Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) is a highly practical, evidence-based direct form of therapy developed by Marsha Linehan, Ph.D. DBT emphasizes working toward the life you want to live by integrating acceptance and change with cognitive behavior therapy (CBT) and mindfulness.
This approach is highly effective for adults and adolescents who have difficulty regulating or managing intense emotions. DBT validates the difficulty of having painful and intense emotions while also supporting your desire to make important behavioral changes.
This approach is highly effective for adults and adolescents who have difficulty regulating or managing intense emotions. DBT validates the difficulty of having painful and intense emotions while also supporting your desire to make important behavioral changes.
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Village Counseling Services has the longest running comprehensive Dialectical Behavior Therapy (DBT) program in central New Jersey. To uphold the integrity of the DBT treatment model, the program features a structured and selective intake process and all members of the DBT Consultation Team have been intensively trained. The team provides each client with intensive, individualized treatment by maintaining a small therapist-to-client ratio, and by offering DBT skills training in small groups. The DBT program provides services to children ages 9 to 13, adolescents ages 14 to 18, adults, and family members, offering several DBT skills groups per week.
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Dialectical Behavior Therapy (DBT) was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as:
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Substance Dependence and Addiction
Depression Bipolar Disorder Post-Traumatic Stress Disorder (PTSD) Obsessive Compulsive Disorder (OCD) and other anxiety disorders Anorexia, Bulimia, and Binge Eating Disorder |
Through the DBT program you will learn to:
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Control your emotions, instead of your emotions controlling you; reduce and then eliminate life-threatening behaviors; decrease behaviors that destroy the quality of your life and build a life worth living; focus on the present moment; notice judgments and practice acceptance of reality; preserve worthwhile relationships and end destructive ones; tolerate distress and get “unstuck” from extreme views; experience feelings without dissociating or avoiding life; build an ordinary life and solve ordinary problems; reach a more stable sense of self; move from incompleteness to completeness; and feel connected.
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What are the components of DBT?
The clinicians at Village Counseling Services, P.C. offer the unmodified form of DBT in which there are four components: skills training group, individual treatment, DBT phone coaching, and consultation team.
The clinicians at Village Counseling Services, P.C. offer the unmodified form of DBT in which there are four components: skills training group, individual treatment, DBT phone coaching, and consultation team.
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DBT skills training group is focused on enhancing our 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 our clients to practice using the skills in their everyday lives. Groups meet on a weekly basis and it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year program. We offer Adult, Adolescent, Family and Advanced Skills Training Groups. Click here to see our weekly schedule.
DBT individual therapy is focused on enhancing our client’s motivation and helping them to apply the skills to specific challenges and events in their lives. Individual therapy takes place once a week for as long as the client is in therapy and runs concurrently with skills groups. DBT phone coaching is focused on providing clients with in-the-moment coaching on how to use skills to effectively cope with difficult situations that arise in their everyday lives. Clients can call their individual therapist between sessions to receive coaching at the times when they need help the most. DBT therapist consultation team is intended to be therapy for the therapists and to support the DBT providers in their work with people who often have severe, complex, difficult-to-treat disorders. The consultation team is designed to help the therapists stay motivated and competent so they can provide the best treatment possible. Teams typically meet weekly and are composed of individual therapists and group leaders who share responsibility for each client's care. Each member of our team has been intensively trained. |
What skills are taught in DBT?
DBT includes four sets of behavioral skills.
Mindfulness:
The practice of being fully aware and present in this one moment.
Distress Tolerance:
How to tolerate pain in difficult situations, not change it.
Interpersonal Effectiveness:
How to ask for what you want and say no while maintaining self-respect and relationships with others.
Emotion Regulation:
How to change emotions that you want to change.
What does "dialectical" mean?
The term "dialectical" means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, we accept our clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).
How does DBT prioritize treatment targets?
Our clients who receive DBT typically have multiple problems that require treatment. DBT uses a hierarchy of treatment targets to help our therapist determine the order in which problems should be addressed.
