Dialectical Behavior Therapy
What Is DBT?
Dialectical Behavior Therapy (DBT) was developed to treat interpersonal chaos, intense emotional swings, impulsiveness, confusion about self-identity, and suicidal behavior. It was developed at the University of Washington by Marsha M. Linehan, Ph.D., ABPP, and is based on the theory that problems develop from the interaction of biological and environmental factors, which together create difficulty managing emotions.
DBT is appropriate for a range of problems that relate to emotion dysregulation, including substance use, eating disordered behavior, and anger-related issues. Research shows that DBT appears as effective or more effective than other psychotherapies for these kinds of problems.
The ultimate goal of DBT is to create a life worth living. To achieve this, the therapy balances empathy and warm acceptance with an unwavering focus on changing problem behavior (problem solving). Through this balance, DBT aims to help change the behavioral, emotional, and thinking patterns associated with problems in living, while promoting the development of and reliance on inner wisdom.
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DBT has been found to be the most helpful for problems related to the following:
- Rapidly shifting emotions that are difficult to manage
- Extreme emotional states that interfere with daily activities
- Impulsive behavior associated with emotional extremes including self-harm and suicidal behavior
- Difficulty managing and expressing anger
- Lack of a sense of self or identity
- Feelings of emptiness
- Difficulty in interpersonal relationships
There are two main elements of DBT:
Dialectics: DBT is based on the idea that opposites can coexist and be synthesized. This means weighing out various points of view in any situation and constantly working on balancing an effort to change things with accepting things as they are.
Behavior Therapy: Behavior therapy is based on the study of how things are learned. It focuses on helping people change ineffective ways of coping by learning new ways of coping and getting things done. It focuses on specific goals that can realistically be attained. For the most part, it is a "doing" therapy rather than a "talking" therapy.
Weekly individual psychotherapy:
- Areas of desired change are identified
- An understanding of what contributes to the problems and interferes with change is developed
- New and more effective alternatives are learned
- Individual sessions are approximately 50-minutes and meet once per week for one year
Skills training classes:
- Specific skills that are essential for managing emotional distress are learned
- Skills classes are two hours long and meet weekly for one year
Between-session coaching with therapist:
- This provides an opportunity for "real-life" coaching for using the skills being learned
Program Director and Supervisor
Jamie Bedics, Ph.D., ABPP, is the clinical supervisor and director of the dialectical behavior therapy training program at Cal Lutheran. He completed a clinical fellowship at the DBT Center of Seattle where he was trained by the leading experts and trainers in DBT. Over the past several years he has worked with the developer of DBT, Marsha Linehan, Ph.D., ABPP, on research examining the role of the therapeutic relationship in DBT. His current research interest involves the implementation and assessment of evidence-based psychotherapy training at the pre-doctoral level.