Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, Ph.D., A.B.P.P., is an evidence based comprehensive cognitive-behavioral treatment. It is designed to treat individuals with Borderline Personality Disorder or Borderline Personality traits. Borderline Personality Disorder is a diagnosis that includes dysregulation of several areas: emotions, interpersonal, self, behaviors and cognition. Clients receiving DBT services may struggle with suicidal thoughts or behaviors, self-injurious thoughts or behaviors, impulsive behaviors that may be self-damaging (i.e., alcohol/drug use, binge eating, restricting food, purging, gambling, reckless driving, sexual behaviors, dissociating, etc.), anger issues, identity issues, a sense of emptiness, fears of abandonment, relationship problems and mood issues. It is common for individuals in DBT to also struggle with depression, anxiety, chemical dependency/abuse, and/or trauma related issues.
The goal of DBT is to create “a life worth living.” Clients work on identifying goals for what “a life worth living” would look like for them. Other goals include decreasing suicidal thoughts and behavior, decreasing self-injurious urges and behavior, reducing impulsivity, decreasing clinical symptoms such as depression, anxiety and anger, reducing frequency and duration of psychiatric hospitalizations, improving interpersonal effectiveness, increasing coping skills and increasing overall functioning.
DBT clients attend a skills group and individual psychotherapy. Skills group is similar to taking a class. Clients learn and practice skills from four modules:
Focuses on quality of attention and awareness.
Focuses on getting through a time of distress/crisis without doing anything to make the situation worse.
Focuses on initiating/maintaining/repairing relationships, effectively making requests and setting boundaries and increasing/maintaining self-respect.
Focuses on decreasing emotional sensitivity/intensity, preventing unwanted emotions from starting and stopping or reducing unwanted emotions once they start.
In individual therapy, clients review a diary card (used to monitor daily symptoms and skills used) as well as chain analyses (used to analyze behaviors the client wants to change and to identify skills that may be helpful). The individual therapist is also available for coaching calls outside of the session to help the client problem-solve barriers and identify skills to try.
Both skills trainers and individual therapists attend a weekly consultation meeting to gain support and consultation from their colleagues. Skills trainers and individual therapists encourage clients to consider a dialectical approach which includes balancing acceptance and change in the therapeutic process.
The DBT team at MCP is currently participating in a Practice Improvement Project through the MN Department of Human Services. The goal of the Practice Improvement Project is to prepare clinics for DBT certification once it is available in the state of Minnesota.
The majority of clinicians who offer DBT services at MCP have been intensively trained through Behavioral Tech, LLC, an organization dedicated to teaching DBT that adheres to Dr. Marsha Linehan’s model.
The DBT services provided at MCP include: