What is Dialectical Behavior Therapy (DBT)?

Welcome to the global DBT community! Training as a DBT therapist is training to save and change lives. It is not for the faint-hearted, AND it is life-changing for both client and therapist. In this series of short videos, journey through the world of DBT and find out if becoming a DBT therapist is right for you.

For those searching for therapy or support, please know that this page is geared towards therapists, but it will be informative to you, too. You can learn more about how to find a therapist here.

 

Modes of Treatment Delivery

There are four modes of standard outpatient DBT: Individual psychotherapy, DBT Skills training, in-the-moment phone coaching, and DBT Consultation Teams for therapists. This is different than many other psychotherapies that consist of just one mode or aspect of treatment, such as individual therapy. In this video, learn how each mode of treatment delivery is intended to meet a specific function. 

 

Individual Psychotherapy

Individual psychotherapy is a mode that serves two functions within DBT.

1) Enhance Motivation with Individual Therapy – DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to specific challenges and events in their lives. In the standard DBT model, individual therapy takes place once a week for as long as the client is in therapy, and it runs concurrently with DBT skills training.

2) Structure the Environment with Case Management in Individual Therapy –  Case management strategies help the client manage his or her own life, such as their physical and social environments. The therapist applies the same dialectical, validation, and problem-solving strategies in order to teach the client to be his or her own case manager. This lets the therapist consult to the patient about what to do, and the therapist will only intervene on the client’s behalf when absolutely necessary.

Skills Training​

Problematic behaviors evolve as a way to cope with a situation or attempt to solve a problem. While these behaviors might provide temporary relief, they often are not effective in the long-term. DBT assumes that clients are doing the best they can, AND they need to learn new behaviors in all relevant contexts.

 The function of DBT Skills is to help enhance a client’s capabilities. There are four skills taught in DBT:

  • Mindfulness: the practice of being fully aware and present in this one moment
  • Distress Tolerance: how to tolerate pain in difficult situations, not change it
  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  • Emotion Regulation: how to change emotions that you want to change

Skills training is frequently taught in groups during weekly sessions, and the full skills curriculum runs for 24 weeks. Group leaders assign homework to help clients practice the skills in their everyday lives. Briefer schedules that teach only a subset of the skills have also been developed for particular populations and settings.

​In-the-Moment Coaching​

DBT uses phone and other in-vivo coaching to provide in-the-moment support. The goal is to coach clients on how to use their DBT skills to effectively cope with difficult situations that arise in everyday life. Clients can call their individual therapist between sessions to receive coaching at the times when they need help the most.

 

Consultation Team for Therapists​

A therapist’s work can be difficult for many reasons. The DBT consultation team is essential to help therapists monitor their fidelity to the treatment, develop and increase their skills, and sustain their motivation to work with high-risk, difficult-to-treat clients.

 

What is the “D” in DBT?

The “D” means “dialectical.” A dialectic is a synthesis or integration of opposites. In DBT, dialectical strategies help both the therapist and the client get unstuck from extreme positions. In this video, learn how dialectical strategies keep the therapy in balance and help clients reach their ultimate goals as quickly as possible.

 

In DBT, acceptance strategies are added to the behavioral change strategies in CBT through validation and through accepting the client just as he or she is. We can observe that too much focus on change results in clients feeling misunderstood and that their suffering is invalid. Working with people with extreme emotional sensitivity requires careful attention to the balance between acceptance and change.

 

What is the “B” in DBT?

The “B” stands for “behavioral.” DBT requires a behavioral approach. This means that we assess the situations and target behaviors that are relevant to our clients’ goals in order to figure out how to solve the problems in their lives. Learn how DBT provides you a path to get the change that your clients so desperately need to see.

 

What is the Science behind DBT?

DBT is an evidence-based therapy. Learn more about how a scientific stance keeps the field of DBT advancing forward and how it can inform interactions with clients.

 

Learn more here about the core evidence behind DBT and emerging studies.

Core Assumptions of DBT

DBT makes a number of assumptions that underlie all components of the treatment. These assumptions allow DBT therapists to see clients in the best possible light. Learn about these assumptions and why they are so important.

 
 

Becoming a DBT Therapist

DBT Changes Lives

You are learning more about what DBT is, and now it is important to learn why it has value.  DBT changes lives for both therapists and clients.  Click here to find out more about DBT and its impact.

Are you ready to dive into DBT training?  Learn more about our trainings and other services here.