Dialectical Behavioral Therapy

What is it and how can it work for you?

Dialectical Behavioral Therapy (DBT) is a combination of therapeutic techniques including behavioral therapy, cognitive therapy, and a bit of Zen mindfulness practices thrown in for good measure. DBT was originally developed to work with clients suffering from self-injury and multiple suicide attempts. Many of these clients were experiencing symptoms of Borderline Personality Disorder. Since the development of DBT, counselors have discovered the benefits of using DBT strategies for a myriad of presenting issues including interpersonal issues, impulsivity, self-harm, and an inability to manage one’s emotions.

DBT counseling assumes a two-prong approach to therapy. A DBT counselor will provide counseling similar to that of a cognitive behavioral therapy approach while introducing new skills to assist the client. DBT skills include emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. These skills are either taught in individual counseling sessions or in a group counseling format. Either way, learning these new skills are essential to dialectical behavioral therapy and will support the work that a client is doing in individual counseling.

DBT counselors are trained to provide risk assessments regularly and to address the primary target behaviors before moving on to address additional behaviors. A DBT counselor is trained to accept the client where she is at and to teach and encourage change. It is this balance of acceptance and change that is at the heart of DBT work.

There are four stages that make up the work done in DBT counseling. Stage one counseling addresses stabilization for the client. In this stage, the client is provided skills and techniques to stabilize problems such as suicidal thoughts, self-harm behaviors, and addictions. In stage two of treatment, a client’s behaviors are more stable but emotional pain may begin to increase. Your trained DBT counselor will assist you in exploring this emotional pain instead of attempting to silence or bury it. If we can experience the pain, use learned emotional regulation skills to address the pain, we no longer have the need to self-medicate with dangerous behaviors.

Stage three of DBT counseling focuses on setting goals and improving the quality of life for the client. Here the focus is on maintaining the progress that has been made and in ensuring stability while continuing to improve. The fourth and final stage of treatment is designed to support the client in finding meaning and value in life. Here, learned skills are continually utilized as the client moves toward enhanced happiness and satisfaction with life.