Is DBT Right for You and Your Clients?

If you can answer “yes” to the below questions, then DBT may be right for you.

  • Are you working with clients with severe, multi-diagnostic disorders?
    DBT is an evidence-based treatment effective with clients who are emotionally dysregulated and as a result engage in suicidal and/or non-suicidal self-injurious and other serious behaviors.
     
  • Are you willing to adopt a dialectical world view?
    Practicing DBT involves a skillful balance of strategies which emphasize both change and acceptance. DBT challenges the therapist to believe that clients are doing the best they can and want to improve; at the same time, clients need to do better, and/or be more motivated to change.
     
  • Are you willing to adopt the assumptions of DBT?
    DBT was originally developed to treat chronically suicidal clients typically diagnosed with borderline personality disorder (BPD). DBT explains BPD as a pervasive disorder of the emotion regulation system, and BPD criterion behaviors function to regulate emotions or are a natural consequence of emotion dysregulation. Additional core assumptions of DBT include: clients must learn new behaviors in all relevant contexts; clients cannot fail in DBT (it is the DBT treatment or therapist that fails); clients may not have caused all of their own problems, but they have to solve them anyway; and, finally, the lives of these individuals are unbearable as they are currently being lived.
     
  • Are you willing to keep your practice informed by evidence?
    As new research comes out, you must be willing to adjust your strategies based on any new information.
     
  • Are you willing to help clients acquire, strengthen, and generalize skills?
    As a DBT therapist, it will be your job to know the steps of applying DBT skills, help your client conceptualize the skills, and help your client apply skills in everyday life.

DBT Changes Lives.

“I am currently in month 5 of 6 of DBT. I am in Canada, and I got a referral to the psych health hospital (through my general practitioner after a brief psychiatric assessment) for short-term assessment and treatment, which utilized some DBT skills training. I was referred by that short-term program to a formal DBT class.

“My level of emotional regulation is definitely better than ever. I am able to change harmful behaviours more effectively without so much drama. Interpersonally, I am very satisfied with how I am experiencing more stability than I’ve ever enjoyed. I am less ashamed of myself. I am not having urges to take drugs or drink alcohol as much as usual. I am making SMART goals and enjoying the idea of creating a life worth living, rather than being filled with the usual doubt and dread. Things do feel a bit more boring, and I feel very impatient with how long it takes to get something interpersonal accomplished without throwing tantrums or manipulating others, but I’m willing to give it the time, for once in my life, because mindfulness has helped me orient towards self-respect and my true values.”

Story submitted by Sonja in Manitoba, Canada

Read more personal stories about DBT.