Dialectical Behavior Therapy

Dialectical Behavior Therapy Program

The Dialectical Behavior Therapy (DBT) Program at GenPsych, PC is a comprehensive, empirically based, and multidisciplinary program for adults and adolescents in New Jersey.   Consistent with DBT protocol, our program consists of group skills training, individual therapy, daily self-monitoring and coaching calls after hours, as well as medication management, family support services, and rehabilitation counseling.  Our highly skilled licensed staff specializes in the treatment of borderline personality disorder (BPD), self-harm, suicidality, and related impulsivity, in particular disordered eating.  We offer both a three-hour Intensive Outpatient Program three times per week and a five and a half-hour Partial Hospitalization Program five times per week.

Marsha Linehan (1993) introduced DBT for the treatment of self-harm within BPD.  It is now recognized as the most empirically supported treatment for BPD and its associated suicidal and self-harm behaviors and has subsequently been found to apply to a range of psychopathology, including substance abuse

DBT proposes that cognitive, behavioral, emotional, interpersonal, and self dysregulation result from both biological and environmental influences, with biology predisposing individuals to experience emotion at a certain intensity and invalidating environments fueling dysregulation by not appropriately modeling and teaching regulatory skills.  DBT seeks to reach a middle ground, fostering balance and the integration of both emotional and rational experience to guide behavior.

THERAPEUTIC INTERVENTIONS

Dialectical Behavioral Therapy Skills Training Groups – Our DBT groups teach skills for being more mindful of the present, tolerating and regulating emotions, improving relationships, and reducing life-threatening and quality-of-life-interfering behaviors, such as self-harm and other impulsive behaviors through the following core modules.

Mindfulness provides training in nonjudgmental observation of the present moment.  Through mindfulness, patients learn to take a step back from their emotions, urges, and thoughts, decreasing their intensity by providing space when their emotions, urges, and thoughts can otherwise feel completely overwhelming.  Through this process, urges to engage in maladaptive behavior can simply be recognized and addressed by using more skillful behavior.

Interpersonal effectiveness teaches skillful ways to meet one’s needs while maintaining and building relationships.

Emotion regulation further covers emotional awareness and focuses on self-care (e.g., moderation in diet; appropriate sleep; building positive experiences and mastery) to help prevent vulnerability to intense emotional responding.

Distress tolerance focuses on alternatives to maladaptive behavior and ways to reduce emotional intensity (e.g., various forms of distraction; strong sensations to impact physiology in non-harmful ways).

Individual Therapy – Each individual will receive an assigned therapist who will conduct a minimum of one individual therapeutic session per week.

Daily self-monitoring involves rating and tracking urges, emotions, and behaviors of interest on what DBT calls a diary card.  Patients and their therapist tailor the diary card to address patients’ specific targets for change.  Patients are also asked to complete skills homework, which generally involves practicing skills and observing that experience.

Coaching calls are calls that patients make to their therapist when they are having an urge to engage in a maladaptive behavior and need help with skills to resist the urge.  This provides patients critical assistance for skills generalization in their environment when experiencing intense urges and emotion.

Multifamily Groups– Within the context of DBT, multifamily groups at GenPsych extend skill teaching to family members, helping provide patients’ families with the tools that their family member is learning.  This permits a common language that can facilitate reinforcement of patients’ learning and enhance progress outside the therapy room.  It can also help family members develop a more mindful, nonjudgmental stance; better regulate their own emotions; be more interpersonally effective; and better tolerate their own distress, reducing triggers for patients’ behavior.

Family Therapy – Family therapy sessions will be conducted by the individual’s assigned therapist.  Families will have the opportunity to participate in both the multifamily groups and individualized family sessions.  Education and support will be provided during these sessions.  The goals of family therapy emphasize facilitation of skills use to help solve family problems, improve communication, and create a better functioning home environment.

Medication Management – Each individual will be assigned a psychiatrist who will monitor and manage medications while the patient is in the program.

Rehabilitation Counseling – Our patients will receive rehabilitation counseling to assist with maximizing their potential and increasing their independence.  The counselor will assist individuals with vocational, independent living, and educational pursuits.

GENPSYCH DBT FAQ

What is DBT Treatment?

DBT – Dialectical Behavior Therapy – is an empirically supported treatment developed by Marsha Lineham, Ph.D. DBT is designed to apply dialectical strategies, which blend acceptance and change through the modification of Cognitive Behavioral Therapy (CBT) and mindfulness.

Who Will Benefit?

DBT is a treatment designed specifically for individuals who have difficulty regulating emotions and who engage in self-harming behaviors such as:

  • Cutting and other forms of self injury
  • Suicidal ideation, urges and attempts
  • Substance abuse
  • Disordered eating
  • Other high risk behaviors

Many clients in DBT suffer from one or more of the following:

  • Borderline Personality Disorder (BPD)
  • Depression
  • Bipolar Disorder
  • Post-Traumatic Stress Disorder (PTSD)
  • Obsessive Compulsive Disorder (OCD)
  • Other Anxiety Disorders
  • Anorexia, Bulimia, and Compulsive Binge Eating Disorder
  • Substance Abuse and Addiction

What is a dialectic?

“Dialectic” means ‘weighing and integrating contradictory facts or ideas with a view to resolving apparent contradictions.’ In DBT, therapists and clients work hard to balance change with acceptance, two seemingly contradictory forces, which help both the therapist and the client get “unstuck” from extreme positions or from emphasizing too much change or too much acceptance. These strategies keep the therapy in balance, moving back and forth between acceptance and change in a way that helps the client reach their ultimate goals.

What is Mindfulness?

Mindfulness skills have emerged as an important focus of several empirically supported treatments, including DBT, mindfulness-based cognitive behavioral therapy for depression, and mindfulness-based stress reduction. The roots of mindfulness practice are in contemplative practices common to both Eastern and Western spiritual disciplines and to the emerging scientific knowledge about the benefits of “allowing” experiences rather than suppressing or avoiding them.

Mindfulness in its totality has to do with the quality of awareness that a person brings to everyday living, learning to control your mind rather than letting your mind control you. Mindfulness as a practice directs your attention to only one thing, and that one thing is the moment you are living in. When you recognize the moment, what it looks like, feels like, tastes like, sounds like – you are being mindful. Further, mindfulness is the process and a window to acceptance, freedom, and wisdom.

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