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Dialectical Behavioral Therapy (DBT)

What Is DBT?

Dialectical Behavior Therapy (DBT) is a powerful combination of individual therapy and group skills training that helps people handle emotions without getting overwhelmed. Using a variety of mindfulness, acceptance, and change strategies, DBT helps people who struggle with distress and emotional dysregulation build a life worth living. 

DBT was developed in the 1970s by Dr. Marsha Linehan, who struggled with borderline personality disorder. Combining her personal experience with her professional exposure to clients who found traditional forms of talk therapy and behavioral approaches relatively ineffective, Linehan developed a cutting-edge treatment that focused on skills building and distress tolerance. 

Though DBT was initially created to target symptoms of borderline personality disorder, it’s now considered a highly effective therapy for any individual who struggles with maintaining control over their emotional response. Today, DBT is used to treat clients who experience depression, anxiety, PTSD, suicidal thoughts and self-harming behaviors, and disordered eating. 

How Does DBT Work?

So, what is emotional dysregulation? 

If you tend to be reactive, have a hard time calming yourself, or if your emotions feel more intense than what others around you experience, you may struggle to regulate emotions. However, strongly felt emotions are not the only signal of dysregulation. If you have a hard time identifying your emotions or you often feel numb or shut down, that may also indicate a lack of regulation. 

The “dialectical” quality of DBT is all about finding balance or a middle ground between opposites. Finding balance within the spectrum—between acceptance and change, emotion and reason, and indulgence and denial—can teach clients to moderate their stress response. The “behavior” portion of DBT revolves around building skills in therapy by breaking down practical exercises into small, manageable steps. 

Typically, DBT treatments involve four components: individual therapy, skills group, and coaching calls, and therapist consultations. Skills Group sessions, in particular, are facilitated to master the four modules of DBT, which are:

  • Mindfulness – the ability to become present and observe emotions 

  • Distress tolerance – the ability to manage emotional crises in both long-term and short-term situations

  • Interpersonal effectiveness – the ability to effectively communicate and set boundaries

  • Emotion regulation – the ability to understand what you are feeling and how to reduce the intensity of emotions 

The shared experiences and perspectives in the skills group are essential to treatment. But individual therapy, coaching sessions, and consultations are also important in reinforcing the skills learned and practiced in a group setting. 

How DBT Differs From Other Forms Of Therapy

 

DBT is unique because it honors emotions while also teaching practical skills, enhancing the element of balance that is vital to treatment. By developing emotional awareness and understanding alongside important life skills, DBT helps people change their lives in immediate, visible, and lasting ways. 

 

In turn, clients who use DBT have better relationships, are able to handle crises as they arise, make better decisions, and keep their emotions in check.   

Our Approach To Dialectical Behavior Therapy At Bay Area Mental Health

 

At BAMH, we believe that anyone can benefit from the valuable life skills learned in DBT treatment. We’ve witnessed how effective DBT can be in treating an array of clients for whom other methods were unsuccessful. 

 

Our clinicians take an integrative approach to the traditional model of Dialectical Behavior Therapy. This means that we incorporate other verified therapeutic methods to help our clients find relief from obstacles to their mental health. Specifically, our clinicians adapt the traditional DBT therapy model to be flexible, trauma-informed and fit the unique needs of our clients. 

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The DBT Skills Group cycle consists of three modules (Distress Tolerance, Interpersonal Effectiveness and Emotion Regulation with Mindfulness incorporated into the beginning of each module), and we recommend completing two full cycles of treatment for best outcomes. We require that anyone participating in a DBT Skills Group at Bay Area Mental Health also see an individual therapist. And while it is most effective to receive both individual therapy and DBT Skills Group at our practice, clients are welcome to continue seeing their individual therapist while joining one of our skills groups.

In addition to group and individual therapy, phone coaching provides our clients with opportunities for crisis support between sessions. Because we incorporate DBT coaching in an app that is available 24 hours a day, clients can also access help as needed and before emotions escalate into a crisis. 

