WHAT IS DBT?

DBT is an evidence based treatment designed to help manage impulsive behaviors, emotional responses, and self-destructive urges. DBT was originally developed by Marsha Linehan, Ph.D., ABPP, as a comprehensive cognitive-behavioral treatment. 

Empirical research has shown that DBT can also help address a variety of other concerns including eating disorders, anxiety disorders, and mood disorders. DBT skills can help you manage stress and live a healthier, more meaningful life.

DBT focuses on the acquisition of 4 critical skill sets: Mindfulness, Distress Tolerance, Emotion regulation, and
Interpersonal effectiveness.

DBT FREQUENTLY ASKED QUESTIONS

A dialectical approach aims to achieve a synthesis among seemingly opposite positions. A core "dialectical dilemma" in DBT is the need to combine acceptance and change. 

DBT teaches us that hospitalization is avoided whenever possible. DBT is very similar to a rehabilitative model. It suggests it is most effective to keep individuals in their stressful environments and help them cope with life as it is.

Individuals are not less likely to attempt suicide if they are hospitalized.

In the DBT Program at Potomac Behavioral Solutions, acute hospitalization is extremely rare (i.e., < 5 participant/year) even for individuals who experience Target 1 Behaviors such as suicidal ideation and self-harm.

To date, there is no empirical data to suggest that acute inpatient hospitalization is effective in reducing suicide risk, even for individuals considered "high risk."

YES! BehavioralTech.org consolidated the following research:

Accumulating evidence indicates that DBT reduces the cost of treatment. For example, the American Psychiatric Association (1998) estimated that DBT decreased costs by 56% – when comparing the treatment year with the year prior to treatment – in a community-based program. In particular, reductions were evident by decreased face-to-face emergency services contact (80%), hospital days (77%), partial hospitalizations (76%), and crises bed days (56%). The decrease in hospital costs (~$26,000 per client) far outweighed the outpatient services cost increase (~$6,500 per client).

What do I need to know if I refer someone to DBT?

"CONSULTATION-TO-THE-PATIENT" 

According to Linehan (1993), the consultation-to-the-patient approach is "quite different from, and sometimes diametrically opposite to, the behaviors expected of mental health professionals." Unlike the traditional medical model, "the role of the therapist is to consult with the patient about how to manage other people, rather than to consult with others about how to manage or treat the patient" (Linehan, 1993, p. 411). "The consultation-to-the-patient approach is designed to make sure that if the individual [patient] is not the expert on herself now, she becomes the expert" (Linehan, 1993, p. 422). In other words, DBT providers do not intervene or solve problems for the patient. Because of this approach, our Providers do not speak to family members or other treatment providers without the individual patient being present for or leading the conversation.

PAUSING TREATMENT WITH OTHER THERAPISTS

• Because of the intensive nature of DBT (i.e., individual therapy, skills class, phone coaching, etc.) and consultation-to-the-patient approach, we STRONGLY suggest individuals in this treatment "press pause" with their other therapists. DBT aims to aid individuals in using DBT skills to manage all of their environment which can be difficult when a participant has multiple individual therapists. 

PHONE COACHING IN DBT:

Individuals who participate in Comprehensive DBT may call their individual therapist in order to get help applying and generalizing skills they learn in skills training to their everyday life.

There are three main purposes of phone coaching:

• Replace behaviors that could lead to self-injurious acts or suicidal gestures.

• Get feedback and suggestions while practicing your skills.

• Relationship repair with your therapist.

PHONE COACHING IS NOT:

• A suicide hotline.

• Therapy over the phone (eg. extra individual therapy sessions discussing abstract concerns).

• A way to soothe yourself when you feel bored or lonely, or have no one to talk to.

24-HOUR RULE:

• Your DBT therapist will not allow any phone contact during the 24-hours after you have last engaged in self harm. If you are in need of imminent medical care, go to your nearest emergency department or call 911.

In DBT, inpatient hospitalization is avoided whenever possible! Our goal is to help participants cope with life as it is, even if it becomes very stressful. In a crisis, DBT says "Now is the time to learn new behavior," instead of temporarily avoiding the stressors by being hospitalized.

Linehan, M.M. (1993). Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford.

INTERESTED IN LEARNING MORE ABOUT DBT?

To request a consultation or inquire about treatment options, please contact us below. Please allow 24 hours for a response to your inquiry.