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DBT (Dialectical Behaviour Therapy) is a combination of Cognitive Behavioral Therapy (CBT) and mindfulness.
DBT was originally developed by Dr. Marsha Linehan at the University of Washington to help people whose suffering prompted them to want to end their lives. It has since been adapted and shown to be useful for many other people. DBT provides concrete tools in the here and now that allow people to make the necessary changes to accomplish their goals and build a better life, while also learning to accept themselves and their emotions.
Our program is adherent to the evidence-based treatment that Dr. Linehan developed so that we know it can be as helpful as possible. DBT, as it was developed, has four different treatment components that all work together as a program. In order for treatment to be provided in the way that we know is helpful and has been studied by research (evidence-based), it has to consist of all four of these components.
As in most other forms of therapy, in DBT therapy, you meet with an individual therapist weekly or every other week to talk about things that are happening in your life and to work towards your goals.
Our Skills Training Group is like a class that teaches you many new specific concrete skills that you need in order to make the changes you want to make in your life.
Your individual therapist is also available to you between sessions for brief 10-15 minute phone coaching calls that allow you to apply the skills you are learning in the moment when problems arise.
Our therapists meet as a team weekly to talk to each other about the work we are doing and to make sure we hold each other accountable to provide the most effective treatment possible to our clients.
◦ Borderline Personality Disorder
◦ Suicidal thoughts or suicide attempts
◦ Non-Suicidal Self Injury (e.g., cutting, burning)
◦ Anger or Anger Management
◦ Intense negative emotions (e.g., sadness; anxiety)
◦ Impulsive, self-damaging behaviours (e.g., binge-eating; unsafe sex; overspending)
◦ Substance abuse
◦ Difficulties with anger management
◦ Difficulties with relationships
◦ Chronic feelings of emptiness
◦ Eating disordered behaviours
◦ Suicide attempts
◦ Self-harm
◦ Suicidal ideation
◦ Hospitalizations
◦ Emergency room visits
◦ Impulsive, self-damaging behaviours
◦ Substance abuse
◦ Hopelessness
◦ Depression
◦ Anxiety
◦ Overall adjustment
◦ Social adjustment
◦ Anger management
◦ Participation in treatment
The evidence from these studies has established that DBT works (Kliem, Kroger, & Kosfelder, 2010; Lieb et al., 2004).
Across all treatments available for Borderline Personality Disorder, DBT is considered to have the largest and strongest base of evidence supporting its effectiveness (NHMRC, 2013; NICE, 2009).
You will meet with a therapist once a week or every other week for 50 minutes. During DBT treatment sessions, your therapist will help you solve problems in your life and achieve your goals. They will do so with compassion and understanding for your perspectives because we know change is difficult and that coming to therapy takes great courage. In DBT individual therapy, we are less focused on the past and more focused on problems that are occurring in your life right now, and providing you with concrete tools to solve these problems. There is a focus on reducing or eliminating life-threatening behaviours (e.g., suicide attempts; self-harm), behaviours that get in the way of therapy (e.g., lateness; not completing therapy homework), and behaviours that otherwise interfere with the quality of life that you desire (e.g., substance abuse; impulsive behaviours; mood and anxiety problems). We build a collaborative and genuine relationship with you, and use a variety of techniques to help you reach your goals.
We believe that everyone who comes to treatment is doing the best that they can in life. We also believe that oftentimes when you come to treatment you may not have the skills you need to make things better. The DBT Skills Training Group will teach you the skills you need to manage your behaviour, thinking, and emotions in effective ways that contribute to the kind of life you want to have. DBT skills groups are in the format of a class held weekly for 2 hours per week for 24 weeks. Each group has 8 to 10 members and 2 co-therapists. The DBT Skills Group allows us to teach you many new skills as efficiently as possible and frees up your individual therapy to focus on using the skills you are learning to reach the concrete goals you want to work towards. We know that many people are apprehensive about joining group and that not everyone needs to be in the group. Your individual therapist will help you figure out whether you will benefit from group and will work with you to get you ready to join group if you feel apprehensive about doing so.
During groups, you will learn the following skills:
◦ Mindfulness: Skills to control attention, become aware of what is happening for you in different situations, understand yourself and situations better, and to stay in the present moment.
◦ Distress Tolerance: Skills to get through a crisis, and to manage extremely difficult emotions without engaging in destructive behaviours that make situations worse.
◦ Emotion Regulation: Skills to change emotions in the long run so that you experience less painful emotions and more positive emotions.
◦ Interpersonal Effectiveness: Skills to make relationships better, and to effectively handle interactions with others including asking for what you want and need and saying no to things you do not wish to do.
We want to make sure that as you learn new skills, you can get help when you practice them. We know that the times when you need to practice your new skills may not happen during your group or individual sessions. That’s why in DBT you have access to phone skills coaching on an ongoing basis. You will be able to call your individual therapist during and after business hours for help with skills. Calls will be brief and focused on helping you use your skills. DBT Phone Coaching is provided by your individual therapist at no additional cost at our clinic.
We believe that everyone is doing the best they can and that everyone can continue to learn to do better. With this in mind, our therapists at the Ontario DBT Centre meet every week as a team to support each other in learning how to continue to get better at what we do (being your therapist) and to make sure we never stop learning and growing. We also remind each other to use the very skills we teach you because we believe that these are skills that everyone needs to use.