
Dialectical Behavioral Therapy (DBT) Track at Enlightened Solutions
Dialectical Behavioral Therapy is a specific modality of therapy developed by Marsha Linehan in the late 1980s. Dr. Linehan originally developed DBT to treat people struggling with chronic suicidality and self-harm behaviors. Since its creation, DBT has also been shown to be evidenced-based and highly effective in treating a range of issues including complex trauma, borderline personality disorder, chronic suicidality, self-harm behavior, eating disorders, substance use disorders, dissociative disorders, mood disorders, and chronic emotional dysregulation.
DBT emphasizes the importance of learning and building new skill sets in order to address these issues and work toward “a life worth living”. DBT is a behavioral approach that focuses on targeting these problematic behaviors and building ways to change them.
DBT also takes the stance of understanding dialectics. A dialectic is when two things that are seemingly opposite can exist at the same time and find a synthesis. Many people with substance use disorders struggle with what is referred to as “dichotomous” or “black and white” thinking. Learning to understand and adopt a dialect stance helps us to stop fighting and being pulled between these opposite poles of thought.
DBT assumes that we act out on unhealthy and destructive behaviors as a maladaptive means of coping. Often times these behaviors do give us relief in the short-term but have serious long-term consequences, such as with substance use.
“DBT assumes that clients are doing the best they can, AND they need to learn new behaviors” 1
There are four skill sets taught in DBT. These are
1. Mindfulness:
Simply put, being aware and in the present non-judgmentally. Mindfulness is something we can practice anytime, anywhere. There are formal and more informal ways to practice mindfulness. Start out by just bringing awareness to where you are right now and what is happening both internally and externally.
2. Distress Tolerance:
Learning how to tolerate painful and upsetting experiences. In recovery, we are going to experience pain and difficult times. These skills help us to learn how to cope through these situations, without acting out on destructive or ineffective behaviors as we normally would.
3. Interpersonal Effectiveness:
Learning how to have healthier relationships with others, while maintaining self-respect and getting your needs met. Setting healthy limits and maintaining them can be challenging in all relationships. We need specific skills to begin to communicate more effectively.
4. Emotional Regulation:
Learning to change the emotions you would like to change. As human beings, we experience a range of emotions. These skills teach us how to respond to an emotional experience more effectively and change the ineffective response patterns we have relied on previously.
At Enlightened Solutions, skills are taught through specific DBT skills group. Clients committed to engaging in Dialectical Behavioral Therapy attend skills groups twice per week and will learn four new skills each week. Homework assignments will be given to help apply and reinforce the application of these new skills. Clients on the DBT track will also be assigned to a primary therapist training in DBT, who will work to reinforce these change strategies.
DBT used four modes/pillars in order to support clients in change. They are:
- Skills training group
- Individual Therapy
- Phone Coaching- (24/7 support available for coaching on the use of skills in difficult times)
- Consultation Team- (for clinicians on the treatment team to reinforce adherence to the model)
Enlightened Solutions clinical staff members have engaged in what is referred to as “foundational” DBT training.
Enlightened Solutions DBT track is “DBT adherent”, meaning rather than offering aspects of DBT sporadically into treatment, we incorporate the full, evidenced-based model, into all aspects of a client’s treatment.
1.behaviortech.org. Copyright 2017 Behavioral Tech.