What is Dialectical Behavioral Therapy ?
Dialectical Behavior Therapy (DBT) is a skill-building therapeutic approach developed in the 1970s by Marsha Linehan, PhD. DBT was originally developed for the treatment of Borderline Personality Disorder (BPD). Research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. Research indicates that, through DBT therapy and DBT skills groups, you can learn healthy coping skills that can help you to make a lasting recovery from your psychiatric disorder or addiction. The overall goal of DBT skills training is to help individuals change behavioral, emotional, thinking, and interpersonal patterns associated with problems in living.
What is the goal of DBT Treatment?
The goal in DBT is to help each client achieve a “life worth living.” What makes a life worth living varies from client to client, but the first step for each client is to bring life-threatening behaviors under control. After this, the focus is on therapy interfering behaviors; and finally, the therapeutic focus shifts to improving quality of life.
What is Dialectics
Dialectics: DBT is based on the idea that opposites can coexist and be integrated. Thinking dialectically means recognizing that both points of view in any situation are valid and means constantly working on balancing change and acceptance.
What are the Methods of Treatment ?
Dialectical Behavior Therapy uses three methods of treatment: individual DBT therapy, DBT skills groups, and phone coaching
DBT Skills training group
DBT skills training group is focused on enhancing clients' capabilities by teaching them behavioral skills. The group is run like a class where the group leader teaches the skills and assigns homework for clients to practice using the skills in their everyday lives. Groups meet on a weekly basis for approximately 2 hours and it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year program.
What Are The Stages of the Treatment ?
DBT is divided into four stages of treatment:
In Stage 1, the client is miserable and their behavior is out of control: cutting, self - harming, drinking, using alcohol or drugs and engaging any other self - destructive behavior that increase depression and anxiety. Progress cannot be made on underlying emotional issues until you have the skill to manage emotion without engaging in dangerous behaviors and are committed to the process of therapy.
In Stage 2, quiet desperation: their behavior is under control but they continue to suffer, often due to past trauma and invalidation. Their emotional experience is suppressed. The goal of Stage 2 is to help the client move from a state of quiet desperation to one of full emotional experiencing.
In Stage 3, the inquiring is to learn to live: to define life goals, build self-respect, and find peace and happiness. The goal is that the client leads a life of ordinary happiness and unhappiness.
In Stage 4 clients move from a sense of incompleteness towards a life that involves an ongoing capacity for experiences of joy and freedom, a way to feel a sense of connection to others and the world around them.
How effective is DBT?
Research has shown DBT to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, depression and improving social and global functioning.
Consultation Team for Therapists
A therapist’s work can be difficult for many reasons. The DBT consultation team is essential to help therapists monitor their fidelity to the treatment, develop and increase their skills, and sustain their motivation to work with high-risk, difficult-to-treat clients .What is Dialectical Behavior Therapy (DBT)? – Behavioral Tech
What is EMDR therapy ?
Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method proven to help people recover from trauma and other distressing life experiences, including PTSD, anxiety, depression, and panic disorders.(About EMDR Therapy - EMDR International Association (emdria.org)
How is EMDR therapy different from other therapies?
EMDR therapy does not require talking in detail about the distressing issue or completing homework between sessions. EMDR therapy, rather than focusing on changing the emotions, thoughts, or behaviors resulting from the distressing issue, allows the brain to resume its natural healing process.
EMDR therapy is designed to resolve unprocessed traumatic memories in the brain. For many clients, EMDR therapy can be completed in fewer sessions than other psychotherapies. (About EMDR Therapy - EMDR International Association (emdria.org)
How does EMDR therapy affects the brain?.
Our brains have a natural way to recover from traumatic memories and events. This process involves communication between the amygdala (the alarm signal for stressful events), the hippocampus (which assists with learning, including memories about safety and danger), and the prefrontal cortex (which analyzes and controls behavior and emotion). While many times traumatic experiences can be managed and resolved spontaneously, they may not be processed without help.
Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create an overwhelming feeling of being back in that moment, or of being “frozen in time.” EMDR therapy helps the brain process these memories, and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved. About EMDR Therapy - EMDR International Association (emdria.org)
Who can benefit from EMDR therapy ?
Our brains have a natural way to recover from traumatic memories and events. This process involves communication between the amygdala (the alarm signal for stressful events), the hippocampus (which assists with learning, including memories about safety and danger), and the prefrontal cortex (which analyzes and controls behavior and emotion). While many times traumatic experiences can be managed and resolved spontaneously, they may not be processed without help.
Stress responses are part of our natural fight, flight, or freeze instincts. When distress from a disturbing event remains, the upsetting images, thoughts, and emotions may create an overwhelming feeling of being back in that moment, or of being “frozen in time.” EMDR therapy helps the brain process these memories, and allows normal healing to resume. The experience is still remembered, but the fight, flight, or freeze response from the original event is resolved. About EMDR Therapy - EMDR International Association (emdria.org)
How did EMDR therapy start?
In the late 1980s, Francine Shapiro discovered a connection between eye movement and persistent upsetting memories. With this personal insight, she began what became a lifelong study and development of Eye Movement Desensitization and Reprocessing (EMDR) therapy.
Over the years, and in the face of initial skepticism, Dr. Shapiro’s work developed from a hypothesis to a formal therapy process. EMDR therapy has been demonstrated to be effective for treating trauma in randomized clinical trials, case studies, and millions of clinical hours treating trauma and trauma-related disorders across the globe. From the American Psychiatric Association, the U.S. Department of Veterans Affairs (USVA) and Department of Defense (USDOD), the United Kingdom’s National Institute for Health Care and Excellence (NICE), and the World Health Organization (WHO), multiple global organizations now recognize the effectiveness of EMDR therapy that Dr. Shapiro developed. Most recently, the public acceptance of EMDR therapy was illustrated when Prince Harry reported that he engaged in EMDR therapy to treat trauma from his childhood.
Dr. Shapiro encouraged the foundation of EMDRIA, which comprises more than 11,000 mental health professionals who use EMDR therapy in their clinical practice to treat many conditions that impact mental health. Dr. Shapiro died in 2019, but her legacy of trauma-informed mental health care lives on in the EMDR therapists, researchers, and patients for whom EMDR therapy heals. About EMDR Therapy - EMDR International Association (emdria.org)
What about medication vs. psychotherapy?
It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness. Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action.
Do you take insurance, and how does that work?
To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them. Check your coverage carefully and make sure you understand their answers. Some helpful questions you can ask them:
- What are my mental health benefits?
- What is the coverage amount per therapy session?
- How many therapy sessions does my plan cover?
- How much does my insurance pay for an out-of-network provider?
- Is approval required from my primary care physician?
Does what we talk about in therapy remain confidential?
Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office. Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone. This is called “Informed Consent”. Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.
Confidentiality & Privacy Policy
The law protects the relationship between a client and a psychotherapist, and information cannot be disclosed without written permission.
Exceptions include:
- Suspected child abuse, dependent adult or elder abuse, for which I am required by law to report immediately to the appropriate authorities
- If a client is threatening serious bodily harm to another person/s, I must notify the police and inform the intended victim.
- If a client intends to harm himself or herself, I will make every effort to enlist their cooperation in ensuring their safety. If they do not cooperate, I will take further measures without their permission that are provided to me by law in order to ensure their safety.