What is DBT???

I seen there is a social forum for DBT and I wanted to ask what DBT is, but it won't let me post the question in the forum. So I guess I have to ask it here. I'm not really comfortable in the general forum and I don't come here very offen but I didn't know where to ask the question. So if someone from the social group could PM me and explain what DBT is I would be thankful.

I know that it's a type of therapy and I don't understand what I read about it. So I'm just wanting to know what it's about.

Thanks

Hi Monty_Girl!!

DBT is Dialectical Behavior Therapy. It is a therapy used to help treat people with Borderline Personality Disorder, but also can be very helpful for people with PTSD and Depression as well. I went through 8 months of DBT and found it very helpful for me in helping cope with stress, uncomfortable emotions, and suicidal ideation, along with self harming behaviors. Here is some info about it...

DBT INTRODUCTION
Dialectical Behavior Therapy (DBT) is a research-supported treatment which combines cognitive-behavioral theory and methods with Eastern meditative principles and practices. Developed by Dr. Marsha Linehan and her colleagues at the University of Washington, DBT addresses problems in regulating emotions, behavior, and thinking.

Emotions
• Heightened emotional sensitivity
• Quick and intense emotional reactions
• Slow return to normal mood
• Chronic problems with depression, anxiety, anger or anger expression

Behavior
• Repeated suicide threats or attempts
• Self-harm behavior such as cutting and burning
• Relationship difficulties including hypersensitivity to criticism, disapproval,
rejection or abandonment
• Impulsive and potentially self-damaging behavior in areas such as binge eating
and purging, alcohol or drug abuse, sexual promiscuity, and gambling or
spending sprees

Thinking
• Extreme (black or white) thinking
• Difficulty with problem-solving and decision making
• Unstable self-image or sense of self
• “Detached” thinking, ranging from mild problems with inattention to episodes of
complete dissociation

The DBT Program lasts approximately six months and is organized into three stages. Each stage is designed to achieve a set of clearly defined treatment goals.

Stage One: Addresses assessment and preparation. Goals of this stage are to 1) conduct a thorough assessment, 2) provide an orientation to treatment, and 3) establish treatment goals and build commitment to working on them.

Stage Two: Specific behaviors are targeted to increase or decrease. Behaviors to decrease include 1) life-threatening behaviors, 2) behaviors that interfere with progress in treatment, and 3) behaviors that interfere with living a reasonably good quality of life.

Behaviors to increase include 1) dialectical (balanced, as opposed to dichotomous and extreme) thinking and behavior patterns, and 2) adaptive skills in living and relating to others.

Stage Three: Focuses on generalizing and maintaining treatment gains. Specific goals are to 1) refine skills use and encourage application across time and settings, 2) solidify environmental changes to support new behaviors, and 3) improve problem-solving and relapse prevention skills.

I will give you a link you can look at that might give you a better understanding:

http://depression.about.com/od/psych...ialectical.htm

It might be cool for you to stop in and listen in on the chat, but if you haven't done DBT before you might not understand all that is being discussed. That still doesn't mean you wouldn't benefit from listening in though!!

Take care.

Still confused. Is it like all you do in T for so many months? I mean how do you work with your T, just come in and only work on just this one thing? See told ya I was confused. The more I read the more I get confused. I don't understand how it works between a T and the patient.

Hi Monty girl. You're welcome to join the social group if you want to, and if you decide you don't want to stay, that's always ok too. Then you can post your questions. But here is also fine. And there is a thread in this forum, although it keeps getting lost to a back page. And you are also welcome to come to the chat on Tuesday morning if you want to try that too.

The basic premis of DBT is balance. We struggle in life when we take things to extremes. A "dialectic" is a pair of concepts that seem to be opposite, or incompatible. DBT (Dialectical Behavioral Therapy) requires finding the balance between those incompatible ideas, where you can accept that they can both be true. For example, at one end of a dialectic might be the need for self-acceptance, and the other end is the need to change patterns and behaviors that cause you trouble in life. The DBT point of view is that you can accept yourself and be ok as you are, and you can still change.

DBT includes learning skills for mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. The chat that we do here mostly focuses on those skills, and applying skills to real life situations, but isn't limited to that. There is a lot more to DBT. It's an entire treatment modality, and adapts to whatever most needs to be addressed. But it is also carefully structured.

Usually the skills training is done in groups, and Individual therapy works with everything else. Official by the book DBT treatment requires both parts - individual therapy, and skills group.

The text book on DBT has strategies checklists and clear directions for therapists such as:

• T BALANCES TREATMENT STRATEGIES within each session.
• T alternates between acceptance and change strategies in such a way that a collaborative working relationship is maintained in the session.
• T balances nurturing the patient with demanding that the patient help herself.
• T balances persistence and stability with flexibility.
• T balances focus on capabilities with focus on limitations and deficits.
• T moves with speed, keeping P slightly off balance.
• T is awake, responsive to P's movements.
• T takes positions whole-heartedly.
• T MODELS dialectical thinking and behaviors.
• T looks for what is not included in P's and own points of view.
• T gives developmental descriptions of change.
• T questions permanence and intransigence of boundary conditions of the problem.
• T makes synthesizing statements, including aspects of both ends of the continuum.
• T makes statements highlighting the importance of interrelationships in determining identity.
• T advocates a middle path.
• T highlights PARADOXICAL contradictions of the following:
• P's own behavior.
• The therapeutic process.
• Reality in general.
• T speaks in METAPHORES and tells parables and stories.
• T plays the DEVIL'S ADVOCATE.
• T EXTENDS the seriousness or implications of P's communication.
• T helps P activate "WISE MIND."
• T makes LEMONADE out of lemons.
• T allows NATURAL CHANGES in therapy.
• T ASSESSES DIALECTICALLY, examining both the individual and the broader social context, for an understanding of P.

(Marsha Linehan: Cognitive-Behavioral Treatment of Borderline Personality Disorder)

Hey Monte...

The DBT program I went to required me to switch T's during my DBT treatment, because my T was not trained in DBT and I was entering an actual program.

I went twice a week, once for a one hour session with a primary T, which was one on one. We discussed what was going on in my life and how I was incorporating my DBT skills in to my experiences. We didn't do much Trauma work because the focus of DBT is to build the skills so you will have them ready when you do start to focus on the heavier, more traumatic things.

The second meeting was a two hour class with a small group of 8 people. This was the educational part of the class where we learned about all the different skills. We would get homework that we would have to do and we would do exercises during class as well.

Some private T's have training in DBT and can treat you privately, but IMO, finding a good, reputable program where you can get the classes as well is the best way to go. There are also some DBT workbooks that you can get from Amazon.com, or from other major book stores and you can read them from home.

If you switch T's to go through a program, you usually have the choice of going back to your original T or staying with your DBT T when you finish the program.

Hope this helps...