Why DBT?

Developed at the University of Washington by Marsha Linehan, Ph.D., DBT was originally designed to treat interpersonal chaos, intense emotional swings, impulsiveness, confusion about the self (identity), and suicidal behavior. It is based on a bio-social theory that states that problems develop from the interaction of biological factors (physiological makeup) and environmental factors (learning history), which together create difficulty managing emotions. DBT is therefore appropriate for a range of additional problems that relate to emotion dysregulation such as depression, anxiety disorders, eating disorders, anger-related problems, and substance use problems. A great deal of research has been conducted on the effectiveness of DBT and, in general, DBT appears as effective or more effective than other “talk based” psychotherapies for the problems mentioned above.

To reach the ultimate goal of DBT—creating a life experienced as worth living—the therapy balances empathy and warm acceptance (validation) with an unwavering focus on changing behavior (problem-solving). Through this balance, DBT aims to help change the behavioral, emotional, and thinking patterns associated with problems in living, while promoting the development of and reliance on inner wisdom (Wise Mind).

DBT is based on the idea that opposites can coexist and be synthesized. This means weighing out various points of view in any situation and constantly working on balancing an effort to change things along with accepting things as they are.

Behavior therapy is based on the study of how things are learned. It focuses on bringing about change by helping people learn new ways of coping. It focuses on specific goals that can be realistically attained. DBT, and other behavior therapies, emphasize making change through practicing new skills to change how you think, act and feel. In this way DBT is more of a “doing” rather than a “talking” therapy.

• Patients in DBT have lives that are unbearable as they are currently being lived
• Patients in DBT are doing the best they can
• Patients in DBT want to improve
• Patients in DBT need to do better, work harder, and be motivated to change
• Patients in DBT must learn and practice new behaviors in all areas of their lives
• Patients do not fail at DBT

• The most caring thing a DBT therapist can do is help patients change in ways that bring them closer to their own ultimate goals
• Clarity, precision, and compassion are of the utmost importance for therapists when conducting DBT
• The therapeutic relationship is a real relationship between equals: one who is expert on change and one who is expert on themselves
• Principles of behavior are universal, affecting therapists no less than patients
• DBT therapists need support and work collaboratively as part of treatment team
• DBT therapists can fail
• DBT can fail even when therapists do not

• Make every reasonable effort to conduct competent and effective therapy and strive to excel in helping their patients
• Obey standard ethical and professional guidelines
• Respect the integrity and rights of the patient
• Maintain confidentiality except when a violation is needed to prevent harm to the patient or others
• Obtain consultation when needed

• Problem-solving therapy focused on identifying desired areas for change, specific problem behaviors, and building a “Life Worth Living” goals
• Focuses on the current context and emphasizes emotions, thoughts, and behaviors
• Helps to identify the factors that interfere with happiness and efforts to make change
• Uses cognitive-behavioral methods to treat barriers to change and replaces ineffective coping with DBT skills
• Provides encouragement and support to reach goals

• Structured skills training group teaching essential strategies for regulating emotions, tolerating distress, increasing mindfulness, and being more effective in interpersonal communication
• Between session practice assignments are given and reviewed to help enhance learning and application of skills

• Receive phone support and coaching from your therapist between sessions (during business hours) to encourage the practice of skillful behaviors in the context of “real-life”

• The therapy team meets weekly to assist each other in providing effective and compassionate treatment.

• Problem-solving therapy focused on identifying desired areas for change, specific problem behaviors, and building a “Life Worth Living” goals
• Focuses on the current context and emphasizes emotions, thoughts, and behaviors
• Helps to identify the factors that interfere with happiness and efforts to make change
• Uses cognitive-behavioral methods to treat barriers to change and replaces ineffective coping with DBT skills
• Provides encouragement and support to reach goals

• Structured skills training group teaching essential strategies for regulating emotions, tolerating distress, increasing mindfulness, and being more effective in interpersonal communication
• Between session practice assignments are given and reviewed to help enhance learning and application of skills

• Receive support and coaching on skills use from clinical staff to encourage the practice of new behaviors in the context of “real-life”

• The therapy team meets weekly to assist each other in providing effective and compassionate treatment.