What is DBT?

Dialectical behavior therapy, DBT for short, is a type of therapy that derived from cognitive-behavioral therapy. Its main goals are to teach people how to live in the moment, cope healthily with stress, regulate emotions, and improve relationships with others.

It was originally intended for people with borderline personality disorder (BPD) but has since been adapted for other conditions where the patient exhibits self-destructive behavior, such as eating disorders and substance abuse. It is also sometimes used to treat post-traumatic stress disorder.

Mindfulness

Mindfulness skills, which is perhaps the most important strategy in DBT, teaches you to focus on the present or “live in the moment.” By doing this, we can learn to pay attention to what's going on inside of us (thoughts, feelings, sensations, impulses) as well as what's outside of us (what we see, hear, smell, taste, and touch). These skills will help us slow down so we can better focus on healthy coping skills in the midst of emotional pain. Mindfulness also helps us stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior.

Distress Tolerance

Distress tolerance teaches us to accept ourselves and whatever our current situation is. More specifically, we learn how to tolerate or survive crises using four techniques: distraction, self-soothing, improving the moment, and thinking of pros and cons. By learning distress tolerance techniques, we'll be able to better prepare in advance for any difficult situations we might encounter and cope with them with a more positive long-term outlook.

Emotion Regulation

Emotion regulation provides a set of skills that help to keep our emotional system healthy and functioning. It will teach us how to adjust our ever-changing emotions, including the intensity, when we have them, and how we react to them. By recognizing and coping with negative emotions (for example, anger or depression), we can reduce our emotional vulnerability and have more positive emotional experiences.

Interpersonal Effectiveness

Interpersonal effectiveness helps us to become more assertive in a relationship (for example, expressing needs and saying "no") while still keeping that relationship positive and healthy. This happens by learning to listen and communicate effectively, deal with difficult people, and respect ourselves and others.

WMC's 30-Week Curriculum

Week 1-6: Mindfulness
- Week 1: Intro to DBT and Mindfulness
- Week 2: Mindful of Inner Critic
- Week 3: Wise Mind
- Week 4: Non-judgemental Stance
- Week 5: Cognitive Distortions
- Week 6: Pocket Mindfulness Exercises

Week 7-12: Distress Tolerance
- Week 7: Distress Tolerance Pocket Skills
- Week 8: 5 Senses
- Week 9: Perception: Making Lemonade from Lemons
- Week 10: Positive coping thoughts
- Week 11: Coping Ahead
- Week 12: Radical Acceptance

Week 13-18: Emotion Regulation

Week 13: Intro to Emotions
Week 14: Alternate Rebellion
Week 15: Physical Vulnerabilities to Emotions
Week 16: Opposite Action
Week 17: Big Picture/Checking the Facts
Week 18: Problem-Solving and Behavior Analysis

Week 19-25: Interpersonal Effectiveness

Week 19: Skills Inventory and Style
Week 20: Emotional Bank Account
Week 21: DEARMAN
Week 22: Setting and Respecting Boundaries
Week 23: Saying “No” and Setting Boundaries
Week 24: How to Receive Feedback in Healthy Ways
Week 25: Blocks to Interpersonal Effectiveness Skills

Week 26-30: Miscellaneous DBT skills

Week 26: Relapse Prevention Plan
Week 27: Dialectical Abstinence
Week 28: Borderline Personality Review
Week 29: Building Mastery
Week 30: Behavioral Chain Analysis

Phone Coaching

Phone coaching is a pivotal element of DBT treatment. DBT therapists are available for phone coaching throughout the course of therapy. You will be encouraged to text/call your therapist when you're in need of help or extra support and in moments of crisis. During the conversation, your therapist will help talk you through the situation, offer support, and help manage self-harm urges/destructive or dangerous actions by way of using DBT skills. The idea is to work with you to use the skills you've learned to handle the situation or crisis appropriately- in real time! Beyond preventing self-harming behaviors, phone coaching will help you navigate difficult experiences and provide encouragement and validation during these times. Through coaching, your skills will be reinforced. Just like coaching helps an athlete, phone coaching allows you to master the techniques you've learned and apply them to real life. This empowers you to handle these situations confidently and eventually be able to get through them alone!

Treatment Teams

In DBT, we like to view our approach to getting better like one would view a football team all working together to score a touchdown! Treatment teams are DBT’s way of collaborating regularly with a client’s providers (including their psychiatrist, sober coach, physician, and parents, if needed) along with the client to work towards meeting with client’s goals. The client plays a vital role in treatment teams, since it is their life, and they get to decide what goals they want to work towards, and how they want to achieve them. WMC loves to collaborate with other professionals and families, which often serves as a great way to help clients heal. You know what they say...it takes a village!