Dialectical Behavior Therapy
At the DBT Center, we practice Dialectical Behavior Therapy (DBT) as it was created and extensively researched by Marsha Linehan, PhD. Karyn Hall, Ph.D., the Director of the Center,, is certified by the DBT Linehan Board of Certification. Other clinicians at the Center are actively pursuing certification.
DBT is an evidenced-based treatment for individuals who have difficulty managing their emotions such that their emotions are interfering with their ability to live a contented life. Evidenced-based means that research has shown the treatment to be effective. In addition, the Center tracts the effectiveness of our work and the results show that the majority of clients experience improvement when they complete the program.
DBT includes the following:
- Weekly individual therapy
- Weekly skills group
- Phone Coaching
- Team Consultation for the Therapist
DBT is an effective treatment for those are controlled by their emotions or who are under-contrlled. DBT has been shown to be effective for individuals who:
- Are suicidal or have suicidal ideation
- Engage in self-harm impulsively
- Have intense emotions
- Act impulsively
- Use destructive behaviors to feel better
- Have chaotic relationships
- Feel empty
- Have a limited sense of identity
Take a step out of pain and suffering. Start creating the life that you want to live. Call for an appointment to determine if DBT is the treatment for you.
Dialectical Behavior Therapy for Substance Abusers
Dialectical Behavior Therapy for Substance Abusers (DBT-S) is a comprehensive psychosocial treatment for those clients who struggle to manage emotions, may be chronically suicidal and abuse substances. This treatment is for those who have an underlying borderline personality disorder and use substances in destructive ways. Studies have reported rates of up to 65% of those seeking treatment for substance abuse also had a diagnosis of borderline personality disorder. DBT -S is also indicated when the individual has not responded to traditional substance abuse treatment.
For substance-dependent individuals, substance abuse is the highest order DBT target within the category of behaviors that interfere with quality of life. DBT’s substance-abuse–specific behavioral targets include:
decreasing abuse of substances, including illicit drugs and legally prescribed drugs taken in a manner not prescribed;
alleviating physical discomfort associated with abstinence and/or withdrawal;
diminishing urges, cravings, and temptations to abuse;
avoiding opportunities and cues to abuse, for example by burning bridges to persons, places, and things associated with drug abuse and by destroying the telephone numbers of drug contacts, getting a new telephone number, and throwing away drug paraphernalia;
reducing behaviors conducive to drug abuse, such as momentarily giving up the goal to get off drugs and instead functioning as if the use of drugs cannot be avoided; and increasing community reinforcement of healthy behaviors, such as fostering the development of new friends, rekindling old friendships, pursuing social/vocational activities, and seeking environments that support abstinence and punish behaviors related to drug abuse
Radically Open Dialectical Behavior Therapy
Radically Open DBT (RO DBT) has been in development for over 20 years but Tom Lynch, Ph.D., the treatment creator, has just released it for dissemination. (RO DBT) is a treatment for patients who suffer from emotional over-control. Many of the clinicians at the DBT Center are trained in RO DBT.
What is emotional overcontrol?
High self-control is generally regarded as a positive trait. However, too much self-control underlies many problems individuals experience in life. Overcontrol is related to social isolation, interpersonal problems, and is seen as a strong underlying component of anorexia, obsessive compulsive personality disorder, and chronic depression. People who are overly controlled need help with learning how to relax overly rigid rules, be more open in expressing their emotions, and develop connections with others.
You may benefit from RO DBT if you have:
- Rigid Rules
- Difficulty forming relationships
- Obsessive thinking
- Difficulty expressing affection and other emotions
- Excessive need for planning and organization
- A sense of not fitting in and loneliness, social awkwardness
Treatments targeting problems of overcontrol require interventions designed to relax inhibitory control and increase emotional expressiveness, receptivity, and flexibility whereas treatments targeting problems of undercontrol should emphasize interventions that enhance inhibitory control and reduce mood-dependent behavior (Lynch, 2017).
What do you learn in RODBT?
The focus of RO DBT is to enhance or develop social connections. You’ll participate in individual therapy and a skills class.
RODBT involves taking a skills class and also individual therapy. RODBT focuses on learning three core principles:
- Openness to feedback, even when challenging.
- Flexibility in responding to challenges in our environment (including other’s behavior).
- Effective communication of our emotions, recognizing that emotion expression is central to forming strong relationships.
How is the skills class structured?
The class uses a traditional classroom format. Everyone who attends sits around a table. The facilitators begin each class with a brief exercise, followed by homework review, the introduction of new material, and homework assignments. It should feel familiar as the format is like other classroom settings. We aim to create a welcoming, warm, and fun environment for learning.
