Dialectical Behavior Therapy Program

Dialectical Behavior Therapy (DBT) is a treatment shown by over 30 years of scientific research to be effective in resolving some of the most difficult behavioral and emotional problems, including severe mood problems, chaotic relationships, extremely poor focus or management of thoughts, very destructive impulses and behaviors, and poor sense of self.  People who struggle with suicidal ideation, multiple psychiatric hospitalizations, or other patterns of behavior that make it hard to lead a stable life may benefit from DBT more than typical treatments.

This is a comprehensive treatment program, meaning it addresses 5 areas:

1.) Enhancing Capabilities

DBT emphasizes teaching actual new behavioral skills people can use to be better at taking control of their emotions and urges, increasing the capacity to bear discomfort, improving things in their relationships, and building concentration, focus, and awareness. We assume that, while no one lacks all these skills, most everyone lacks some, and this is usually a major factor in people’s dysfunctional behavior patterns.  Usually, the most effective way to learn DBT skills is in DBT skills training group, which is a 2 hour class that takes place once per week.

2.) Generalizing Skills to Natural Environments

It isn’t enough just to learn the methods for being more effective in important areas of life. We have to make sure you can use those skills in real life when it matters most.  Therefore, people who go through DBT must be prepared to practice the new behaviors in all the areas they are needed! Not only do we provide structured ways to track your progress and practice efforts (worksheets, for example) we also expect that people in DBT will call their individual therapist for skills coaching between sessions.  This helps to ensure that when you are struggling to make your skills work in your daily life, you can get real-time feedback and tips to make sure you are able to be successful when it really counts.

3.) Enhancing Motivation

People who are in DBT are those whose problems are typically more complex and difficult to solve than ordinary psychotherapy sessions alone can accomplish. Frequently, people who find their way to DBT have tried and tried to get their goals met, with little success, in other, less intensive therapies.  This can be frustrating after awhile, and people tend to feel like quitting at times.  We expect that, with serious, complicated problems, the pace of change can be slower than many people would prefer, and therefore, we make it a point to focus on increasing motivation when it lapses.

4.) Structuring the Environment

It is very hard to hang onto the progress we make on our new behaviors when the environment around us can put up barriers or punish the more skillful ways of acting. In DBT, we pay particular attention to how the family systems, work or school environments, or other influences may be contributing to the problems, and we help the client to address these problems, so as to make it easier to be skillful! In addition, the environment of the treatment program, itself, has been developed to promote long term success for learning and sustaining more effective behaviors, including gaining control over emotions.

5.) Motivating and Improving the Skills of the Therapists

All treatment providers who are involved in DBT cases meet once per week to discuss problems in treatment, to share ideas, and to prevent burnout. This is called the DBT consultation team, and you will benefit from more than just one mind working on your case in this way! We place particular emphasis on training and staying current in research on the best and most effective ways to do treatment that works.

 

What is treatment in DBT like?


 

People who have fully engaged in the treatment program attend a skills training class once per week for 2 hours.  This class starts with a mindfulness practice, followed by homework review (what worked and what didn’t when each member tried their skill from last week), a brief break, and then new material is introduced, which is usually 1 new skill.  The group concludes with a “wind-down” practice.  Clients in full DBT also attend a 60-minute individual therapy session once per week as well.  This allows for more individualized and specific work on problem behaviors and what is causing them.  Also, any difficulties with the new, skillful behaviors can be worked through and corrected.  Finally, as mentioned above, clients contact their therapist, as needed, for coaching on the skills through the week and after clinic hours. Treatment usually lasts at least 1 year, although, for more complicated problems, the treatment may last longer.

 

How do I find out if DBT is right for me?


 

Very good information about DBT can be found on the internet. If you are looking to do more research about the treatment, a good place to begin is www.Behavioraltech.org.  Once you have decided to go further, contact Valley Health – East Huntington to set up an intake with one of our DBT providers. The DBT provider will ask you questions about your problems and symptoms and have you fill out some brief assessments. She will also talk to you further about the DBT program, your goals, and whether DBT is a good fit for you as well as answer any questions and address any concerns you may have.  To contact us, please call 304.339.3310 and mention you would like to discuss DBT with Dr. Fernandez.

 

Dialectical Behavior Therapy for Substance Use Disorders (DBT-SUD)


 

A special adaptation of DBT specifically created for treating chemical addictions (drug or alcohol abuse) is now available at Valley Health – Hurricane.  People who participate in DBT-SUD complete all of the same treatment components as people in regular DBT (see above), but DBT-SUD adds special skills and supports (including Suboxone, if indicated) that are shown by research to increase success in long-term recovery from addictions.

People who do well in DBT-SUD are those who, in addition to struggling with addictions, also deal with the same difficulties, challenges, and symptoms as those in standard DBT.  Thus, they may have frequent suicidal ideation, other self destructive behaviors, and very intense, difficult-to-manage emotions.  While most substance abuse recovery programs target a primary goal of eliminating use of substances, DBT-SUD may be needed for those whose lives remain deeply unsatisfying and chaotic, even in the absence of drug or alcohol addiction.

The ultimate goal of DBT treatment programs is to assist each client in building all the skills needed to experience their lives as worth living!

If you would like to learn more about DBT for Substance Use Disorders, please contact Martha Fernandez, PsyD, at Valley Health –  Hurricane, 304.760.6040.

 

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