What is DBT?

Overview — The Five DBT Skills — Target Population

Overview

Dialectical Behavior Therapy (DBT) is a treatment approach developed by Dr. Marsha Linehan to treat clients with suicidal and self-harming behavior. Often these clients were diagnosed with Borderline Personality Disorder. Over the past decade, clinicians and researchers have determined that the strategies, techniques and theory which comprise DBT are effective in working with a variety of clients who have mood, anxiety, eating, substance abuse and personality disorders. This treatment approach is effective both with adolescents and adults.

DBT traditionally includes both individual therapy and group therapy components. Individual therapy consists of clients completing a diary card each day to track their target behaviors and working with the individual therapist using a variety of cognitive-behavioral techniques and concepts to help alter behavior patterns and extinguish self-harm behaviors. Group therapy consists of a psycho-educational skills training group where facilitators teach clients information and lead clients in exercises around the five skill sets of mindfulness, emotion regulation, interpersonal effectiveness, distress tolerance and walking the middle path.

The original DBT model includes individual and group therapists who work together as a treatment team. Until we opened in 2021, this option was not available for many adolescents and young adults in New Hampshire. We are committed to sharing this evidence-based option with New Hampshire and Maine youth and families.

The Five DBT Skills

Interpersonal Effectiveness is the skill set which provides clients with the understanding and skills to function more effectively in their interpersonal relationships. These skills help clients get their needs met more often within relationships.

Mindfulness is the skill set which helps clients decrease confusion about the self and increase the capacity to focus attention and awareness in the present moment.

Distress Tolerance skills are crisis skills. Clients learn how to tolerate painful emotions without giving in to behavioral urges which cause self- harm or create longer term negative consequences.

Emotion Regulation skills provide clients with an understanding of how emotions function, the purposes they serve, and how to increase positive emotional experiences and decrease negative emotional experiences.

Walking the Middle Path skills teach clients how to think dialectically and decrease black and white or “all or nothing” thinking.

Target Population

DBT is useful for people who struggle with emotion dysregulation and /or have difficulty coping with urges to engage in behaviors that are not in their best interest.

Teens and young people who attend our DBT program often struggle with one or more of the following: suicidal thoughts or behavior, cutting or other self harm, panic attacks, impulsive drug or alcohol use, school avoidance, angry outbursts, chronic anxiety or depression, or attentional issues. Younger teens who do not have self-harming or impulsive behaviors but instead struggle with coping and intense emotions can also be very good candidates.