Dialectical Behavioral Therapy (DBT)

 What is Dialectical Behavioral Therapy (DBT)? Dialectical Behavior Therapy (DBT) is a comprehensive behavioral intervention designed to treat individuals with severe mental disorders and out-of-control cognitive, emotional and behavioral patterns. It has been commonly viewed as a treatment for individuals meeting criteria for Borderline Personality Disorder (BPD) with chronic and high-risk suicidality, substance dependence or eating disorders. However, over the years, research has shown that it is effective in treating a wide range of other disorders such as depression, anxiety and post- traumatic stress disorder (PTSD). It is also effective in treating problems with suicidal behaviors, intentional self-injury, history of chaotic and intense relationships and frequent psychiatric hospital visits.

In MN, the Department of Human Services certifies DBT programs that have demonstrated competencies and training in providing standardized DBT the way the research has shown to be effective. Peaks of Hope is currently working on this certification. We plan to provide a comprehensive Intensive Outpatient DBT program certified by the state of MN which means our program will provide all of the components of the model.

Nationally, Dr. Marsha Linehan, the treatment developer, has formed the DBT-Linehan Board of Certification (DBT-LBC). The DBT-LBC was formed to develop a comprehensive way to certify individual therapists in their competency to deliver DBT effectively and to certify programs that demonstrate their ability to deliver DBT programmatically with fidelity to the model as it has been researched. Currently, Britney Meyers has completed this process and is DBT-Linehan Board of Certification, Certified Clinicians™.

What are the components of DBT?
DBT has four components:  (1) skills training group, (2) individual treatment,  (3) DBT phone coaching, and (4) consultation team.

1. DBT skills training group is focused on enhancing clients' capabilities by teaching them behavioral skills. The modules that are taught are: Mindfulness, Distress Tolerance, Interpersonal Effectiveness and Emotion Regulation. Each module focuses on the skills that help clients learn and the practice of being fully aware and present in this one moment, how to tolerate pain in difficult situations, not change it, how to ask for what you want and say no while maintaining self-respect and relationships with others and how to change emotions that you want to change. The group is run like a class. The group facilitators teach the skills and assign homework for clients to practice using the learned skills in their everyday lives. Groups meet on a weekly basis for 2 hours. It takes approximately 6 months to get through the full skills curriculum, which is repeated to create a 1-year program. It is a requirement to commit to the full year.

2. DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to specific challenges and events in their lives to create their “life worth living.” Individual therapy takes place once a week in conjunction with the Skills group. A daily diary card is developed to help the client track behaviors they want to increase or decrease.

3. DBT phone coaching is focused on providing clients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives.

4. DBT therapist consultation team is intended to be therapy for therapists and to support DBT providers in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help therapists stay motivated and competent so they can provide the best treatment possible. The consultation team meets weekly and is composed of individual therapists and group leaders who share responsibility for each clients' care.