What is DBT?

DBT treatment is comprehensive for individuals who have a complexity of problems, needs, symptoms, and diagnoses. DBT excels in treating a variety of severe, problematic behaviors, pervasive emotional difficulties, and many diagnoses. It treats problems and symptoms including suicidal behavior and thinking, self-injurious behaviors, repetitive exposure to severe abuse, neglect, and other trauma. Although the original target population were women with chronic suicidality, it has since been implemented with other populations including females, gender nonbinary, and transgender individuals, It has been carefully adapted for adapted adolescents and their families (DBT-A). And, due its research demonstrating highly effective outcomes, it has been implemented into higher levels of care besides outpatient including partial programs, residential, and inpatient psychiatric settings. It has also been implemented into juvenile justice systems and correctional settings. 

DBT is a multi-component treatment consisting of individual therapy, skills training (typically with a group of individuals), skills coaching, and provider consultation team. DBT skills are broken down into 4 modules which are core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. DBT-A includes multifamily skills training, including parents and caregivers as well as family therapy. Also, an additional module called the middle path is added to skills training. Components of this module can be found under interpersonal effectiveness in the adult model. 

Why DBT?

DBT is comprehensive and can be considered a holistic treatment for individuals who have a complexity of problems, needs, symptoms, and diagnoses. Treatment does not need to be pieced together. Instead, clients can obtain most treatment within one treatment team. DBT therapists tread where other therapists may fear to tread.  It often is utilized when CBT or other short term treatments, which tend to be problem-specific, are exhausted.  The ultimate goal of DBT is to build an effective and healthy life worth living.  The rest of the treatment goals are to help individuals achieve this.

There has been extensive research conducted including over 60 “randomized control trials” (“RCTs” are the gold standard in clinical research).  Through a meta-analysis, which is an analysis of many research studies, it is proven to be the leading treatment for adults and adolescents with suicidal and non-suicidal self-injurious behaviors in the world. 

Some specifics of the proven outcomes are reducing suicidal behavior, psychiatric hospital admissions, days in hospitals, non-suicidal self-injury, binge-eating, bulimia nervosa, substance abuse, and addiction with multiple specific studies on opioid addiction. 

After repeated positive outcomes in multiple randomized controlled trials (gold standard of research) in outpatient settings, it was adapted with care for acute inpatient hospitals, long-term hospital settings, campus-based and community residential treatment settings, and partial hospital programs.   

It has been skillfully adapted for adolescents and families (DBT-A) in an outpatient setting and later in other levels of care such as community residential programs and in secondary education targeting all students and therapeutic educational programs. In summary, DBT is a versatile treatment that can be adapted with care while also maintaining fidelity.

In summary, the dialectical approach is to provide treatment to reduce and prevent the need for higher levels of care and to provide more skills to reduce and prevent readmission to higher levels of care.

How to obtain DBT?

Training and consultation packages are tailored to customer’s goals. They are available for multidisciplinary audiences found in higher levels of care. In higher levels of care, DBT is integrated beyond formal therapy sessions with therapists. All providers will obtain a comprehensive foundation of DBT including all DBT skills, application of skills both in therapy, milieu and skills training/group settings, and team development for multidisciplinary providers. 

See below for which training approach and package is best suited for you and your agency or schools.