What is DBT?
Learn about Dialectical Behavior Therapy (DBT).
What is DBT about?
DBT has several main principles.
Acceptance and change. DBT is strongly focused on helping people accept the difficult experiences and painful emotions in life. At the same time, DBT also aims to help people create change to live the life they want, what we call ‘a life worth living.’ The word dialectical speaks toward this. Dialectical means holding opposites as both true at the same time; it means finding the synthesis – the overlap – between opposites. Ultimately, DBT is about acknowledging and allowing difficult situations and emotions – what we call acceptance – as well as making changes in behaviors that get in the way of have that imagined life worth living.
Everyone is always doing the best they can. DBT has several important assumptions that therapists and individuals strive to hold true at all times. A DBT therapist always remembers that people are doing the best that they can, at any given moment in time, given everything they are experiencing and know.
Biology and the environment together make you who you are. In DBT, people learn about the biosocial theory for emotion dysregulation. This theory states that for people with strong emotions and trouble regulating these strong emotions, they likely have a body that is more sensitive and reactive than others. These people have also experienced an environment – at least at some point – that makes them feel as if they are being invalidated or told there are things wrong with them. Together, this leads to even more trouble regulating emotions, and eventually leads to the symptoms that bring people to DBT.
Who does DBT therapy work for?
If an individual experiences strong emotions, feels out of control, thinks life is not worth living, engages in behaviors that make a situation worse, and/or could be more skillful when upset, DBT is likely appropriate.
DBT works for individuals who have symptoms such as:
- Suicidal thoughts
- Self-injurious behavior
- Trauma and dissociation
- Quickly-changing moods
- Substance use
- Bingeing and purging
- Defiant behaviors and aggression
- Impulse control problems
What is comprehensive DBT?
DBT has a great deal of research support. Studies have been done on ‘comprehensive DBT’ – this means that there are four specific components that must be occurring. In order for you to be receiving the DBT that has been shown to work, you need to be receiving all four components.
Those four components are:
- Once weekly individual DBT therapy: During your weekly one-on-one sessions with one of our DBT-trained clinician, you will review your symptoms, analyze the behaviors you are struggling with, and determine what DBT skills to use to address the symptoms and issues that brought you to therapy. Therapy sessions focus on principles of both acceptance and change.
- Once weekly DBT skills group: Skills group is a weekly session that you do with a group of others who are also receiving DBT. In group, you learn skills, and then determine how to build those skills into your life through homework assignments.
- Between-session skills coaching: This is the part of treatment in which you communicate with your therapist outside of your one-on-one session to get help with applying skills when you need it the most; DBT clinicians provide skills coaching in the moment that it is needed.
- Clinician participation in a once weekly consultation team: In consultation team, providers meet once a week to help one another apply DBT as skillfully as possible and maintain a balanced attitude and motivation toward their work. This is not a component you directly receive, but it still impacts you while you are receiving DBT.
DBT and Trauma
Many of the people who find their way to DBT have experienced trauma. Our therapists are well-versed in working with people who have had single or chronic traumas in their lives. We provide gold-standard treatment for people’s trauma – prolonged exposure – when both the individual and the therapist decide that the time is right.