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What is DBT?

What is DBT?

Dialectical Behavior Therapy (DBT) was founded by Marsha Linehan: Ph.D., internationally renowned top researcher, ZEN MASTER, Professor of Psychology at the University of Washington and overseer of Behavioral Tech|Linehan Institute. Current research shows that DBT’s effectiveness is expanded to populations struggling with pervasive emotion regulation struggles linked with multiple-disordered symptomology. At Dialectical Behavioral Therapy of Charleston we take an approach that is about treating suffering and symptoms, and that generally moves away from “labeling” or “diagnosing” when it may reinforce self-alienation and self-judgment. We take a mid path approach of balanced compassion and rigorous accountability. Originally, DBT was designed for individuals diagnosed with Borderline Personality Disorder (BPD); now we know this “label” is, in many cases, potentially interchanged with or more accurately represented with the “diagnosis” Complex Interpersonal Post Traumatic Stress Disorder (C-PTSD) and/or Pervasive Emotion Dysregulation Disorder (PEDD).  Criteria for C-PTSD and/or PEDD (out datedly known as BPD) may include the following symptoms; self-harm behaviors —  i.e. – self-sabotage, cutting, suicide attempts, thoughts, or urges, significant relationship challenges, struggles with regulating emotions and impulses-  as well as; Individuals who have “BPD”-like symptoms tend to struggle with other problems that relate to overlooked complex trauma-related responses such as; depression, anxiety, emotional numbing, severe body sensory overload from a hyper-active nervous system, confusion around intimacy & relational attachment, traumatic shame and guilt, rage or anger (behaviorally turned outward and/or inward), disordered eating, unannounced withdraw or sudden disengagement, a masked distrust in others, mood swings (highs and lows that may “resemble” bipolar disorder) and disordered substance use or abuse. It cannot be overstated that the stance of Dialectical Behavioral Therapy of Charleston rather centers treatment around specific behaviors that maintain suffering, rather than emphasizing a likely oppressive, judgmental label that may be unhelpful and potentially even counterproductive or harmful.

In developing this program, Dr. Linehan initially relied on cognitive behavioral therapy to help these people who tended to be marginalized in the history of mental health treatment effectiveness, who struggle with the issues discussed above.  When this did not work, Dr. Linehan and her research team developed DBT. Thus, DBT has become an “empirically-supported treatment.”   This means it has been researched in clinical trials (see articles at  A “DBT” program will follow the principles of “standard or comprehensive” DBT. “Standard or comprehensive” DBT refers to the intensive outpatient DBT program as it is researched and developed at Dr. Linehan’s research lab.  Our center meets the requirements of “standard or comprehensive” DBT.

What kind of therapy do you receive in DBT?

There are three modes of treatment – individual sessions, skills group, and telephone coaching.

Individual sessions are typically 50 minutes and meet weekly. Skills class meets weekly for two-hours. The format for skills class emerges as an educational course, unlike group psychotherapy. Five modules are taught: Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness and Mid Path; along with two sub-modules: Self-compassion and Self-validation. Phone coaching is to teach clients alternative behaviors using skills to replace self harm and other problematic behaviors that lead to suffering- phone coaching is mandatory BEFORE acting on these urges so the new effective skill behavior can be applied in place. Coaching by phone occurs when clients call their therapist prior to engaging in self-harm and problem behaviors. The most overall important goal in this therapy is to help clients build “lives worth living.”

How is DBT different?

Fiercely proactive, immensely educational and deeply compassionate, DBT is truly of its own field; it is a refreshing approach distinguished greatly from the mental health talk therapy world. DBT is a unique synthesis of eastern philosophy adapted into tangible skill sets, emotion didactics, interpersonally effective assertiveness training and self-respect development, all heavily rooted in behavior modification science. Clients attend a year-long DBT course where they learn skills, and leave with a specific skill set to practice each week. This process is crucial in learning new behaviors. Diary cards are used to help therapists and clients track and record their emotional intensity and problem behaviors. Change and Acceptance Strategies are weaved all through DBT to help in learning not only new behaviors, but how to tolerate times that are unbearable and unchangeable. DBT teaches skills to help you learn to tolerate instead of running away; to understand why life at times can be so hard. These are just a few differences and as you work this program you will see that it is a very hands on working therapy. DBT also has many published articles and is an evidenced-based therapy.