Dialectical Behavior Therapy (DBT) is an empirically supported treatment model aimed at helping clients manage overwhelming emotions, problematic relational patterns, and self-destructive behaviors. DBT was originally developed as the primary approach indicated for treatment of borderline personality disorder and the associated symptoms. It has since been broadened in its application and has been shown to be very effective with a broad range of clients and issues related to emotion regulation difficulties and self-destructive behaviors. DBT treatment focuses on four primary skill sets that address key areas of functioning. These skill sets are:
- Distress Tolerance: These skills focus on helping clients learn to manage highly upsetting, distressful situations with resilience and effectiveness. Often, when in distress, clients learn to make choices that lead to rapid avoidance of pain, but unfortunately make matters worse over time. These skills provide alternative coping mechanisms that relieve distress and propel the client towards more healthy responses.
- Mindfulness: These skills help clients lean to stay in the present moment, increase awareness, and focus less on painful experiences of the past, or fears of the future. These skills also help clients learn to overcome negative judgments about themselves, others and the world around them.
- Emotion Regulation: The goal of emotion regulation skills is to assist clients in modulating emotions so they don’t become overwhelmed by them, and act self-destructively. Clients learn to identify what makes them vulnerable to overwhelming emotions, and structure their lives to build resilience. They earn to identify and express feelings in healthy ways, rather than acting them out destructively.
- Interpersonal Effectiveness: Oftentimes overwhelming emotional responses result in hurting those closest to us. These skills are aimed at learning to express feelings and beliefs effectively, setting appropriate limits, and building assertiveness and problem solving skills to assist clients in maintaining caring, quality relationships.
In addition to the above skills, DBT also places a great deal of emphasis on validation. The process of validation assists the client in “accepting” that life is difficult at times, and that their cognitive or emotional responses to this difficulty are valid. This “acceptance” helps the problem seem more manageable, and less “impossible”, thus empowering the client to take productive steps towards resolution.
At Solstice, DBT is integrated significantly into the daily program. In addition to weekly skills training groups led by a licensed and DBT trained clinician, our clients use daily diary cards to track skill use and development. They also carry with them DBT skills cards that can be used as reminders of skillful responses and options in difficult moments. All staff at Solstice are trained in DBT skills and interventions, enabling them to assist the girls at anytime throughout the day when she may need a reminder, or support in implementation of a DBT skill.
Furthermore, in addition to the traditional DBT Skills group, the weekly experiential group also incorporates interventions and opportunities for girls to learn and practice DBT skills in a creative, experiential manner.