Shot of various beauty essentials used with DBT Therapy
Dialectical Behavior Therapy (DBT), is a modification of standard cognitive behavioral therapy (CBT). In the development of DBT, Marsha Linehan, Ph.D. found that using standard CBT was ineffective in helping many individuals with intense emotion dysregulation to make changes in their lives.
While CBT helps many people, some individuals feel frustrated with its constant focus on change. To address this, Linehan developed DBT by adding acceptance-based strategies—like mindfulness and validation—to the standard change strategies used in CBT. She aimed to help individuals recognize which parts of their experiences are valid and make sense.
In DBT, we actively balance change strategies with acceptance of the current situation. This approach teaches you to think in a “dialectical” way. Linehan uses the image of a teeter-totter to illustrate this concept: the therapist sits on one end and the patient on the other. Both work together to create an environment that fosters acceptance and change at the same time. Acceptance anchors one end of the teeter-totter, while change grounds the other. Together, therapist and patient meet in the middle, allowing real movement toward the patient’s goals.
DBT proves especially useful for managing painful or overwhelming emotions, rapidly shifting moods, emotions that drive impulsive actions, intense self-hatred or shame, and feelings of emptiness, loneliness, or numbness. Many people also find DBT helpful for coping with relationship problems such as fear of abandonment, extreme sensitivity to criticism, and vulnerability to irritability or anger.
Beyond emotional struggles, DBT teaches practical skills for managing behaviors like self-harm, suicidal actions, and disordered eating, including bulimia and binge eating disorder. It also supports recovery from substance use disorders and other behaviors that people use to cope with difficult emotions.
Read NY Times Article: Expert on Mental Illness Reveals Her Own Fight
How do I know if DBT is right for me?
Our team will determine whether or not you need comprehensive DBT during the intake process. If you are interested and it is determined that you are appropriate for comprehensive DBT, you will be invited to take a vacation from your current therapy, make a time commitment to DBT, and fully invest yourself in the treatment so that you can make optimal change in your life. DBT is a voluntary treatment, so it is only with your voluntary consent and commitment that you will be accepted into the program.I'm only interested in joining a group. Do I still need a therapist?
If you are only interested in joining one of our skills groups, you are welcome to do that as well. Individuals who are not in need of comprehensive DBT often opt to do this. Sometimes they have an individual therapist with whom they are working and they really trust, and just want to learn the skills as an adjunct to their current work.In this case, we encourage the individual to stay with their therapist, invite them to join our groups, and require the individual therapist to take on phone coaching and learning about the skills and talking about them in sessions. It is a prerequisite that individuals who join skills groups must be in some form of ongoing, weekly, individual therapy during the course of the group commitment; however, it is not required that the therapist be a DBT therapist. This is not standard DBT…but DBT informed treatment.
I'm only interested in individual therapy. Do I still need to join in on group sessions?
Rarely, but occasionally, folks come to us with no interest in skills at all and only want individual therapy. This option is up to the individual therapist and the client. Often the client does not want skills group because of worries or concerns about being with others, NOT because the skills aren’t needed. In this case, we often take some time to help the client learn the necessary skills or behaviors to join the group, as this is a critical component of DBT.While in comprehensive DBT, we are working with you to learn the new strategies (skills acquisition) as well as strengthen and generalize these skills to all relevant contexts. In the service of that, we will also provide out of session coaching to you so that you can learn how and when to utilize what you are learning outside the therapy room.
In addition, each therapist providing DBT for you is required to participate in a weekly DBT consultation team with other DBT providers. This is an essential component of treatment since it helps our DBT therapists provide the most effective, highly competent DBT services to you and you receive the expertise and experience of the entire group, not just your individual therapist.
You can feel like a mental patient, but that doesn’t mean you have to act like one.