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Accepting clients seeking DBT and DBT-SUD. Intake appointments in 1-2 weeks. Until I open an in person office, I provide telehealth appointments only.
Who Benefits From DBT?
People who may consider DBT, are those who tend to have the following experiences:
Intense physical sensations that impair functioning and are contradictory to the life they want to be living. These could be described as feelings of panic, intense energy, tension, hypervigilence, and unbearable distress. On the flip side, individuals might experience the absence of physical sensations. Feelings of emptiness, darkness, numbness, disorientation, and apathy.
You might categorize these as anxiety, trauma, dissociation, obsessions, compulsions, abandonment issues, depression, substance abuse, or other behavioral issues.
Intense emotions that tend to cause negative or unwanted consequences. These emotions might be - fear, sadness, guilt, shame, anger, grief, jealousy, envy, and disgust. These emotions could present themselves in romantic relationships, peer relationships, family relationships, parent-child relationships, at school, at work, at home when you're alone, in public places, or when you're trying to complete tasks.
These emotion patterns could be related to- Complex PTSD, PTSD, Borderline Personality Disorder, Obsessive Compulsive Disorder, Generalized Anxiety Disorder, Major Depression, Bipolar disorder, etc.
Urges and impulses that limit one's ability to meet the standards they set for themselves. Urges and Impulses compel us to confront or avoid situations regardless of their effectiveness. We could have compulsions and impulses to engage in repetitive, risky, substance use or sexual behaviors. Most importantly, DBT is especially helpful for thoughts and urges about suicide and self harm.
Oftentimes, individuals are curious about DBT but are unsure of whether or not this entire program is a great fit for them. Here at Create Meaning, this is entirely welcomed. You may receive a diagnostic assessment that determines whether DBT is the best type of therapy for you. There will be no pressure or judgment, only acceptance and understanding. If you chose to decline participating in DBT, you can have your diagnostic assessment sent to another provider or program you're most interested in.
4 Core Components of DBT
Individual Therapy
Weekly one-on-one therapy with your DBT Therapist.
This is where we both 1) Emphasize a trusting therapeutic relationship 2) Incorporate DBT skills and concepts.
One noteworthy component of individual therapy, is the diary card. Weekly, we review your diary card and use this to help us set our agenda. The diary card is a 3-5 minute check in with yourself. This allows us to monitor your experiences and what DBT skills are or could be used.
Skills Group
Skills group is where you and your DBT Peers come together to discuss your experiences completing homework and practicing DBT skills.
This group is intended to be academic and supportive. You can expect to take 5-10 sharing your homework and receiving education.
The group is telehealth and is scheduled weekly on Tuesdays from 5-7:30pm.
24/7 Phone Coaching
Phone coaching is where you will have full access to your DBT therapist. This is proof of the commitment your therapist has for your well-being.
Coaching Calls are there for you when you are struggling and need to use skills to help manage your emotions and the situation effectively. The calls are skills focused and immensely beneficial.
Consultation Meetings for the Therapist
This is the "therapy for the therapist". This is where your DBT therapist attends a weekly meeting with other DBT therapists to discuss our work with our clients. In essence, you have an entire team of therapists hoping to provide you the best care possible.
DBT Skills
Mindfulness Skills
Being mindful is 1) Focused awareness on the present moment 2) Without judgment and 3) Without attachment.
We teach and practice mindfulness in order to experience reality with accuracy and fulfillment. We then use this information to increase happiness and reduce suffering.
Distress Tolerance Skills
Distress Tolerance skills are methods of blocking the behaviors and physical sensations that tend to make situations worse and create new problems.
Distress Tolerance skills also guide us towards accepting reality as it is when changing our situations is not possible.
Emotion Regulation Skills
Emotion Regulation Skills cover how to name and understand emotions, how to change them, and how to reduce our vulnerability to unwanted emotions.
Emotion regulation skills both help us understand the components of our emotions and how to effectively problem solve.
Interpersonal Effectiveness Skills
Interpersonal Effectiveness Skills facilitate effective conversations. These skills show us how to make, strengthen or end relationships.
Interpersonal Effectiveness skills also illustrate how to walk the middle path with validation, mindfulness and dialectics.
What is the Duration of DBT?
Let's talk about commitment. Since this treatment was designed for those who have had difficulties with individual therapy, this leads us to question a couple of things. First, why was individual therapy unsuccessful? Was it due to the treatment structure not being fully designed to meet clients' needs? Was it partially due to the therapist's lack of commitment to training or lack of experience?
In DBT, we believe it's essential for the therapist to be as committed to the therapy as the client is. As a testament to this, the therapists participate in weekly "therapy for the therapist". We attend a consultation meeting with other DBT therapists to discuss how we and our clients are doing.
In DBT, we believe it's important for the client to be prepared for a 1 yr commitment to the program. At the end of 1 year, it is oftentimes the case that clients experience significant growth and are much closer to creating what we call a "Life Worth Living".
What is Dialectical Behavior?
Dialectical behavior, is when we hold and balance multiple truths and walk the middle path. Oftentimes, these truths are contradictory and create tension. It is from the tension, we experience reality from new perspectives and find wisdom. Marsha LInehan is the creator of DBT and she set out to create a model of treatment that assists those who have had difficulties obtaining their goals with individual therapy alone. She decided to combine core components of Cognitive Behavior Therapy (CBT) and Zen Buddhism.
CBT has historically been focused on "Change". For example, changing our thoughts can change our behaviors and changing our behaviors can change our thoughts. Operating from this stance, may prompt questions like "What outcome am I seeking?" "What obstacles are blocking the path?", "What action steps would get me closer to my goal?".
Zen Buddism emphasizes mindfulness and acceptance of "what is". What we teach and practice in DBT, is that when we are present in this current moment, we are holding space for two opposing tensions "Change and Acceptance". When this occurs, we fully experience reality for "what it is".
When we are mindful and present, this could prompt curious questions like "what is reality right now?", "what are the facts within this moment?", "what are my thoughts about facts?", "Which emotions are present?", "What am I believing right now and how does this relate to my emotions?" and "What do I desire, what changes would make me feel better?".
DBT has systematic principles and protocols that promote healing while also incorporating effective skills and concepts. When we incorporate dialectical behavior, this allows us to get unstuck and move forward.
How Does DBT Treat Trauma and PTSD?
Please visit the DBT-PE page to learn more
Here is a helpful video that describes DBT. Please note that the title of the video refers to adolescents, but this video actually describes DBT for adults very well.
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