What is Dialectical Behavior Therapy? And how does it differ from other therapies?

What is DBT?

Dialectical Behavior Therapy (DBT) is a type of therapy that helps people who struggle with emotional dysregulation.

This post will answer common questions about DBT.

But first, let’s start by describing what emotional dysregulation looks like.

How DBT defines emotional dysregulation:

People who have a hard time regulating their emotions can either be overwhelmed by emotions, or numbed out and not know what they’re feeling – or both.

If you tend to get overwhelmed by your emotions, it can feel like your emotions come out of nowhere and overwhelm you.

When you have an emotion, it can feel really intense and may take a long time to pass.
You may be impulsive when you’re upset, doing things you later regret.
You may feel like your emotions control you, not the other way around.

If you tend to be more numbed out by your emotions, you don’t know what you’re feeling a lot of the time.

Your emotions confuse or scare you.
You may be checked out or dissociated often.
You may not understand why you do some of the things you do.

Often people fall on one side of the spectrum, either feeling overwhelmed by emotions or not feeling much most of the time. Some people vacillate between the two, feeling flooded by emotions some of the time and numb other times.

Do I have to have a specific diagnosis to benefit from DBT?

No. People with a range of issues can benefit from DBT.

There are specific diagnoses that DBT has proven to be highly effective for, though.
These are:
Depression, Substance Abuse Disorders, Bulimia and Binge Eating Disorder, Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder (BPD).

Even though the cause and symptoms of these diagnoses differ, difficulty with regulating emotions is universal to them all.

How is DBT different from other types of therapy?

Adherent (or full DBT) is different than other therapies – it actually has four components. The four components to full DBT are:

• Individual therapy (which includes use of a diary card)
• DBT Skills group
• Phone skills coaching between sessions
• DBT consultation team (for the therapist)

Let’s look at each of these components:

Individual DBT therapy

This involves weekly sessions with your DBT therapist, although some people benefit from meeting more often.

In your session, you’ll review your diary card. The diary card is a snapshot of how your week went. It lets the therapist know if you struggled that week with any difficult emotions or behaviors, and if you were able to try out any skills.

What is a diary card?

A diary card is a system for tracking behaviors, emotions and use of skills. Your therapist will give you a copy of the diary card, or you can use a DBT app.

The diary card helps you and your therapist see where you’re progressing – and where you’re getting stuck.

What is a DBT skills group?

The group is similar to a class and is not a process or support group.

There are four skill modules taught in Dialectical Behavior Therapy: mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.

These are great, practical skills that you can begin trying out in your life right away.

It takes 6 months, or 24 weeks, to complete learning all the skills.
And, many people find the group so beneficial that they continue after the first 6 months.

What is phone coaching?

Phone coaching is held between individual sessions – via phone calls – to help you apply the skills in your life.

It’s one thing to learn the skills in group, but when you’re in a crisis, you need to be able to figure out which skills to use to help you get through.

Your therapist acts as a coach on the sidelines, cheerleading you to use different skills to get through a hard time.
Phone coaching is provided by your individual DBT therapist.

What is a DBT consultation team?

This part of DBT is for the therapist, to help them provide you with the most effective treatment. It’s a behind-the-scenes, but necessary, component of DBT.

It’s ok to ask a potential DBT therapist if they’re a member of a DBT consultation team before you begin therapy with them.

Why do I have to do a group as well?

DBT skills group teaches you a range of skills to help you better manage your emotions, behavior and relationships.

DBT group is therapeutic but isn’t actually therapy. The therapy part of DBT happens in your individual session – where you get focused one-on-one attention in applying the skills to your particular challenges.

DBT is focused on your goals

The therapy is focused on helping you create the life you want.

How this looks for each person, of course, differs. But for everyone, it entails a life with less emotional suffering and more opportunities for contentment, connectedness and meaning.

Call (415) 310-5142 to see how DBT can help you.