What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy or DBT in a mindfulness-based, cognitive behavioral treatment that in its comprehensive form includes individual therapy sessions, skills training in groups, strategic coaching calls to apply skills, and family or agency support when needed. While recognized as the gold standard treatment for borderline personality disorder (BPD), research has shown that DBT is also effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

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Resources for families coping with mental and emotional disorders

TADBiT

Triangle Area DBT, or TADBiT, is a cooperative network of clinicians in the Triangle Area who are trained in Dialectical Behavior Therapy. Meggan Moorhead and Norma Safransky founded TADBiT in 1996 with the goal of promoting the use of Dialectical Behavior Therapy to treat disorders of emotion regulation in the Triangle (Raleigh, Durham, Chapel Hill, and surrounding counties).

What do I look for when seeking a DBT therapist?

Ideally, your therapist has significant experience in the application of DBT and has participated in a DBT Intensive (or equivalent training). It is essential that the therapist is on a DBT Team.
DBT is a comprehensive behavioral treatment that serves five functions.

DBT therapists help enhance the capabilities of their clients who lack needed behavioral skills.
DBT therapists help enhance the motivation by reducing or removing factors that detract from therapy success and increasing reinforcement of effective behaviors.
DBT therapists also reinforce generalization of skillful behaviors to the relevant needs of their clients' daily lives, at home and at work or school.
DBT therapists work with their clients to structure the client’s environment and intervene in their world in ways that effectively address the target behaviors.
DBT serves the function of enhancing therapist capabilities and motivation to decrease therapist burnout and increase the chances of therapy being successful.

To accomplish these five functions, DBT uses five modes: skills training group, individual therapy, telephone coaching of skills, agency/school collaboration or family interventions, therapy, skills training when appropriate, and therapist consultation teams.

How does the Family Skills Training and DBT Skills for Couples fit in the treatment model?

Family and Couples Skills classes serve to meet the function of increasing skillfulness, enhancing motivation, reinforcing generalization of skillful behaviors, while clearly structuring the environment such that family members have behavioral skills to more effectively support their loved one in standard DBT, as well as to more effectively regulate their own emotions. These classes are NOT a substitute for the yearlong standard DBT Skills Group. While graduates of DBT Skills Groups are welcome to come with their family members, the Family Skills Training and Skills for Couples classes are not recommended as the entry point for those beginning DBT.

Perry Hoffman and Alan Fruzzetti have pioneered the application of DBT with family members, as you can read in their chapter "Dialectical Behavior Therapy with Families" in Dialectical Behavior Therapy in Clinical Practice: Applications across Disorders and Settings [Linda A. Dimeff Phd, Kelly Koerner PhD, Marsha M. Linehan PhD]. The Family Connections Program they created provides these skills around the globe.

What is the format for Family Skills Training and DBT Skills for Couples classes?

Begin each class with an opportunity to build up our mindfulness skills with a mindful awareness practice that is relevant to the skills we are learning.
Homework review where each person get some supportive guidance and reinforcement on the skill that s/he practiced during the past week.
Explore the key teaching points of the new skill with roleplay and discussion.
We make a plan to practice this new skill and gather information on the results in the coming week.

How much do I have to share during the homework review?

You decide how personal you want to get. This is not individual or couple therapy where your being transparent may well serve you. In this group setting, our time is limited and our focus is on the goal of your learning, practicing, and eventually, generalizing each skill into your daily life.