Dialectical Behavioral Therapy

Jourdan Travers, LCSW, summarizes everything you need to know about DBT.

By Jourdan Travers, LCSW | January 2, 2022

Have you ever heard of Dialectical Behavioral Therapy, or DBT, but weren't sure what it is? Well, that's what I'll discuss in this article. I'll go over:

  • What DBT is
  • Who it benefits
  • Why a psychiatrist or mental health practitioner would recommend DBT
  • Its effectiveness
  • The downsides of this treatment modality
  • AND, how to get started

Let's jump right into it.

DBT is a treatment modality created by Dr. Marsha Linehan in the late 1980s and was first created to help individuals with borderline personality disorder, or BPD, and those who struggled with suicidal ideation and a history of self-harm. That said, DBT has been shown to be an effective treatment for other disorders, such as:

In fact, Dr. Linehan discusses in her book, Cognitive-Behavioral Treatment of Borderline Personality Disorders, that she had created DBT because she herself suffered from BPD and wanted to create a treatment to help patients struggling with self-harm, overwhelming emotions, and suicidal ideation.

You might be wondering, what specifically is DBT and how is it different than other therapeutic treatment modalities?

DBT is a type of cognitive-behavioral therapy that focuses on helping patients stay present in the here and now. It teaches people how to recognize, manage, and change maladaptive thoughts as well as overwhelming emotions. Through this process, patients can improve the relationship they have with themselves and others.

I am often asked what makes DBT different than CBT, or Cognitive Behavioral Therapy. DBT is different in that it is specifically made up of four main skills that all patients work on during the course of their treatment, including:

  1. Mindfulness – which is practicing complete and total awareness of the present moment
  2. Distress Tolerance – i.e., managing difficult or painful situations without changing them
  3. Interpersonal Effectiveness – i.e., asking for what you want and need while learning how to respect others' boundaries
  4. And, Emotion Regulation – i.e., creating an action plan where you learn how to decrease unwanted negative emotions and how to change them

And, yes, it works! DBT has been shown time and time again to be an effective treatment. But it does require time, commitment, and in many cases, financial resources.

This leads me to what some patients might consider a downside of this specific treatment modality.

When I say it's a commitment, I mean just that: it's a complete and total commitment that typically takes around 6 months or more (depending on the complexity of the case) to complete.

It's also important to note that while there are many clinical therapists, like myself, who are trained in DBT, a true DBT experience is much different. The components necessary for having a true DBT experience include:

  • A skills training group that typically meets for 1.5-2.5 hours per week where patients learn new behavioral skills and receive homework to help implement these new skills in their daily life.
  • Individual therapy once per week for 60 minutes to help clients process their emotions and apply the new behavioral skills to their daily life
  • AND, phone coaching to help guide patients in managing difficult situations or distressing symptoms

Let's say, hypothetically, that your current provider is recommending you enter a DBT program. Or perhaps you've been recommended to enter a DBT program in the past. What does that mean?

The truth is that patients recommended for DBT treatment often have many problems happening in their lives simultaneously and DBT is used to address these problems based on the order of their severity using a team-based approach.

So if DBT is something that's been recommended to you, or it's something that you're just interested in exploring there are a few ways to find a DBT provider near you.

One option is that you can google Behavioral Tech, which is a resource created by Dr. Linehan that provides you with a directory of DBT providers and resources in your state. Another option is to look up providers using Psychology Today's "Find A Therapist" search function to see if there are DBT certified or trained therapists near you. You can also contact me at Awake Therapy as we have therapists on our team trained in DBT.

Thank you for reading. I hope you found this article both helpful and informative. Remember, the content addressed in this article is not meant to serve as a substitute for individualized psychotherapy. If you are in need of mental health assistance to address an existing issue or to help you on your journey to living a more fulfilling and intentional life, feel free to book a session with me or another member of the Awake Therapy team.