Our Graduate Skills Group

 

Bay Area Mental Health is also one of few practices to offer a DBT Graduate Group for clients who have completed three full modules of our Skills Group. This is an opportunity to reinforce skills and apply them to everyday use and challenging situations–all while maintaining a sense of community through the treatment process. Whereas our Skills Groups are more instructional, the DBT Graduates Group is more oriented around verbal processing and discussion. 

 

Does DBT Really Work?

We believe that DBT can help every single person and have found it incredibly helpful in our own lives. No one can teach DBT unless they use it themselves—and at Bay Area Mental Health, we do. 

Here’s what past clients have had to say:

“Your DBT classes have changed my life! It has helped me more than 10 years of traditional talk therapy could. Thank you so much!”

“I’ve taken DBT before at other places, but I didn’t really understand the skills until now. You are amazing therapists, and I can’t thank you enough. You have changed my life.”

“These skills really should be taught in school. I could have used them when times were the toughest. Thank you for doing this.”

 

“Linnea and Ann are wonderful teachers. They are compassionate and warm, and teach the skills in a way that helps me use them in my life every day. My only regret is that I didn’t find out about this sooner."

You Can Learn To Manage Your Stress Response

 

If you have ever worried that your emotions were “too much” or that your mental health challenges were beyond help, we have worked with many people who felt just like you. Dialectical Behavior Therapy (DBT) can help you accept yourself as you are. 

 

For more information or to schedule a free, 15-minute consultation with one of our DBT therapists, please reach out via our contact page

Individual Therapy

It’s most effective if you work with a Bay Area Mental Health therapist during the time you are in DBT because we know what you are working on in group and can support that process. However, if you already have a therapist, we want to honor that relationship and are happy to collaborate with them. In other words, you can stay with your current therapist if you prefer.

Phone Coaching

Coaching calls are short phone calls (less than 10 minutes) in-between sessions designed to help you use the coping skills that you learn in a group. This is not the same thing as phone therapy. There is no charge for this support.

DBT Skills Group

Groups meet once a week for two hours and are like a class. We teach you skills to help you manage emotions, assign skills to practice (“homework”), and review homework from the previous week. Groups are a maximum of eight people and are run by two DBT therapists.

App-Based Support

We incorporate app-based care in or program to reinforce the skills you are learning in group and individual therapy. Through the app we can share lessons for in between sessions and monitor your progress. You can choose how much or how little you would like to share with your therapist through the app.

DBT Graduates Group

Once clients have completed a DBT program with either Bay Area Mental Health or another program, they can join one of our Graduates Groups. The DBT Graduate Groups are intended to provide a safe space to deepen your use of DBT skills. These groups are a mix of skills training and processing.

Therapist Consultation

Our therapists consult regularly to provide you the best experience possible. We function as a team to give you excellent care.

Skills Group Modules

The full DBT Program consists of three group modules with Mindfulness incorporated into each one:

  • Distress Tolerance (8 weeks) – Learn skills to manage emotional crisis situations, short-term and long-term.

  • Interpersonal Effectiveness (8 weeks) – Learn to communicate more effectively, to ask for what you want, and to say no. Learn to set and maintain boundaries.

  • Emotion Regulation (10 weeks) – Learn to identify and understand what you are feeling. Learn to reduce the frequency and intensity of emotions, and even to change them once they start.

DBT Skills Groups

  • Mondays 6:00 pm – 8:00 pm

  • Thursdays 12:00 pm – 2:00 pm

  • Thursdays 4:00 pm - 6:00 pm

  • Thursdays 6:00 pm – 8:00 pm

DBT Graduates Group

  • Tuesdays 6:00 pm – 8:00 pm

How do I sign up?

We open up groups to new clients at the beginning of a new module. Because we have multiple groups running, there is usually only a three- to six-week wait to get into a group. Groups tend to fill up quickly so we maintain waitlists for each group. We can reserve a spot for you – call now to hold your place in line. If you are ready to start now, we can make an appointment to start to see you individually.