Dialectical Behavior Therapy is an evidenced based practice for teens and adults that have ongoing difficulties with emotional regulation and interpersonal effectiveness. DBT helps by providing skills that are balanced between acceptance and change that support individuals and their families in learning how to take back control of their emotions and form healthier relationships, which sets the foundation for future trauma processing.
DBT offers support by providing individual counseling sessions, phone coaching in between sessions, skills groups, and therapist consultation.
How does it work?
DBT has 4 stages and 4 modes.
Let’s start with the modes. Think of modes as ways getting of support in DBT:
Individual Therapy Sessions: These are your regular weekly sessions. The content of sessions will depend upon the stage of therapy.
Skills Group or Individual Skills: This is where you will learn mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness skills (a.k.a. communication and peer relationship skills) that will be used to replace or interrupt problem behaviors.
*Please note groups starting in January 2023
*Please note that if two sessions per week are not conducive to your schedule or finances, we can work in a “DBT informed” manner – I just want to provide you with as much information as possible here!
Phone Coaching: This is the live action part of therapy. You can call the therapist when you are in a moment of distress and get live coaching on how to effectively use the skills.
Consultation: I participate in DBT consultation with other therapists to ensure I am honoring DBT principles and get feedback about how I am doing. Please be assured I do not share personal details during the consults.
Let’s get to the stages. It’s kind of like building a house:
Stage 1: Behavior Stabilization: During the first stage of DBT, the therapist will ask you to complete a weekly “diary card”, which is simply a sheet that helps you keep track of problem behaviors (a.k.a., things that are getting in the way of the life you want to live) as well as the skills you have used throughout the week. The therapist will work with you to find the things that are triggering and/or reinforcing these behaviors and find ways to interrupt the problematic pattern in order to get to a place of emotional stability.
Stage 2: Emotional experiencing: During the second stage of DBT, the therapist will work to uncover and process the emotions and experiences that are at the root of the problematic patterns so that they don’t end up popping up in some other way, at some other time.
Stage 3: Everyday Living: During the third stage of DBT, the therapist will help you take what you have learned about yourself and guide you in creating the life you want to live. At this point, most of the emotional ups and downs as well as problem behaviors are no longer present, which allows you to work towards the things you want!
Stage 4: Completeness: The fourth stage of DBT is kind of this existential process. Most of the time, people leave therapy after stage 2 or 3 because the problems in their life are gone and they are living the life they want.
Stage 4 is for people who want something, well, more.
Who is it for?
DBT is for teens 13+ and adults with severe emotional dysregulation and/or interpersonal effectiveness challenges that are often a result of a history of trauma.
Possible Traumas: experiencing bullying, physical abuse, sexual abuse, emotional abuse, neglect, car accident, dog bite, divorce, loss of loved one, severe illness, witnessing violence, going through a natural disaster – or any other life threatening or scary event. Please note that trauma is any event that exceeds our ability to cope and trauma will try to convince you not to seek help by saying “it’s not that bad.”
Emotional Dysregulation: frequent ups and down (happy/sad, anxious/depressed, etc.) anger outbursts, not trusting yourself or emotions, racing thoughts, physiological reactions (heart pounding, dizzy, difficulty breathing).
Interpersonal effectiveness challenges: difficulties making friends, disruptions in relationships, not trusting others, not asking for help, not expressing emotions/needs to others.