in situations where they may be unable to do so, they will certainly be able to refer you to someone within their professional network that is able to point you in the right direction. Word of mouth recommendations can yield positive results, so it may behoove you to check with your family and friends and see if anyone has any recommendations. There are also a variety of online resources that can help you find a DBT provider in California. For example, Psychology Today has compiled a list of qualified mental health professionals that offer DBT services in Los Angeles. It is important bear in mind that not all mental health clinicians will resonate with every client. Further, each mental health clinician brings with them differing educational backgrounds, professional experiences, and personalities, all of which are woven into their practice.

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

DBT Therapy During Covid

DBT therapy session during Covid

Psychologist, Marsha M. Linehan, developed dialectical behavior therapy (DBT) in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with Borderline Personality Disorder (BPD). DBT is a type of cognitive behavioral therapy (CBT) that places greater emphasis on the psychosocial aspect of therapy. Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD, and has also proven effective in treating individuals with eating disorders (e.g. anorexia, bulimia, etc.), severe anxiety, substance use disorder, other personality disorders, and certain mood disorders. DBT is comprised of three distinct settings: weekly individual therapy sessions, weekly DBT group skills training sessions, and phone coaching. 

4 Skills Modules

DBT utilizes four main strategies for teaching individuals skills that help with effectively changing their behaviors. They include the following, as provided by Behavioral Tech

  1. Mindfulness: the practice of remaining present and fully in the moment at any given time
  2. Distress Tolerance: learning to tolerate pain in challenging situations, without changing it or escalating it
  3. Interpersonal Effectiveness: increasing one’s self-awareness through learning to advocate for one’s own wants and/ or needs by saying no and/ or expressing one’s desires while maintaining self-respect 
  4. Emotion Regulation: learning how to understand, shift and/ or change unwanted emotions 

The entire DBT program (provided skills modules are not repeated) usually lasts about six months long, as approximately six weeks are allocated to each of the four skills modules. 

COVID-19 DBT Modifications

The swift arrival of the extraordinarily contagious novel coronavirus (SARS-CoV-2), also known as COVID-19, quickly plunged all corners of the world into a universal pandemic. In efforts to slow the spread of COVID-19, America implemented strict stay-at-home orders for all non-essential workers, closed schools, prohibited in-restaurant dining, shuttered movie theaters, museums, sports and exercise clubs, and more. Mental health treatment services are included on the list of essential businesses and provided they adhered to the evolving health and safety protocols set forth by the CDC, they were able to remain open and operational throughout the pandemic. 

Although many mental health providers were able to facilitate dialectical behavior therapy for their clients, several modifications, including shifting certain therapeutic settings, were implemented in order to accommodate the continuously evolving safety guidelines. While the precise adjustments are left to the discretion of each mental health provider, commonly implemented changes to the DBT therapeutic settings included: 

  • Individual sessions: 
  • Hold the weekly individual therapy sessions remotely over videoconference platforms (e.g. Skype, FaceTime, Google Meet, Zoom, etc.)
  • Hold the weekly individual therapy sessions in person, while both clinician and patient remain masked and a minimum of six feet apart
  • DBT group skills training sessions:
  • Hold the weekly sessions remotely over videoconference platforms (e.g. Skype, Google Meet, Zoom, etc.)
  • Hold the weekly sessions in person, in a highly ventilated location (e.g. outdoors), while all members present remain masked, and seated a minimum of six feet apart
  • Phone coaching: this component does require much modification for COVID-19, as it is already carried out in a socially distant fashion.

Dialectical behavior therapy aims to teach individuals healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others. Rest assured, regardless of the modifications, every mental health clinician that continued providing DBT services during the pandemic did so with deep consideration for his or her client’s physical and mental wellbeing, and rendered services in the safest manner possible. 

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

What Is A DBT Worksheet?

Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy (CBT) that places primary emphasis on the psychosocial aspect of therapy. Intended as a means to better treat chronically suicidal individuals and those diagnosed with borderline personality disorder (BPD), Marsha M. Linehan developed DBT in the late 1980s. The purpose of DBT is to teach individuals applicable skills that enable them to effectively manage painful emotions and decrease conflict in relationships. Dialectical Behavior Therapy is composed of four components that include:  weekly individual therapy sessions, weekly group skills classes, 24/7 skills coaching with the therapist and DBT Team Consult for the therapists.  Research shows that DBT has the best result if patients stay in treatment for a minimum of one year; our program asks that patients commit to an initial six months and then renew their commitment at the end of each six month period. 

