Dialectical

Behavior

Therapy

(DBT)

By Allyson Lindsey

Campbell University

Psych 491

Intro to Counseling

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DBT is a modification of cognitive behavior

therapy (CBT) and a variety of other research

techniques.

Of note: DBT is empirically supported treatment.

DBT is designed to treat “individuals with self-

harm behaviors, such as self-cutting, suicide

thoughts, urges to suicide, and suicide

attempts.” Click

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Empirical- DBT was researched and developed in clinical trials due to the therapy’s initial ineffectiveness and rejection by clients.

Treatment: Typically those with the listed behaviors tend to also meet criteria for Borderline Personality Disorder (BPD) and

subsequently also struggle with depression, bipolar disorder, post-traumatic stress disorder (PTSD), anxiety, eating disorders, or

dependency on drugs and alcohol.

Specifically designed as a year long “outpatient” therapy (length of therapy is dependent on patient)

In DBT therapy, the therapist could be compared to a patient’s life coach, sponsor, and firewall

No one gets to the patient without going through the individual therapist – who is “in charge” of the patient

Three modes of treatment: Individual therapy, skills group and phone coaching

In addition to the 3 modes of treatment, DBT is often a combined therapy

Some patients with severe disorders require pharmacological therapy

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Skill groups are designed to arm patients with effective tools for working through their issues

Groups are set up as classroom-type skill builder sessions Learn one skill set thoroughly before moving on to the

next

Groups focus on 4 sets of skills Mindfulness – eyes wide open

Interpersonal effectiveness

Emotional regulation

Distress tolerance

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Discussion of Skillsets:

Mindfulness – you can’t learn if you fail to really see what’s around you

Interpersonal Effectiveness – defined but not in great detail as the topic is so large that it could result in a whole other

discussion piece

Emotional Regulation – learning to understand how emotions work and the skills needed to manage emotions instead of

being managed by them, to reduce vulnerability, and to build positive emotional experiences by validating ALL emotions (not

discounting them) even negative ones will ultimately provide a sense of control

Distress tolerance – builds on tolerating painful emotions and events when it’s not possible to make things better

immediately broken down into 4 sub-sets: distract, self-soothe, improve the moment, and pros & cons

Stage 1 - Moving from being out of control of one’s behavior to being in control Covers approximately 3 weeks

Focus is on the problem behavior responsible for treatment

Stage 2 – Moving from being emotionally shut down to experiencing emotions fully Targets understanding of the disorder or problems

Acquiring skills for addressing the problems

Reinforcing desired behaviors following self-injurous or suicidal communication

Stage 3 – Building an ordinary life, solving ordinary life

problems Focus is on working through ordinary problems and stressors, with or without a therapist

Stage 4 – Moving from incompleteness to completeness or connection Finding a way to fill the void of a life full of therapy treatment, building on skills learned in therapy

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Bohus, M., Haaf, B., Stiglmayr, C., Pohl, U., Bohme, R., & Linehan, M. (1999). Evaluation

of inpatient dialectical-behavioral therapy for borderline personality disorder -

a prospective study. Behavior Research and Therapy, 38(2000), 875-887.

Retrieved from http://depts.washington.edu/brtc/files/Bohus et al 2000.pdf

Dietz, L. (2003-2009). Dbt self help. Retrieved from

http://www.dbtselfhelp.com/html/dbt_skills__defined_.html

Dietz, L. (2003-2009). Dbt self help. Retrieved from

http://www.dbtselfhelp.com/html/flash_cards.html

Linehan, M. (1993). Skills training manual for treating borderline personality disorder.

New York, NY: The Guildford Press.

Linehan, M. (2009). Dialectical behavior therapy [Web]. Retrieved from

http://www.youtube.com/watch?v=ZTperp0Aa8Q

Linehan, M. (2009) Mindfulness & DBT I [Web]. Retrieved from

http://www.youtube.com/watch?v=Eec_SA6oSEA

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Linehan, M. (2009) Mindfulness & DBT II [Web]. Retrieved from

http://www.youtube.com/watch?v=-1ceBmqZnSI

Linehan, M. (2009) Mindfulness & DBT III [Web]. Retrieved from

http://www.youtube.com/watch?v=UTWITUGhDZs

Linehan, M. (2009) Mindfulness & DBT IV [Web]. Retrieved from

http://www.youtube.com/watch?v=yoLKQLvGylQ

Linehan, M. (2009) Mindfulness & DBT V [Web]. Retrieved from

http://www.youtube.com/watch?v=TFYGEbDzjnM

McKay, M., Wood, J., & Brantley, J. (2007). The dialectical behavior therapy skills workbook.

(pp. 1-224). Oakland, CA: New Harbinger Publications, Inc. Retrieved from

http://www.amazon.com/Dialectical-Behavior-Therapy-Skills-

Workbook/dp/1572245131/ref=pd_bxgy_b_img_b

Sanderson, C. (1997). Dialectical behavior therapy frequently asked questions. Retrieved from

www.behavioraltech.org

DBT skills workbook – an AMAZING tool for learning, but more specifically if this is a chosen specialty of interest.