Dialectical Behavior Therapy (DBT) is a treatment modality that was developed by Marsha Linehan to treat persons with Borderline Personality Disorder (BPD). DBT combines cognitive behavior techniques for emotion regulation and reality testing with concepts of mindfulness, distress tolerance, and acceptance. Dialectical Behavior Therapy has been the first therapy that has been experimentally demonstrated to be effective for treating Borderline Personality Disorder. Research has shown that Dialectical Behavior Therapy is also effective in treating clients who struggle with varied symptoms and behaviors associated with spectrum mood disorders as well as substance abuse. DBT is divided into four modules, each addressing key areas needed in recovery:
In Dialectical Behavior Therapy emotional intensity is rated on a Subjective Units of Distress Scale (SUDS), from 0-100. The lower the SUDS level, the less intense a client’s emotion. Once a client reaches a SUDS level of 70 or higher, a client is considered to be in emotional crisis. It is at this point that a client can no longer problem solve the issue but instead needs to focus on lowering their SUDS level. The distress tolerance module is designed to help clients do just that. Distress tolerance skills are aimed to help clients learn how to tolerate a crisis situation utilizing different coping skills as well as helping clients learn how to accept life on life’s terms. The module utilizes a variety of coping skills, all of which are utilized in treatment at BlueSky.
The emotional regulation module is designed to help clients problem solve their emotions when they are SUDS level is below a 70. This module has three main goals. The first goal is to teach clients to understand their emotions. The second goal is to allow clients to learn new skills that will help them to decrease emotional sensitivity. The final goal of the module is to teach clients new treatment that will allow them to decrease emotional sensitivity. Each of these goals allows clients a new way to look at processing their emotions with a new set of coping skills.
A large area where many clients at BlueSky struggle is communicating their needs with those around them. The Dialectical Behavior Therapy interpersonal effectiveness module teaches clients appropriate ways to advocate for themselves. The skills in this module instruct clients how to get their needs met while keeping relationships and maintain self-respect. Many clients who come to BlueSky struggle with “asking for what they want” or saying “no” to those around them. Interpersonal effectiveness in DBT utilizes three treatment acronyms breaking down ways clients can improve their communication with those around them.
The mindfulness module of DBT is the shortest module in Dialectical Behavior Therapy, yet it is often the hardest for clients to master. Mindfulness is the practice of being aware and staying in the present moment. Many clients at Blue Sky struggle with ruminating thoughts or cravings, making it extremely difficult to stay in the moment. Through the DBT module of mindfulness, clients are taught two major skill sets allowing clients concrete tools that will help them stay in the moment.
Dialectical Behavior Therapy at BlueSky is made up of two components. The first is an individual component. All therapists at BlueSky are familiar with DBT and utilize this training with clients in individual therapy. Using Dialectical Behavior Therapy diary cards allows our clients to get an individualized approach. These diary cards are used each and every week in order to obtain information on a daily basis about relevant emotions and behaviors. Tracking emotions and behaviors allows the client and their therapist to process patterns of thinking and behaviors. Individualizing DBT also allows for clients to spend more time learning this type of treatment.
The second component of Dialectical Behavior Therapy treatment at BlueSky is the group therapy approach. Dialectical Behavior Therapy groups are offered four days a week at BlueSky. Mondays and Thursdays are skills-based DBT groups. In these groups, clients are taught specific Dialectical Behavior Therapy skills and how to apply them. On Wednesdays, clients participate in a DBT activity group. This group focuses on teaching clients how to apply DBT treatment into their lives. There is also a DBT weekend group offered at BlueSky. This group is aimed at helping clients plan for their weekend while identifying what DBT skills they can practice throughout the weekend. Individual Dialectical Behavior Therapy tutoring is also available.
The ultimate goal of BlueSky treatment is to help our clients replace negative coping skills with positive ones. DBT groups are part of a continuum of groups that focus on skills training and the processing of emotions. The individuals in these treatment groups examine specific issues relation to the individual’s past, the associate feelings, and its impact on current behavior. Dialectical Behavior Therapy treatment at BlueSky provides a behavior therapy approach that has been proven to be effective with those who are struggling with mental illness and addiction.