Dialectical Behavior Therapy is an advanced derivation of Cognitive Behavior Therapy that was originally developed by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with borderline personality disorder (BPD). DBT combines concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice with cognitive-behavioral techniques for emotion regulation and reality-testing.
Dr. Linehan recognized early on that the chronically suicidal patients with BPD she had been treating had been raised in profoundly invalidating environments. This first step in addressing this was to create a climate of unconditional acceptance. This was followed by identifying the need for a true commitment to treatment from patients, who also needed to be willing to accept their dire level of emotional dysfunction.
The DBT approach emphasizes a strong patient-therapist relationship, with the therapist being seen as an ally rather than an adversary throughout the course of treatment. Therapists sincerely accepts and validates the client’s feelings at any given time, while simultaneously helping the client realize that some feelings and behaviors are maladaptive, and teaching them better alternatives.
Main Components of Dialectical Behavior Therapy:
The DBT therapist and patient work through issues experienced by the patient over the prior week, systematically recorded on diary cards. This therapy component follows a treatment target hierarchy. The highest priority on this hierarchy is always Self-injurious and suicidal behaviors. Second in priority are behaviors that interfere with the course of treatment, referred to as therapy-interfering behaviors. Third in priority is the improvement of the patient’s general quality of life. Individual therapy provides the safe environment for the therapist and patient work towards improving skill use.
DBT Skills Group
A DBT Skills Group, run by two therapists, meets weekly for two hours and teaches patients to use specific skills that are broken down into four skill modules: core mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Ongoing individual therapy with a DBT therapist is required for participation in the skills group.
About The Delray Center for Healing’s DBT Program:
Florida’s Premier Dialectical Behavior Therapy
The Dialectical Behavior Therapy program at The Delray Center for Healing is the most intensive and developed in the state of Florida, and one of the most advanced in the United States. The multidisciplinary Delray Center treatment team is comprised of 8 members, including a double Board Certified DBT Psychiatrist. This is the only program that has adapted an introduction level group for immediate participation, a teen focused skills group, and a full scale DBT skills group for family members of clients. This comprehensive approach has yielded extraordinary results in even the most complex cases.
The existence of multiple skills groups provide options to help accommodate personal and professional schedules. Some prefer daytime groups while others prefer the 6:00PM groups that allow for a full-time work schedule. The presence of so many DBT trained professionals allows the possibility for treatment with a DBT psychiatrist, nutritionist, and a number of different individual and family therapists. When necessary, the different Dialectical Behavior Therapy groups can be incorporated into higher levels of care such as Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP) for conditions such as depression, addiction, bipolar disorder, eating disorders, and trauma.
The “Introduction to DBT Group” was designed to allow immediate participation in a group setting while preparing clients to start the more advanced and structured DBT Skills Group. The introductory group familiarizes participants with the general therapeutic concepts, to facilitate the learning of more advanced concepts later. The curriculum is not yet organized into the formal DBT modules. Individual therapy participation is strongly recommended, but not absolutely required for this level of treatment. In addition, the Delray Center offers a unique Family DBT skills group, which convenes on Wednesdays at 10:00AM.