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Dialectical Behavioral Therapy
DBT therapist in Boca Raton, BPD therapist in Boca Raton, Emotion regulation therapist in Boca Raton, teen therapist in Boca Raton, OCD therapy in Boca Raton, PTSD therapy in Boca Raton, Attachment therapy in Boca Raton, Abandonment therapy in Boca Raton
Dialectical Behavior Therapy (DBT) is a structured form of psychotherapy with a strong educational component designed to provide skills for managing intense emotions and negotiating social relationships. Originally developed to curb the self-destructive impulses of chronic suicidal patients/clients, it is also the treatment of choice for Borderline Personality Disorder (BPD), emotion dysregulation, and a growing array of psychiatric conditions such a Post Traumatic Stress Disorder (PTSD) & Obsessive Compulsive Disorder (OCD). DBT consists of group/individual instruction and individual therapy sessions, both conducted weekly for eight months to a year.
The “dialectic” in dialectical behavior therapy is an acknowledgment that real life is complex, and health is not a static thing but an ongoing process hammered out through a continuous Socratic dialogue with the self and others. It is continually aimed at balancing opposing forces and investigating the truth of powerful negative emotions. DBT acknowledges the need for change in a context of acceptance of situations and recognizes the constant flux of feelings, many of them contradictory without having to get caught up in them.
At Waves Therapy Group, DBT-informed strategies can be incorporated into individualized therapy to
help adolescents, young adults, and adults navigate emotional overwhelm, relationship difficulties, and
patterns of emotional reactivity. Learn more about emotion regulation therapy in Boca Raton and
discover how our therapists help clients develop practical skills for navigating life's challenges.
When Is DBT Used
With its strong emphasis on emotion regulation skills, DBT is one of the leading treatments used for a wide range of mental health conditions.
They include:
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Personality disorders, including Borderline Personality Disorder (BPD)
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Obsessive Compulsive Disorder (OCD)
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Bulimia
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Binge-Eating Disorder
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Substance Use Disorder
What To Expect
Expect a course of treatment that typically consists of a weekly group/individual, skill-focused psychoeducational session as well as an individual therapy session targeting behavioral urges to use old coping mechanisms derived from trauma and dysfunctional ways of navigating emotional responses.
Skills sessions in adherent DBT usually consisting of four to 10 people can also be adjusted to an individual skills session, and are designed to run for an hour or up to two hours depending on the structure (individual/group). In addition, clients typically have access to therapists between sessions for skills coaching if they are in a crisis. DBT is present-oriented and skills-based, and clients are asked to practice their skills between sessions. Clients can expect homework assignments, which reinforce the skills learned in the psychoeducational sessions.
Individual sessions usually last an hour, Clients are asked to keep a diary tracking their emotions and impulses, a tool that helps them gain awareness of their feelings, understand which situations are especially problematic for them, and use the information to gain control over their own behavior while also watching the patterns of their behavior for greater personal insight. Clients review difficult situations and feelings they faced the prior week and engage in problem solving by actively discussing ways of behaving that might have delivered a positive outcome.
DBT specifically focuses on providing
therapeutic skills in four key areas:
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Mindfulness: Encourages individuals to remain present in the moment while observing and accepting their emotions without judgment. By recognizing that emotions are temporary and do not have to dictate behavior, mindfulness helps reduce emotional reactivity, creating space to pause, respond intentionally, and access healthy coping strategies during distressing situations.
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Distress Tolerance: The ability to tolerate negative emotion rather than needing to escape from it or acting in ways that make difficult situations worse.
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Emotion Regulation: Strategies give individuals the power to manage and change intense emotions that are causing problems in their life.
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Interpersonal Effectiveness: Allowing a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships; a core principle is that learning how to ask directly for what you want diminishes resentment and hurt feelings.
DBT incorporates many of the techniques of cognitive behavioral therapy (CBT). It helps clients recognize and challenge the varieties of distorted thinking that underlie negative feelings and prompt unproductive behavior.
For example, clients learn to identify when they are catastrophizing assuming the worst will happen in order to avoid acting as if it were the case. They review their own past and present experience for instances of all-or-nothing thinking, seeing everything in extremes of
black or white, devoid of the nuance that
is more generally the nature of life.
How Dialectical Behavioral Therapy Works
DBT is focused on emotions and how they feed ineffectual action patterns. Many elements of the therapy are aimed at teaching patients how to recognize, understand, label, and regulate their emotions and how to handle interpersonal situations that give rise to negative or painful emotions.
Each week, for individual therapy sessions, patients complete a diary “card”, a self-monitoring form that tracks individualized treatment targets relating to moods, behavior, and skills. Patients identify and rate the intensity of emotions they experience each dayfear, shame, sadness, anger, pain, suicide attempts, and more and space is provided to discuss emotional experience in more detail if needed. In addition, using a checklist of skills which also serves as a handy reminder to deploy them patients note the frequency with which they engaged in positive practices, from self-soothing and radical acceptance to reducing vulnerability and acting in ways contrary to how they felt.
The information on the diary card lets the therapist know how to allocate session time.
Life-threatening or self-injurious behavior takes priority, not surprisingly. After identifying the behavioral targets for a session, the therapist helps the patient engage in behavioral analysis, figuring out what led to a specific problem situation the patient encountered, including any underlying beliefs or attitudes that surreptitiously reinforce the behavior, and discussing the consequences of the patient’s actions. The therapist and patient discuss more skillful
ways to solve emotional and life problems.
At Waves Therapy Group, we understand that DBT is a demanding therapy
to deliver even for experienced therapists, Our therapists use adherent DBT delivery
and are in consultation with a team and meet regularly. The team’s recommendations
are often applied in individual therapy sessions.
Learn more about our approach with DBT and emotion regulation therapy in Boca Raton.
References
Chapman AL. Dialectical Behavior Therapy: Current Indications and Unique Elements. Psychiatry. Sep 2006;3(9):62-68
Panos PT, Jackson JW, Hasan O, Panos A. Meta-analysis and systematic review assessing the efficacy of Dialectical Behavior Therapy (DBT). Research on Social Work Practice. 2014;24(2).
Valentine S, BankoffSM, Poulin RM, Reidler EB, Pantalone DW. The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology. Jan 2015;71(1):1-20.
Dialectical Behavior Therapy, Fact Sheet, The Association for Behavioral and Cognitive Therapists. https://www.abct.org/fact-sheets/dialectical-behavior-therapy/