Eve Parker, ASW

for Vista Hill Learning Assistance Center

Dialectical Behavior Therapy

DBT is a cognitive-behavioral therapy developed by Marsha Linehan at the University of Washington for patients with Borderline Personality Disorder

DBT has been proven effective at treating a myriad of other disorders including eating disorders, treatment-resistant depression, ADHD, substance use disorders, and other mental health disorders

DBT is used in inpatient and outpatient settings, correctional facilities, schools, etc

Background

Dr Linehan recently revealed that she suffered from severe mental illness and was hospitalized as a young woman

The first manuals were published in 1993 and updated in 2014 and worksheets/handouts are available online

Trainings and certification are offered through Behavioral Tech/The Linehan Institute

Dialectics: bringing two opposing ideas together to create a new idea

Background cont.

Traditional DBT includes individual psychotherapy group skills trainingteam consultationallow the clients to call in 24/7 for support

DBT skills training groups and teaching skills on an individual basis is less rigorous and an effective intervention

Format

Group usually is 2.5 hours long, often starts with a mindfulness activity, reviews homework from previous session, and teaches a new skill from a rotation of the 4 modules

Individual sessions often focus on reviewing the client's diary card and/or completing a BCA on an event from the previous week

Treatment usually lasts at least 1 year

Format cont.

Core MindfulnessInterpersonal EffectivenessEmotion RegulationDistress Tolerance

Modules

Skills for learning to pay attention to what you're doing and how you're feeling

You can't change ineffective behavior and feelings if you aren't aware of what you're feeling or doing

Core Mindfulness

Skills for learning to effectively interact with othersget what one needssay nodeal with conflict, stress, and loneliness

Interpersonal Effectiveness

Skills for coping with difficult emotions, mood-dependent behavior, and reducing emotional vulnerability

Emotion Regulation

Crisis survival skills for temporarily distracting and escaping the

"crisis" situationReality acceptance skills

for non-judgmentally accepting reality for what it is and finding meaning in suffering

New skills added for addiction issues

Distress Tolerance

Behavior Chain Analysis helps client and therapist take an in depth look

at the ineffective behavior from a given situation

Diary Card helps client keep track of their goals and how

often they're using their skills

Tools