FAQ’s about DBT Treatment
[The information provided below is derived from an interview with Dr. Hellkamp Ph.D. of Xavier University, Emeritus and LakeWest DBT Center therapists.]
Q: What is DBT?
A: While initially developed for suicidal and self-harming behaviors, Dialectical Behavior Therapy, commonly known as DBT, has been shown to be effective in treating a range of symptoms. DBT is used to treat concerns including anger, eating disorders, substance use, trauma-related symptoms, anxiety, and other behaviors involving difficulty regulating emotion. DBT is a well-researched, evidence-based treatment program that aims to help individuals develop and enhance their lives worth living.
DBT was developed by psychologist, Marsha Linehan. It is within the family of psychotherapy and was created as a branch of CBT (cognitive behavioral therapy), however, it is a more comprehensive and holistic approach.
DBT uses a skills-based approach to teach you how to manage your emotions and handle distress to avoid harmful behaviors. This therapy includes group and individual therapy and phone coaching. A key component of DBT therapy is the ability to contact your therapist outside of session time for coaching in the moment.
Q: Who can best benefit from DBT treatment?
A: DBT is effective for those diagnosed with borderline personality disorder, which involves frequent emotional dysregulation. Based on this success, the therapy has also proven to be beneficial in treating other diagnoses that encompass similar emotional dysregulation such as: anxiety, depression, substance abuse, post-traumatic stress, eating disorders, anger issues. As it has developed, the scope of DBT has been expanded to treat more types of mental health conditions and found to be successful for teens and their families.
Q: What does “dialectical” mean?
A: The term “dialectical” refers to the opposing approaches to a conflict, hoping to arrive at the best option. In other words, two things that seem completely opposite can both be true. An example of this is, “I want my child to go to college, get a good education, and be independent. I also want them to live with me where I can support them and where they can have access to the therapy that they need.” These viewpoints have completely opposite outcomes, but they are equally true to the individual. It is acceptable and commonplace to have very conflicting yet equally strong emotions about things that seem opposite.
DBT is based on the idea that opposites can coexist and be synthesized. This means weighing our various points of view in any situation and constantly working on balancing in an effort to change things along with accepting things as they are.
Q: What is the goal of DBT?
A: The main goal of DBT is balancing acceptance and change to build a life worth living. An objective of DBT is to replace harmful coping mechanisms with helpful ones.
Q: What is a coping mechanism?
A: A coping mechanism is a physical way to deal with emotional issues. There are harmful coping mechanisms such as abusing drugs or alcohol, and there are positive coping mechanisms including journaling, relaxation techniques, reading, listening to music, etc.
Q: What are some of the techniques taught/reinforced in DBT?
A: The DBT skills program for teens consists of five modules: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path. Each skill is a tool you can use to navigate situations that cause high anxiety. LakeWest offers separate programs for adolescents and adults that have slight differences in the skills modules to be taught.
One of the unique factors of DBT skills is the use of Eastern mindfulness practices. It goes beyond thinking patterns (like you might see in CBT) and moves into thinking and practicing. You can see it as more of a holistic approach to the mind. It helps you balance acceptance and change, hence the term “dialectical.”
Examples of other skills incorporated into the five skill modules above include:
Radical Acceptance: Accepting painful things that are unchangeable about your life and yourself, which includes doing things you do not want to do. For instance, you do not want to go to class and finish high school, but it is required to go to college.
Ride the Wave: When certain emotions or experiences feel very overwhelming, sometimes you just have to experience every emotion and go right through it because that is the most efficient way to achieve the desired result.
Other techniques utilized in DBT therapy include: meditation, raising self-esteem and promoting a positive self-image, formation of healthy coping mechanisms and effective communication tools.
Q: How do I know DBT is working for me?
A: Assessing whether DBT is working for you can be challenging —this is true for all therapeutic regimens. However, it is common for the therapist to be able to notice the minor changes and little accomplishments that the patient may not immediately recognize in themselves. The therapeutic relationship is important in this regard. Another sign of progress is when a patient finds it easier to participate in things that they previously avoided or struggled to do.
Q: Is DBT considered an intensive therapy?
A: Therapy is intensive by nature, but DBT is not more intense than other modalities. It is comprehensive, but is provided in an outpatient setting, allowing adults and adolescents to continue living their lives while receiving treatment.
Q: What is the best way to embrace DBT as a family member?
A: You can best support your family member by supporting their positive behaviors and celebrating what they accomplish, no matter how small. Participation in family sessions and coaching offered by your DBT therapist can be crucial to recovery.
Researching DBT and your family member’s condition is another way to better understand what they are going through and how you may be able to help them. Understanding how DBT works may also provide you with more confidence and trust in what your family member is working through and why. Finding accurate information can be challenging. You are welcome to reach out to LakeWest DBT https://www.lakewestdbtcenter.com/ for the best resources.
Q: What questions should an individual or their parent/guardian ask when interviewing a potential therapist?
A: Asking the clinician about their training and the techniques they use is a good way to determine the type of therapy you/your child will receive. You may wish to ask if they have experience treating the issues your family is experiencing and if they believe their treatment modes will sufficiently serve you/ your adolescent. Asking about billing, availability, and whether the provider sees clients in person or virtually are also important.
It is also important to ask if the clinic/clinician provides “adherent DBT,” meaning all four modes of treatment (individual therapy, skills group, phone coaching, and treatment team) and if providers have successfully completed DBT training. Other logistical questions that are important include: how quickly you will be able to get started, the cost and length of treatment, if the sessions will be virtual or in person or both, and the group size and who attends the group.
Q: What kind of information should you be prepared for a prospective therapist to ask you?
A: Typically, clinics/clinicians will ask: how you were referred for treatment, for a summary of the presenting problems you (and your teen, if applicable) have been dealing with, the age of your child (if applicable), and what treatment you (or your teen) has received in the past or currently. They will likely discuss availability, the group schedule, and starting the intake process.
More information regarding Dialectical Behavior Therapy may be accessed at https://www.lakewestdbtcenter.com/
