What is DBT?

Dialectics
Behavior Therapy
DBT Assumptions
DBT Therapists
Skills Taught
What's Involved in DBT?
DBT Treatment Targets
Quality Assurance
Closest DBT Providers
Research on Therapy

Developed at the University of Washington by Marsha Linehan, Ph.D., DBT was originally developed to treat interpersonal chaos, intense emotional swings, impulsiveness, confusion about the self (identity), and suicidal behavior. It is based on a bio-social theory that states that problems develop from the interaction of biological factors (physiological makeup) and environmental factors (learning history), which together create difficulty managing emotions. DBT is therefore appropriate for a range of problems relating to emotion disregulation, including substance use problems, eating disordered behavior, and anger-related problems. A great deal of research has been conducted on the effectiveness of DBT and, in general, DBT appears as effective or more effective than other psychotherapies for the problems mentioned above.

To reach the ultimate goal of DBT-creating a life worth living-the therapy balances empathy and warm acceptance (validation) with an unwavering focus on changing problem behavior (problem-solving). Through this balance, DBT aims to help change the behavioral, emotional, and thinking patterns associated with problems in living, while promoting the development of and reliance on inner wisdom (wise mind).

Dialectics

DBT is based on the idea that opposites can coexist and be synthesized. This means weighing out various points of view in any situation and constantly working on balancing an effort to change with accepting situations as they are.

Behavior Therapy

Behavior therapy is based on the study of how behaviors are learned. It focuses on helping people change ineffective ways of coping by learning new, skillful ways of coping. It focuses on specific goals that can realistically be attained. For the most part, it is a "doing" therapy rather than a “talking” therapy.

DBT Assumptions

  • People in DBT are doing the best they can
  • People in DBT want to improve
  • People in DBT need to do better, to work harder, and be motivated to change
  • The lives of suicidal individuals are unbearable as they are currently being lived
  • People in DBT must learn new behaviors in all areas of their lives
  • People cannot fail in DBT

DBT Therapists

  • Make every reasonable effort to conduct competent and effective therapy
  • Obey standard ethical and professional guidelines
  • Are available for weekly therapy sessions, phone consultations, and provide needed therapy back-up
  • Respect the integrity and rights of the patient
  • Maintain confidentiality
  • Obtain consultation when needed

Skills taught

  • Mindfulness
  • Interpersonal Effectiveness
  • Emotion Regulation
  • Distress Tolerance
  • Self-Management

What's typically involved

Weekly individual Psychotherapy

  • An understanding of what contributes to the problems and interferes with change is developed.
  • New and more effective alternatives are learned.

Skills training classes

  • Specific skills that are essential for managing emotional distress are learned.

Consultation meeting for therapists

  • The therapy team meets regularly to assist each other in providing effective and compassionate treatment.

Between-session coaching with therapist

  • This provides an opportunity for "real-life" coaching for using the skills being learned.

DBT Treatment Targets

  • Orienting and agreeing on goals

Stage One

  • Decreasing or eliminating life-threatening behaviors (suicide attempts, suicidal thinking, self-injury, homicidal and aggressive behaviors)
  • Decreasing or eliminating therapy-interfering behaviors (missing sessions, not doing homework, behaving in a way that burns others out)
  • Reducing or eliminating hospitalization as a way of handling crisis
  • Decreasing behaviors that interfere with the quality of life (eating disorders, not going to work or school, addiction, chronic unemployment)
  • Increasing behaviors that will enable the person to have a life worth living
  • Increasing behavioral skills that help to build relationships, manage emotions and deal effectively with various life problems

Stage Two

  • Decreasing Post Traumatic Stress

Stage Three

  • Increasing respect for self
  • Setting individual goals
  • Solving ordinary life problems

Stage Four

  • Developing the capacity for freedom and joy

Quality Assurance

As part of our commitment to our mission of providing evidence-based treatment, the DBT Center of Seattle maintains a system for evaluating our programs, including the progress in our DBT programs. This means participants are asked to complete a set of instruments at the beginning of treatment, every 3 months they are in treatment, and at the end of treatment. Our intake coordinator, client services coordinator, and therapists can provide detailed information about our quality assurance program.

Providers

I live outside Washington State. How can I find a DBT provider in my area?

In order to find the closest DBT provider in your area, please call Behavioral Tech at (206) 675-8588 or refer to their clinical resources web page. Behavioral Tech, LLC, trains mental health care providers and treatments teams.

For Whom has Research shown DBT to be Effective?

Please refer to the following link: DBT Summary of Data to Date