The treatment targets in order of priority are:
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1. Life-threatening behaviors:
First and foremost, behaviors that could lead to a client's death are targeted, including all forms of suicidal and non-suicidal self-injury, suicidal ideation, suicide communications, and other behaviors engaged in for the purpose of causing bodily harm. 2. Therapy-interfering behaviors: This includes any behavior that interferes with a client receiving effective treatment. These behaviors can be on the part of a client and/or a therapist, such as coming late to sessions, cancelling appointments, and being non-collaborative in working towards treatment goals. 3. Quality of life behaviors: This category includes any other type of behavior that interferes with a clients having a reasonable quality of life, such as mental disorders, relationship problems, and financial or housing crises. 4. Skills acquisition: This refers to the need for clients to learn new skillful behaviors to replace ineffective behaviors and help them achieve their goals. |
What are the stages of treatment in DBT?
DBT is divided into four stages of treatment. Stages are defined by the severity of a client's behaviors, and the therapists work with their clients to reach the goals of each stage in their progress toward having a life that they experience as worth living.
In Stage 1, the client is miserable and their behavior is out of control: they may be trying to kill themselves, self-harming, using drugs and alcohol, and/or engaging in other types of self-destructive behaviors. When the client first starts DBT treatment, they often describe their experience of their mental illness as "being in hell." The goal of Stage 1 is for the client to move from being out of control to achieving behavioral control.
In Stage 2, they're living a life of quiet desperation: their behavior is under control but they continue to suffer, often due to past trauma and invalidation. Their emotional experience is inhibited. The goal of Stage 2 is to help the client move from a state of quiet desperation to one of full emotional experiencing. This is the stage in which post-traumatic stress disorder (PTSD) would be treated.
In Stage 3, the challenge 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, finding a deeper meaning through a spiritual existence is for a client for whom a life of ordinary happiness and unhappiness fails to meet a further goal of spiritual fulfillment or a sense of connectedness of a greater whole. In this stage, the goal of treatment is for the client to move from a sense of incompleteness towards a life that involves an ongoing capacity for experiences of joy and freedom. This stage is not needed for all of the clients.
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, and depression and improving social and global functioning. For a review of the research on DBT, watch the video below. In this video, DBT Developer, Dr. Marsha Linehan, describes the amazing changes she's seen in people who have received DBT and gotten out of hell.
DBT is divided into four stages of treatment. Stages are defined by the severity of a client's behaviors, and the therapists work with their clients to reach the goals of each stage in their progress toward having a life that they experience as worth living.
In Stage 1, the client is miserable and their behavior is out of control: they may be trying to kill themselves, self-harming, using drugs and alcohol, and/or engaging in other types of self-destructive behaviors. When the client first starts DBT treatment, they often describe their experience of their mental illness as "being in hell." The goal of Stage 1 is for the client to move from being out of control to achieving behavioral control.
In Stage 2, they're living a life of quiet desperation: their behavior is under control but they continue to suffer, often due to past trauma and invalidation. Their emotional experience is inhibited. The goal of Stage 2 is to help the client move from a state of quiet desperation to one of full emotional experiencing. This is the stage in which post-traumatic stress disorder (PTSD) would be treated.
In Stage 3, the challenge 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, finding a deeper meaning through a spiritual existence is for a client for whom a life of ordinary happiness and unhappiness fails to meet a further goal of spiritual fulfillment or a sense of connectedness of a greater whole. In this stage, the goal of treatment is for the client to move from a sense of incompleteness towards a life that involves an ongoing capacity for experiences of joy and freedom. This stage is not needed for all of the clients.
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, and depression and improving social and global functioning. For a review of the research on DBT, watch the video below. In this video, DBT Developer, Dr. Marsha Linehan, describes the amazing changes she's seen in people who have received DBT and gotten out of hell.
Watch From Chaos to Freedom: Getting Through a Crisis Without Making it Worse, by Marsha Linehan
How to Make an Appointment
Complete an intake online or call 609-844-0452, extension 713 to schedule an intake. We accept most insurance.
Complete an intake online or call 609-844-0452, extension 713 to schedule an intake. We accept most insurance.