• Feeling hopeless because other types of therapy haven’t worked for you? 
• Have you been diagnosed with emotional sensitivity or borderline personality disorder? 
• Is there anything better than feeling good about who you are, instead of always wishing that you were someone else? 

You should consider dialectical behavior therapy (DBT). 

Dialectical Behavior Therapy (DBT): how does it work?

There is a one-year commitment required for a standard DBT program. A shorter program, sometimes called “DBT-informed,” uses some DBT methods and can be incredibly helpful for some people.

There are five components to a standard DBT program, each serving a specific purpose:

• A skills therapist facilitates a DBT skills training group similar to a class. Practice tasks are provided between sessions for people to complete. By introducing effective and practical skills into people’s lives, they will be able to cope with distress in the future. The goal is to replace unhealthy and negative behaviors with these skills. Typically, the class meets once a week for 2.5 hours. A one-year program is usually created by repeating the full skills curriculum over 24 weeks. Four skills are taught in the class:
  • Practicing mindfulness means being present in the moment and acknowledging thoughts, feelings, and behaviors as they emerge without attempting to control them
  • distress tolerance: learning to deal with crises, especially when they can’t be changed, and accepting them as they are, instead of trying to change them
  • interpersonal effectiveness: maintaining self-respect and relationships while asking for what one needs and saying no when necessary
  • emotion regulation: establishing control over one’s thoughts and behaviors in the face of emotions.
• Individual psychotherapy aims to improve motivation and help people apply skills to specific challenges and events in their lives. Individual goals are discussed during these sessions between the client and therapist. A 60-90 minute session is usually held every week.
• To provide in-the-moment support, in-the-moment coaching uses telephone coaching and other real-life (“in-vivo”) coaching methods. When a person experiences a stressful event, the therapist will coach them and encourage them to use their DBT skills. It is important to ensure that skills are generalized and applied to daily life.
• Individuals taking control of their lives and care are empowered by case management strategies. Therapists teach patients how to be autonomous and manage their own cases using the strategies they have learned.
• In addition to supporting therapists, skills therapists, case managers, and others who provide DBT, the DBT consultation team provides support for people who deliver DBT. The consultation team is designed to keep therapists motivated and competent to provide the highest quality treatment. Through burnout management and knowledge sharing, the team helps each other.

All of these elements aim to help the person live a life they feel is worthwhile.

Skills Training

Individuals with Borderline Personality Disorder who see a therapist in the community at least twice a week are eligible for this program.

Skills therapists will facilitate a weekly DBT Skills training group similar to a class format. Exercises are provided between sessions so that people can practice their skills. In order to cope with distress, people are encouraged to develop effective and practical skills. By replacing unhealthy and negative behaviors with these skills, other unhealthy and negative behaviors can be replaced. The class usually meets once a week for two hours. It takes 24 weeks to complete the full skills curriculum. Four skills are taught in the class:

• Being mindful involves acknowledging thoughts, feelings, and behaviors as they arise without trying to control them
• Adapting to stress, especially when it is impossible to change, and accepting a situation as it is, rather than how it should be
• A person’s interpersonal effectiveness includes being able to ask for what they need and say no when necessary, while still retaining self-respect and maintaining relationships with others
• Managing emotions so that thoughts and behaviors are not controlled by them is called emotion regulation.

Are you worried that therapy won’t help you?

Do you suffer from borderline personality disorder? Are you worried that you are beyond help? In fact, our expert, the creator of DBT, suffered from BPD herself and was institutionalized for it. Her sensitivity meant the very process of therapy made you feel judged and invalidated, which made it hard to feel motivated to change.  In order to resolve this problem, dialectical behavior therapy was developed. 

DBT: How it works

In dialectical behavior therapy, you learn how to control your emotions and reactions. In addition to lowering your trauma response, it works to raise your self-respect and stop your suicidal tendencies. In order to accomplish this, it focuses on four key skills:

• Mindfulness at its core (staying present)
• The ability to get along with others (interpersonal effectiveness)
• Modulation of emotions (controlling your emotions)
• The ability to handle stress without melting down (distress tolerance).

How does a session work?

It differs from other therapies in that you don’t just talk about your experiences, thoughts, or feelings in dialectical behavior therapy. This is a much more practical approach. As part of your DBT course, you will complete worksheets from a workbook, practice skills, and complete homework. 

Often, DBT is administered as a group therapy or as a combination of groupwork and one-on-one sessions, but it can also work as an individual therapy. 

In what ways can DBT therapy be helpful?

In addition to being the first talk therapy proven to help with BPD (also known as ’emotionally unstable personality disorder’), dialectical behavior therapy can help with a variety of other issues as well. Examples include: 

• Substance abuse 
• Anger management problems
• Anxiety
• PTSD in children
• Sexual abuse in childhood
• Mood disorder
• Anorexia
• Depressive disorders
• Suicidal thoughts
• Self-injury. 

Is there a private DBT therapist near me?

Are you looking for a highly rated DBT therapist with years of experience? In our offices at Expert Therapy, we provide private DBT therapy to individuals.

 

Related topics

• What is dialectical behavior therapy?
• Emotionally unstable personality disorder in times of change
• Should you date someone with BPD? What you need to know
• A personality disorder diagnosis: helpful, or a trap?
• Living as a “borderline”: a BPD case study
• What types of therapy work for emotionally unstable personality disorder?
• Compassion for Borderline Personality Disorder – How to treat someone with BPD?

 

Frequently asked questions

 

Is DBT a kind of CBT?

This form of cognitive behavior therapy teaches you how to manage your thoughts and actions through the use of elements of cognitive behavior therapy.

As well as dialectical thinking (seeing from different perspectives), Zen Buddhism (with its key concept of staying present), and metaphorical thinking (viewing situations practically), it is also a form of hybrid therapy.

What is the difference between cognitive and dialectical behavior therapy?

DBT and CBT both help patients identify and change unhelpful ways of thinking so that they don’t lead to unhelpful behaviors. The key difference between CBT and DBT is that CBT focuses on having balanced thoughts, whereas DBT focuses more on acceptance, helping you accept your negative thoughts without judging yourself.   

What are the four modules of DBT?

The following are among them:

• Mindfulness (being in the present moment and accepting it)
• The ability to relate to others in a way that makes them feel understood (interpersonal effectiveness)
• Accepting stressful situations without lash out or having a meltdown (distress tolerance) 
• The use of techniques that prevent you from acting out as a result of intense emotions (emotion regulation).