Dialectic Behavior Therapy Groups

What is DBT and is it the right approach for you?

Dialectical Behavioral Therapy or DBT is a cognitive behavioral approach focusing on those who struggle with an inability to navigate their emotions in every day situations. Specifically, it is for those who view the world in black and white terms, have extreme emotional responses to stresses, and who struggle to maintain relationships because of emotional instability. The goal of DBT is “to help individuals change behavioral, emotional, thinking and interpersonal patterns associated with problems in living.” This is accomplished by focusing on different areas of distress and identifying coping tools to manage emotional deregulation.

Is it right for me or my child?

This approach may seem straightforward and easy to implement. Those that benefit the most from this approach to therapy suffer when they are unable to center their emotions or tolerance levels to a baseline that is reasonable for them or those around them. If this is the case, it is important to find a therapist certified in DBT.

DBT is now more accessible in group and individual therapy.

In the 1970s, Dr. Marsha Linehan and her team began adding acceptance-based or validation strategies to the change-based strategies of CBT. In the course of weaving in acceptance with change, Linehan noticed that another set of strategies – dialectics – came into play. Dialectical strategies give the therapist a means to balance acceptance and change in each session. In the 1990s, DBT approaches were standardized, studied, and mental health professional began training on these approaches in the past decade.

What is involved in DBT therapy?

There are several approaches to DBT Therapy but the most common is individual and group therapy. Individual therapy focus on skills to be learned, practiced and monitored to address struggles successfully. This therapy often includes weekly homework and diaries to monitor the practice of DBT skills. DBT groups reinforce the practice of DBT skills as well as provide support from peers with these emotional struggles. While Individual and Group settings are the most frequent, some additional focused and team approaches are available for complex situations.

Different areas of focus in DBT

DBT includes four sets of behavioral skills.

  • Mindfulness: the practice of being fully aware and present in this one moment
  • Distress Tolerance: how to tolerate pain in difficult situations, not change it
  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  • Emotion Regulation: how to change emotions that you want to change

There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.

“In my experience of training for and working with DBT approaches, focusing on these four behavioral skills have brought real change in individuals I have worked with. While mindfulness and distress tolerance are generally known concepts in our society, the inability to control your emotions can be a challenge, but for some, like a client of mine, they find that their emotions are “like a rollercoaster; once it gets going, you can’t control the ride.” Building emotion regulation skills allows for an understanding of the emotion and a way to alter that emotional thought to be more centered. In times where emotions are “out of control”, relationships can be altered and/or unhealthy relationships can be formed. The use of interpersonal effectiveness skills allows for a person to examine a situation, focus on the conflict and identify ways to minimize the conflict in the moment. Furthermore, relationships are examined and tools are created to identify healthy relationships as well as ways to minimize unhealthy relationships. It is not easy work, but it does lead to change.” – Jamie Blum, LCSW-C, CPE Clinic, LLC