Four DBT Modules

DBT group skills training sessions specifically focuses on providing distinct therapeutic skills in the following four key areas:

  • Mindfulness: the practice of being fully present and aware in the moment 
  • Distress tolerance: becoming tolerant of pain in difficult situations instead of attempting to change it
  • Emotion regulation: decreasing emotional impulsivity, learning to manage and shift intense, problematic emotions   
  • Interpersonal effectiveness: authentically advocating for one’s wants and needs in a relationship in a way that is both self-respecting and non-damaging

Dialectical behavior therapy provides a somewhat differentiated teaching strategy when introducing and teaching DBT skills. This is helpful because DBT is mindful of the fact that all individuals learn and retain information differently. For example, some individuals may be primarily visual learners, while others may be experiential learners. Through the three different components of DBT (individual therapy sessions, DBT group skills training sessions, and skills coaching) the unique and nuanced needs of each individual are sure to be aptly accommodated. Further, DBT group skills training session facilitators assign homework, including DBT worksheets, to be completed by participants when they are not in session.  

DBT Worksheets

DBT worksheets are an integral tool used throughout the DBT process. In order to fully implement the information addressed during DBT group skills training sessions, participants are provided with relevant DBT worksheets that they are expected to complete. There are certain DBT worksheets that directly relate to specific topics covered in the different DBT group skills training sessions. 

As such, there are a variety of DBT worksheets that are assigned at different times throughout the program. There are some random DBT worksheet templates that are easily accessible on the Internet. For individuals interested in accessing a more complete, chronologically organized set of DBT worksheets, please feel free to refer to any of the following DBT supportive resources and publications:

DBT relies on supportive resources, including workbooks and worksheets, to help reinforce the skills taught during group DBT skills training sessions and to provide additional opportunities for participants to continue to practice implementing the learned skills.

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

DBT Therapy for Children – What You Need to Know

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy. DBT stems from and includes many components of the cognitive behavioral therapy (CBT) approach. DBT differs from CBT in that dialectical behavior therapy prioritizes focusing on the psychosocial aspect of therapy. It was developed by Marsha M. Linehan in the late 1980s, intended to be used as a means to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). In addition to DBT currently being recognized as the gold standard treatment method for BPD it has also become known as an effective treatment method for other mental health conditions (e.g. bulimia, binge-eating disorder, substance use disorder, depression, bipolar disorder, attention-deficit hyperactivity disorder, and more). Further, standard DBT has been adapted and DBT for children (DBT-C) is used to treat pre-adolescent children.

Standard DBT

Dialectical behavior therapy is comprised of three components: weekly individual psychotherapy, weekly DBT group skills training sessions, and optional phone coaching. One-on-one therapy sessions offer individualized support to go over any confusion surrounding DBT skills, address personal challenges and discuss successes that occurred during the pervious week. The DBT group skills training sessions focus on four behavioral skill modules, two of which are acceptance-oriented and two of which are change-oriented:

  • Core mindfulness (acceptance-oriented): learning to be present and fully aware in the moment
  • Distress tolerance (acceptance-oriented): learning to tolerate pain in difficult situation, instead of attempting to change it
  • Emotion regulation (change-oriented): learning to honor boundaries, and advocate for one’s wants and needs in relationships in a way that is both self-respecting and non-damaging 
  • Interpersonal effectiveness (change-oriented): learning to manage and deal with primary emotional reactions before they have a chance to turn into distressing secondary reactions

As additional support, phone coaching is available between sessions and can be used at the individual’s discretion. The entire DBT program (assuming skills modules are not repeated) typically lasts about six months long, as approximately six weeks are allocated for each of the four skills module. 

Adaptations

According to Behavioral Tech, DBT for children (DBT-C) was developed to “address treatment needs of pre-adolescent children with severe emotional dysregulation and corresponding behavioral discontrol.” DBT-C relies on the same principals, theoretical model and therapeutic strategies of standard DBT. However, the DBT-C curriculum is re-framed in a way that considers and accommodates the developmental and cognitive levels of pre-adolescent children and provides age-appropriate services. DBT-C is comprised of three main categories, which are subdivided into the following subcategories, as provided by Behavioral Tech

  1. Decrease risk of psychopathology in the future
    1. Life-threatening behaviors of a child
    2. Therapy-destroying behaviors of a child
    3. Therapy-interfering behavior of a child
    4. Parental emotion regulation
    5. Effective parenting techniques
  2. Target parent-child relationship
    1. Improve parent-child relationship
  3. Target child’s presenting problems
    1. Risky, unsafe, and aggressive behaviors
    2. Quality-of-life-interfering problems
    3. Skills training
    4. Therapy-interfering behaviors of a child

As is articulated in Behavioral Tech, the goal of DBT-C is to eliminate the “harmful transaction between a child and an environment and replace it with an adaptive pattern of responding to ameliorate presenting problems, as well as to reduce the risk of associated psychopathology in the future.” Through DBT-C a young person will learn a variety of adaptive coping skills and effective problem-solving strategies. Further, DBT-C helps the parents of the pre-adolescent learn how to create a supportive, validating and stabilizing environment. 

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

Finding The Best DBT Workbook

DBT workbook

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that is founded on the principals of cognitive behavioral therapy (CBT). In the 1980s, Marsha M. Linehan developed DBT as a means to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). While dialectical behavior therapy incorporates many aspects of the CBT approach, it differs in that DBT places primary emphasis on the psychosocial aspect of treatment. Since its inception, dialectical behavior therapy has not only become the gold standard for treating individuals with BPD, but has also become known an effective treatment method for other mental health disorders (e.g. depression, bulimia, bing-eating disorder, bipolar disorder, substance use disorder, etc.). 

