Dialectical Behaviour Therapy (DBT)

What is Dialectical Behaviour Therapy? (DBT)

Using sophisticated strategies and interventions, DBT focuses on increasing emotional functioning and building a life worth living. DBT is a modification of traditional CBT. DBT involves all the cognitive and behavioural techniques used in standard CBT and adds mindfulness approaches and acceptance-based practices.

From a DBT framework, impulsive and self-destructive behaviours (suicide, self-injury, shoplifting, binge eating, excessive spending) are the result of two interacting systems:

A biological vulnerability to emotions (based on genetics)
Chronic invalidation (based on the environment)

Researchers studying disorders of emotion regulation have discovered that chronic behavioural dysregulation is partly biologically based (e.g., genetics, temperament) and partly environmental.

What does it mean to have a biological sensitivity to emotion?

What is an Invalidating Environment?

Invalidation occurs when a person or environment communicates that you are wrong, invalid, bad, unwanted, or unimportant. Numerous research studies have shown the impact of invalidation on the body (increased heart rate, higher blood pressure, greater emotion dysregulation). The consequences of pervasive invalidation are profound. When a person is frequently misunderstood, negatively evaluated, ignored, or told they are not okay as they are, a number of predictable outcomes appear as listed in the post. Understanding how learning history and experiences have impacted your ability to regulate emotion and shaped your identity is key to learning how to recover from such invalidation.

Invalidation exists on a continuum from mild to severe and from acts that vary from unintentional to intentional. Much of what happens in families is on the left end of the continuum, where invalidation presents in the context of misunderstandings. Amazing and loving families sometimes aren’t a great fit with a child who is higher in emotional sensitivity.

The same happens in adult relationships. What can happen is a type of misalignment between two people who experience the world differently. Often we miss what the other person needs, we don’t see it, hear it, or “get it”. For someone who is “in need” though, that subtle and repeated effect of “being missed” or being misunderstood is profoundly unsettling (“Why don’t they get me?”, “What’s wrong with me?”, they start to ask, they start to internalize).

Invalidation intensifies as you move along the continuum. When one is purposely ignored, bullied, teased, rejected, and emotionally abused, the effects multiply. The most invalidating environments are those that involve sexual or physical abuse. Teaching families how to effectively validate loved ones is a game changer. Teaching people how to soothe an unsettled biology through skills like self-validation is inspiring.

Is DBT just for Borderline Personality Disorder

Due to its success in treating self-destructive behaviours and difficulties with emotions, DBT has evolved into an effective treatment for psychological issues that are rooted in emotion regulation difficulties (e.g., bipolar disorder, eating disorders, substance abuse).

At the Centre, we offer:

Comprehensive DBT (see below)
Skills Only DBT
DBT adapted for Eating Disorders
Radically-Open DBT

What is Comprehensive or “Standard” DBT?

DBT is a multi-modal treatment in which the individual receives individual DBT therapy, DBT skills training, phone skills coaching, and all therapists must attend a weekly consultation team to ensure that they are staying adherent to the treatment model. For those with personality disorders comprehensive DBT is the gold-standard treatment as it has the strongest evidence base. We also recommend standard DBT for individuals who present with multiple problem behaviours for which emotion dysregualtion plays a key role.

In our DBT treatment track, individuals make a six month commitment to receive:

Weekly individual therapy with a DBT trained and adherent therapist
Weekly 90 minutes DBT skills training group
Telephone skills coaching as needed

For more on DBT, please see this link – BTech Linehan

Standard DBT Outcomes

Treatment is most effective when all four modes are in place.

Standard DBT is associated with the following changes:

Reduced suicidal and self-injurious behaviour
Fewer hospital admissions
Less impulsivity
Less impulsive or destructive expressions of anger
Better social functioning

DBT Skills-Only Training

There is evidence that 20 weeks of DBT skills training can be effective for some individuals. Our six month intensive skills-only program is ideal for those who want to learn how to better regulate emotion and have healthier relationships and who do not need more clinical support. We find that those with current suicidal and self-injurious behaviours, and those with more complex clinical presentations respond better to the comprehensive model.

We offer a six month intensive DBT skills only program for clients who are eligible.

Our skills only program teaches four core skill modules:

Mindfulness training
Distress tolerance
Emotion regulation
Interpersonal effectiveness

The group (offered virtually) meets once per week for 90 minutes and is facilitated by two DBT trained clinicians.

Visit

267 King Street
Midland, Ontario Canada
L4R 3M4
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Open Hours

Monday 9am – 6pm
Tuesday 9am – 6pm
Wednesday 9am – 6pm
Thursday 9am – 6pm
Friday 9am – 6pm

Let′s Talk

Phone: 249 492 2673
Fax: 249 492 2640
Info@Psych-EReg.ca