Do You Have Some Questions for a DBT Therapist? We Have Some Answers!

Dialectical Behavior Therapy (DBT) has gained popularity in recent years for its effectiveness in treating a wide range of mental health conditions. Originally developed to help individuals with borderline personality disorder, DBT has evolved to address many other psychiatric diagnoses and symptoms such as anxiety, depression, substance abuse, and eating disorders. DBT is an evidenced-based treatment that draws from cognitive-behavioral therapy (CBT) and mindfulness practices. The goal of the therapy is to teach clients to manage intense emotions, communicate effectively, and develop greater self-awareness. In this blog we will explore the major tenets of DBT, and answer some common questions you might have for a DBT therapist. 

First of all, what is a DBT therapist?

A DBT therapist has been specifically trained to instruct clients to apply specific DBT tools to real-life circumstances. A clinician who is certified in DBT has undergone comprehensive training in the theoretical and empirical foundations of DBT and has demonstrated mastery in helping patients implement and apply DBT strategies and techniques to real-life challenges and interpersonal conflicts. 

What are the main life tools taught in DBT?

DBT techniques fall into four major categories: distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness. Distress tolerance refers to the ability to experience negative emotions without needing to avoid them with self-destructive behaviors such as substance abuse or self-harm. Emotion regulation strategies help individuals tolerate and deal with difficult feelings that cause problems in their lives, for example losing their temper or acting impulsively. Interpersonal effectiveness is learning to communicate with others in a manner that is respectful and assertive and strengthens relationships. Mindfulness teaches you to be present and in the moment, and to experience emotions without judgment. 

What does the D mean in DBT?

As mentioned above, DBT stands for Dialectical Behavior Therapy. In colloquial language, the word dialectic has several meanings, one of which is a method of examining different and opposing ideas to arrive at the truth. The dialectic in DBT is the acknowledgment that real life is complex, as we are constantly balancing opposing viewpoints and emotions. DBT recognizes that mental health is an ongoing process, and involves a continuous dialogue with oneself and others, reconciling opposing feelings and needs. For example, if we find ourselves disappointed with a particular outcome in life, we can learn to accept what we cannot change while still feeling sad, and at the same time, be excited about moving forward. All of these emotions can be held simultaneously while you move forward to face challenges and achieve your goals.

How is DBT different from other forms of therapy?

DBT is one of the “third wave” psychotherapies that have a unique focus on both acceptance and change. It emphasizes the importance of acceptance of oneself while making efforts to evolve and grow psychologically. Unlike other forms of therapy, DBT often asks clients to participate in both group and individual therapy. DBT places a strong emphasis on skill building and homework assignments to help patients implement what they learn into their daily life. The goal of DBT therapy is that by the end of treatment, the patient will know as much about the tools and techniques as the therapist.

What does a typical DBT session look like?

DBT sessions occur individually and within a group. Individual sessions usually last 45 minutes. The session might begin with the therapist and the client working together to reduce any behavior interfering with therapy. The therapist will address challenges that encroach on your goals. You will learn new skills to replace self-defeating patterns. Your therapist might ask you to complete diary cards that track emotions and identify triggers and work with you to balance change and acceptance techniques to improve your quality of life.

Group sessions are not typical therapy sessions, but more like a classroom, where the therapist teaches clients DBT skills. The group meets for 60-90 minutes. The session will begin with a mindfulness technique, a review of homework, and previously taught skills. New skills are taught, and you will engage in role-playing and other exercises to solidify learning and real-life application. 

Do I have to participate in both individual and group therapy if I am in DBT treatment?

At The Midtown Practice, although we encourage you to participate in both group and individual therapy, we understand that not everyone has the time and ability to do both. Therefore, we do not require you to participate in both.

Is there anyone who does not do well in DBT?

DBT is not the treatment for you if you wish to focus on understanding your developmental history, and unconscious motivations. In this case, we suggest you seek out one of our therapists who use a Psychodynamic approach. If you are not motivated to do homework assignments and prefer a less structured therapy, Supportive Therapy may be a better fit. Issues amongst couples or families are better off addressed with couples or family therapists. If you are looking to increase your psychological flexibility, identify core values, and align your behavior with those values, you might explore Acceptance and Commitment Therapy (ACT). If you are having trouble with PTSD or processing a trauma, Eye Movement Desensitization and Reprocessing (EMDR) or Cognitive Processing Therapy (CPT) might be particularly effective treatments.  

What age do patients benefit from DBT?

DBT benefits patients from adolescence to the elderly to improve their ability to regulate difficult emotions, limit self-destructive behaviors, develop interpersonal communication skills, and build more fulfilling lives.

In order to provide a customized treatment suited to each client, many of our therapists draw upon multiple different therapeutic approaches, as needed.  In addition to the type(s) of therapy which your therapist is using with you, the fit between you and your therapist is at least as important to its effectiveness, especially since there can be substantial overlaps between some of these psychotherapies, such as DBT and ACT.  So regardless of what you are experiencing, we encourage you to speak to our Clinical Coordinator to match you with a therapist with whom you can form a meaningful connection, obtain relief from your distress, achieve your treatment goals, and meet life’s challenges with more ease.