Dialectical behavior therapy - used to treat emotional disregulation.
If they are doing OFFICIAL DBT:
Depending on the program, there are 4 or 5 modules of skills. Skills are taught in a group setting if you are getting true DBT. The group is 6 months, sometimes it is required to do 2 rounds. They are: Core Mindfulness (how to stay in the moment), Distress Tolerance (how to manage crisis), Emotional Regulation (how to keep emotions in check), Interpersonal Effectiveness (how to communicate with others to meet your needs), and Middle Path (move from a world of black/white to grey).
DBT individual therapy requires you complete a diary card, to monitor your emotions, urges, any suicidal attempts, and use of skills and their effectiveness. A true DBT therapist will begin with obtaining your diary card at the start of session and review it. The diary card sets your session. They will focus on lowering life threatening behaviors, therapy interfering behaviors, quality of life interfering behaviors, etc. Focus of session agenda is set on where you are in terms of your behaviors and how intense they are.
DBT also offers coaching weekly. That means your therapist will commit to a weekly check in or check ins to monitor you throughout the week. They will also be available for skills coaching only (NOT processing things, only helping with skills on the phone call).
DBT therapists are also commiting to: being in DBT consultation, being available for phone consultation, doing the best they can to meet your needs in the moment while also keeping appropriate boundaries for health and safety in place.
The client is commiting to do the best you can, that you will attend, that you will use the skills and commit to really wanting to change behaviors. If you miss 4 weeks of therapy in a row for any reason (sickness, vacation, hospitalization, etc) you are out of the DBT program.
This is phase 1 of treatment. Per psychcentral article:
In stage 1 of the treatment, therapy is focused on getting behavioral control. People who enter treatment at this stage are actively struggling with life threatening behaviors (e.g. cutting, suicide attempts, excessive drinking), treatment interfering behaviors (e.g dropping out of treatment, hostility towards therapist, skipping therapy) and major quality of life interfering behaviors (e.g. risk of losing housing, being expelled from school, losing marriage, custody of children).
The rationale for focusing on gaining behavioral control at this point is that it is assumed that a life lived out-of-control is excruciating. Progress cannot be made on underlying emotional issues until you have the skill to manage emotion without engaging in dangerous behaviors and are committed to the process of therapy.
Stage 2 begins to focus on emotional experiencing. For those with Post Traumatic Stress, this is the stage where past trauma is explored and maladaptive thoughts, beliefs and behaviors are identified. The primary goal of stage 2 is to reduce traumatic stress. This is achieved by remembering and accepting facts of earlier traumatic events, reducing stigmatization and self-blame, reducing the denial and intrusive response syndromes and resolving dialectical tensions regarding who to blame. Stage 2 targets are worked on only when behavior is under control.
The goal of stage 3 is to solve the problems of everyday living and improve happiness and joy in life. This stage of treatment focuses on owning your own behavior, building trust in yourself and learning to value yourself.
And finally, stage 4. In this stage the focus is on achieving transcendence and building a capacity for joy. I believe that most people, from Oprah Winfrey to Madonna would feel they could benefit from work on this stage.
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