The purpose of DBT, according to Psychology Today is to teach individuals applicable skills to manage painful emotions and decrease conflicts in relationships. 

DBT Basics

Dialectical behavior therapy is comprised of three distinct components: weekly individual psychotherapy sessions, weekly group DBT skills training sessions, and as-needed phone coaching. One-on-one therapy sessions are intended to provide personalized support for individuals with processing experiences, addressing issues, navigating challenges and identifying successes that occurred in the previous week. The group DBT skills training sessions are used to teach and help facilitate building upon skills in four core areas:

  • Mindfulness: skills focused on improving an individual’s ability to accept and be present in any given moment.
  • Distress tolerance: skills focused on increasing an individual’s tolerance of negative emotions instead of attempting to avoid or escape from them.
  • Interpersonal effectiveness: skills focused on increasing an individual’s communication strategies.
  • Emotion regulation: skills focused on helping an individual identify, name, and understand the function of emotions, and increasing one’s ability to regulate emotions.

Dialectical behavior therapy has a homework component, which is to be completed by participants outside of the DBT group skills training session. Additional support is provided via phone coaching, which is available between sessions, if needed. Approximately six weeks are spent on focusing on each of the four areas. The entire DBT program (if skills modules are not repeated) will last about six months long.  

Supportive Resources and DBT Workbooks

Dialectical behavior therapy has been in existence for less than fifty years, yet there is a plethora of DBT-specific supportive resources available, including a variety of DBT workbooks that have been published. Some of the most widely known and commonly used DBT workbooks include, but are not limited to the following:

Please note that there continue to be additional supportive DBT resources, including different DBT workbooks published, regularly. Dialectical behavior therapy encourages individuals to take an active role in the treatment process, and by working in a DBT workbook participants are left with a tangible and personalized resource. 

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment. 

A Guide To DBT How Skills

people holding hands

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that was developed in the late 1980s by Marsha M. Linehan. It is based on principles of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspect of treatment. Psychology Today explains that the “goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes.” Dialectical behavior therapy was initially developed as a treatment method for individuals diagnosed with borderline personality disorder (BPD) and people experiencing severe suicidal thoughts. DBT is not only the gold standard form of treatment for individuals diagnosed with BPD, but according to Behavioral Tech has been found to be effective in treating other mental health conditions such as bipolar disorder, eating disorders (e.g. bulimia nervosa, binge eating disorder, etc.), transdiagnostic emotion dysregulation, attention deficit hyperactivity disorder (ADHD), depression, and more. The DBT process is comprised of various components: individual psychotherapy sessions, group DBT skills sessions, and optional phone coaching.

How Does It Work?

The components that make up dialectical behavior therapy each have a distinct purpose. Individual psychotherapy sessions are typically held on a weekly basis. They are intended to provide an individual with the opportunity to focus on and address specific issues and solutions that had arisen in the previous week. The DBT skills group sessions are also held on a weekly basis. There are four main skill areas that are:

  1. Interpersonal effectiveness: teaching skills related to effectively interacting with others and advocating for one’s needs within a relationship in a way that is non-damaging and productive. 
  2. Distress tolerance: teaching skills related to accepting, tolerating, and learning from suffering.
  3. Emotion regulation: teaching skills related to managing and dealing with primary emotional reactions prior to them leading to distressing secondary reactions. 
  4. Core Mindfulness: teaching skills related to remaining aware and accepting in the present moment.

About six weeks are allocated to each of the four DBT skills areas. The entire dialectical behavior therapy program usually lasts for twenty-four weeks, but some programs repeat the skills training modules, which doubles the length of time, making the program last a full year long. During the group sessions, individuals will learn the skills and engage in various group activities designed to help each member practice the skills. After each group skills session there will be homework assigned to further facilitate implementing and integrating the skills learned. 

DBT How Skills

The mindfulness module of dialectical behavior therapy is divided between two sets of skills: DBT what skills and DBT how skills. ‘What’ skills are practiced one at a time and include: observing, describing, and participating. ‘What’ skills help an individual learn to identify and pinpoint what he or she is focusing on (e.g. emotions, thoughts, sensations, the present, separating emotions and sensations from thoughts, etc.). The ‘how’ skills are how an individual practices the ‘what’ skills. ‘How’ skills should be practiced concurrently, and include the following: nonjudgmentally, one-mindfully, and effectively. ‘How’ skills help an individual learn to how to be more mindful (e.g. balancing rational thoughts with emotions, taking effective action, regularly using mindfulness skills, etc.). When practicing the ‘what’ and ‘how’ skills referred to in the core mindfulness module of DBT, individuals will learn to be wholly present in each moment, with awareness and without judgment. 

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment.