What is DBT?
Dialectical Behavior Therapy is an evidenced based therapy developed by Marsha Linehan, Ph.D. and was originally developed to treat chronically suicidal individuals. Since its original inception in the late 80s and early 90s, DBT has been effectively applied to a variety of disorders which have at its core emotional dysregulation (hyperlink to page What is Emotional Dysregulation), a disturbance to the emotional regulation system which is often accompanied with impulsivity.
DBT is very effective in individuals with substance use disorders and co-occurring disorders, as these are disorders of emotional dysregulation and poor impulse control.
At Futures of Palm Beach, we offer only Adherent DBT vs Informed DBT, which is the form of DBT provided in most treatment programs in the U.S.
Futures is the only treatment program in the U.S. that offers the full module of Adherent DBT while the client is in residential treatment.
Dialectical Behavioral Therapy is considered to be adherent when the treatment reflects what the literature and research has validated as effective. Four DBT treatment components must be in place concurrently in order for DBT treatment to be considered adherent. These four (4) components are as follows:
- Individual DBT Therapy: to improve an individual’s motivation to learn DBT skills;
- DBT Skills Groups: to comprehensively teach skills from all 4 of the skill modules (see below);
- Phone Coaching: to facilitate the generalization of skills to the environment;
- Therapist Consultation Team: for DBT therapists, to maintain therapist adherence and effectiveness to the treatment.
The adherent DBT skill modules comprise the following 4 areas:
- Core Mindfulness Skills: to facilitate clarity about self, others and the world.
- Distress Tolerance Skills: to lessen impulsivity and to increase tolerance and acceptance of reality.
- Emotional Regulation Skills: to reduce labile emotions and unstable moods.
- Interpersonal Effectiveness Skills: to decrease chaotic relational functioning and increase interpersonal competence.
DBT At Futures of Palm Beach
Futures offers adherent DBT which forms an integral component of the residential clinical program as follows:
- Skills Groups: Residents participate in DBT skills group held 4 times weekly. As such, residents learn and practice skills from the 4 skill modules, including: Core Mindfulness, Distress Tolerance, Emotion Regulation and Interpersonal Effectiveness. Non Adherent programs typically teach only a few of the skills rather than comprehensively cover the 4 skill modules.
- Individual DBT: Residents receive individual DBT sessions held once weekly.
- Phone Coaching: Phone coaching is encouraged and residents are provided with the DBT therapist’s cell phone number to use under specific conditions.
- Therapist Consultation Team: The DBT therapist at Futures is part of a regularly held consultation team and participates on the DBT list-serv, an internet based resource of DBT therapists practicing world-wide. In addition, the DBT therapist at Futures is a Licensed Psychologist with more than 17 years of clinical experience and has been intensively trained in the use of DBT. This training occurs over the course of 1 year and includes 10 days of didactic training and 12 months of supervised practice under the close supervision of a DBT Trainer.
DBT-Informed (Non-Adherent) Therapy
DBT programs that are non-adherent refer to treatment that is not validated as effective in the research. DBT treatment that is non-adherent typically includes a portion of DBT but fails to incorporate the entire regimen known to be effective and proven in the research. For example, non-adherent programs may offer a skills group, wherein a few select skills are taught. Many times, the skills taught do not encompass the 4 DBT skill modules, i.e., core mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness, and instead focus on a few of the skills. Additionally, non-adherent DBT programs rarely include individual DBT sessions which are essential in generalizing the skills into a client’s unique situation.