Dialectical behavior therapy (dbt) is an innovative treatment, which combines cognitive-behavioral therapy with arriving at truths through the exchange of logical arguments. DBT is a treatment for complex, difficult-to-treat mental disorders. Developed by Dr. Marsha Linehan at the University of Washington, the treatment was first used to treat individuals with borderline personality disorder. DBT has since been adapted for other behaviors including substance abuse, eating disorders, self-injury, and suicidal individuals.
DBT addresses problems in regulating emotions: heightened emotional sensitivity, quick and intense emotional reactions, slow return to baseline (normal) mood, chronic problems with depression, anxiety, anger or anger expression, thinking: extreme (black or white) thinking, poor self image and unstable sense of self, difficult with problem-solving and decision making, and problems with “detached” thinking, ranging from mild inattentive states to episodes of complete dissociation, behavior: repeated suicide threats or attempts, self-harm behavior such as cutting or burning, impulsive and potentially self-damaging behavior in areas such as binge eating and purging, alcohol or drug abuse, high-risk sexual activity, gambling or spending sprees, and problematic interpersonal behaviors related to fears of rejection or abandonment by others.
Dialectical behavior therapy consists of two parts: Once-weekly psychotherapy sessions, and weekly 2-hour group therapy sessions. During individual therapy, events from the past week are explored in detail, beginning with the chain of events leading up to it, going through alternative solutions that might have been used, and examining what kept the individual from using more adaptive solutions to the problem.
Both between (through phone consultations) and during sessions, the therapist teaches and reinforces these adaptive behaviors. The emphasis is on teaching patients how to manage emotional trauma in a healthy manner, instead of in crisis.
During group therapy sessions, acceptance skills, emotional regulation, and mindfulness skills are taught. Group therapists are not usually available over the phone between sessions; they refer patients in crisis to the individual therapist.
1. Mindfulness practice
2. A brief check-in around how you are doing that day/week, followed by a report on homework: special assignments, reading discussion, how skills were used over the past week.
3. Unit material is covered to date is reviewed
4. New information is presented
5. If scheduled, group practice exercises are done.
6. A closing check-out. Each client makes an "oberserving comment" based on their experience in that day's/evening's group.