DBT Therapy – What is it?

DBT Therapy – What is it?

Everyone’s talking about DBT, but what is it, exactly?  

You tell your friend about the recent behavioral issues your teen has been having, and they tell you that their child was in DBT (Dialectical Behavior Therapy) and that it really worked!  They tell you that you should consider putting your child in DBT.  Your doctor refers your teen to DBT after he discover she has been cutting herself.  Your cousin, who is a therapist, suggests you look into DBT for your daughter after your daughter has an emotional outburst at the family reunion.  

Young teenager girl typing and messaging on her smartphone

You Google “DBT” online and find the same information over and over: It’s a cognitive behavioral treatment that was originally developed to treat borderline personality disorder and people who were chronically suicidal.  It’s now been shown to be effective in treating a wide range of mental health issues such as depression, anxiety, PTSD, eating disorders and substance use disorders.  It teaches mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills.  While all of the above is accurate and informative, chances are you still don’t have a clear understanding of what it is your teen will actually be getting out of DBT or how it will help your teen.  Let me try to help.   

DBT is a treatment approach meant to help those who might be more emotionally sensitive and reactive than the average person.  What do I mean by emotionally sensitive?  People who are emotionally sensitive tend to experience emotions more frequently and more intensely than others.  For example, when the average person gets cut off in traffic, they will likely feel frustrated or mad for a short time and then go back to thinking about what they were thinking about before they got cut off.   A person with high emotional sensitivity, however, may react by cursing, flicking the person off, and speeding up to pass and cut them off.  They may think about the event for hours after it happened. Another example is a person who plays the wrong key at their piano recital.  The average person would be embarrassed or disappointed in themselves, think about it for the evening, but sleep on it and move forward within the next couple of days. A person with high emotional sensitivity may become depressed, suicidal, and internalize this mistake by telling themselves that they are a screw up, a failure, and don’t deserve to be alive.  These intense feelings and thoughts may lead a person to engage in behaviors such as isolation, self-harm, substance use, or other unhealthy behaviors.  

The examples above show how being emotionally sensitive can negatively impact a person’s life. However, being emotionally sensitive can also be a very positive quality.  Feelings such as love, happiness and joy are felt more often and more intensely.  People who have high emotional sensitivity often exhibit characteristics such as kindness, creativity and empathy.  The goal of DBT is not to get rid of a person’s emotional sensitivity, it is to help a person learn how to manage these extreme emotions.  

A full DBT-intensive outpatient program includes weekly individual therapy, phone coaching calls between client and therapist and a weekly skills training group.  Typically these programs are anywhere from 6 months to 14 months in length.  Some programs, however, adapt DBT to fit the population in which they are serving.  For example, there are DBT groups that have been developed specifically for people struggling with substance abuse.  Many eating disorders treatment programs have been incorporating DBT into their programming to address problems specific to eating disorders.  I have adapted DBT to be more teen-friendly and meet the needs of adolescents who don’t need an intensive DBT program. What this means is that I don’t do coaching calls, we only meet once per week, and the teen is not required to be in individual therapy with me to be in the group. My model is less intensive, more user friendly for today’s busy teens, and focuses on learning skills. Click here for more information about my next Teen DBT group in St. Paul.

This blog was written by Nicole Kerr, MA, LPCC, therapist at Sentier Psychotherapy