To learn more about emotional overcontrol and whether RODBT might be relevant for you or a loved one, you can watch the video below.
DBT-Prolonged Exposure Therapy (DBT-PTSD)
For the treatment of trauma we offer DBT-PTSD) which follows the modifications to Prolonged Exposure Therapy developed by Dr. Melanie Harned, a DBT expert and researcher trained under Dr. Marsha Linehan. For clients who are not ready to start PTSD treatment right away but know they will want to do so in the near future, we provide Stage 1 DBT while preparing for PTSD treatment through psychoeducation about PTSD and managing symptoms. We are committed to using PTSD treatments with the largest evidence bases: Prolonged Exposure and Cognitive Processing Therapy.
Most PTSD treatments strongly suggest postponing treatment for people who are at risk of suicide or non-suicidal self-injury, have current substance abuse/dependence problems, or have other major quality of life interfering behaviors until these problems have been fully addressed. We are excited to offer a treatment that addresses PTSD as soon as possible, while simultaneously working on these other types of difficulties.
Primary goals of DBT-PTSD:
- Establish safety and stability by learning and practicing DBT skills to target behavioral, emotional, and cognitive dysregulation.
- Learn to use DBT skills to effectively manage PTSD symptoms.
- Treat PTSD through Prolonged Exposure therapy while engaged in Stage 1 DBT treatment, for those clients who want to do so as soon as possible.
- Work with therapists trained in PE and CPT for those clients who eventually want to do PTSD treatment but first want to resolve life-threatening or major quality of life interfering behaviors. This paves the way to beginning PTSD work as soon as the client is ready.
- Build a life worth living, without PTSD.
DBT-PTSD is for those who have co-occurring diagnoses of PTSD and other concerns such as depression, anxiety, substance-use, chronic pain, insomnia, or behaviors that are life threatening or quality of life interfering.
Prolonged Exposure Therapy (PE)
Chronic post traumatic stress disorder (PTSD) is often a complex and challenging disorder to treat. PE is an empirically validated treatment with more than 20 years of research supporting its use. Based on cognitive behavioral principles it is a treatment that produces clinically significant improvement in about 80% of the clients with chronic PTSD.
Cognitive Processing Therapy for Trauma
Trauma can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy.
CPT teaches you a new way to handle these upsetting thoughts.. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide the truth. THis therapy includes writing about the trauma (gradually) and resolving issues in relationships that may may have been affected by the trauma.
Intensive Outpatient Program
The DBT Center has been offering intensive outpatient treatment for over 12 years. We currently offer IOP for both individuals with problems relating to maladaptive over-control (obsessive compulsive personality disorder, dependent personality disorder, anorexia nervosa, chronic anxiety disorders, and chronic depression) and under control (borderline personality disorder, emotion regulation disorders). The IOP varies in terms of the needs of the client, and is typically 9 hours per week. An individual session is included in the IOP.
Sometimes individuals live in areas where treatment is not available or are returning to other countries or states after completing treatment at the Center. For those who are not suicidal, some Center therapists offer coaching via videoconferencing. Coaching is different from therapy and primarily involves helping you maintain the gains you have made in treatment by discussing how to apply skills effectively to situations that arise. Coaching can help you realize new options, problem solve, and overcome obstacles that seem daunting. Coaching offers support and encouragement as well as feedback. Coaching will help you maximize your strengths to achieve the goals you want to achieve in your life.
Dialectical Behavioral Therapy for Children (DBT-C) is a treatment developed by Francheska Perepletchikova, PhD for pre-adolescent children ages 7-12. DBT-C is a treatment that focuses on severe emotional dysregulation and behavioral dysregulation. These children struggle with high emotional sensitivity, high reactivity (go from 0-100), and severe reactions that last a long time. Behaviors that correspond with emotional dysregulation may range from verbal/physical aggression to suicidal ideation/behaviors and self harm. DBT-C teaches that emotional sensitivity is a special ability that children will learn how to control instead of it being a problem that needs to be corrected. The main goal of this treatment is to prevent psychopathology by following the structure of DBT with parents being the most important tool for the child’s success in treatment. The difference between DBT-C and traditional DBT is the main focus is teaching the environment (parents or caregivers) how to effectively respond to their child’s emotional sensitivity and behavior.
- Structure (32-36 week Outpatient Treatment)
- Parent Training
- Didactics of Emotions
- Individual Sessions with child and parent
- Skills Training