Dialectical Behavior Therapy (DBT) in West Palm Beach, Florida

What Is Dialectical Behavior Therapy?

Developed by psychologist Marsha Linehan in the late 1980s for people with borderline personality disorder, DBT has been studied and validated as an effective treatment for emotional dysregulation, impulsivity, self-harm, and relationship difficulties.[1]

DBT is named for its dialectical component, which focuses on maintaining a balance between acceptance of your current reality and commitment to change.[2] DBT clients are asked to embrace both sides of the dialectic simultaneously: you’re doing your best, and you can improve. It is that balance of two truths that distinguishes DBT from other therapeutic modalities that focus primarily on change.

At Helios West Palm, DBT is provided by licensed mental health clinicians, including social workers and mental health counselors (LCSWs and LMHCs), who deliver DBT services in both individual and group formats to clients. The residential environment allows for much more frequent and integrated delivery than would be possible in outpatient DBT services.

 

How DBT Works

DBT is organized into four modules of skills, with each module addressing different aspects of emotional and behavioral regulation:

• Mindfulness is the foundation of DBT, teaching clients how to observe their own thoughts and emotions without judgment and to remain present in their experiences rather than acting on impulse. Mindfulness is the foundational skill that all other DBT skills build upon.
• Distress Tolerance involves learning skills to use in moments of extreme emotional pain that help clients survive a crisis without making the situation worse through their behavior. Distress tolerance skills are not intended to solve the crisis; they are to help the client get through it.
• Emotion Regulation involves learning skills to help recognize, understand, and manage intense emotions; to build a life that minimizes emotional vulnerability; and to live a more emotionally stable life.
• Interpersonal Effectiveness skills to enhance the ability to communicate clearly and respectfully in relationships by asking for what is needed, saying no, maintaining healthy relationships, and resolving conflict without damaging important connections.

Typically, DBT is taught in a group setting and practiced during individual therapy. In the inpatient program at Helios West Palm, concurrent DBT skills groups and individual DBT therapy sessions are provided, and the program allows for daily, real-life application of DBT skills.

Who Benefits from DBT?

DBT is appropriate for anyone who experiences high emotional intensity, has difficulty regulating those emotions, and whose personal, social, and daily functioning has been significantly impaired as a result.

It is particularly effective for:

• Borderline Personality Disorder — DBT is the gold standard treatment for BPD and has the strongest research support of any intervention for the condition.[3]
• Chronic Self-Harm and Suicidal Ideation — DBT was has been shown to produce significant reductions in self-harm behavior.[4]
• Eating Disorders — DBT is particularly effective with binge eating and other eating disorders that have emotional dysregulation as part of their presentation.[5]
• Substance Use and Co-Occurring Disorders — DBT addresses the underlying emotional pain or dysregulation driving substance use, rather than solely addressing the behavioral aspect.[6]
• Bipolar Disorder and Mood Disorders — The emotion regulation and distress tolerance skills developed through DBT can be used to manage the intensity of emotions associated with mood disorders.[7]
• PTSD, ADHD, and Other Conditions — DBT has been shown to be beneficial for people with PTSD, ADHD, and a variety of other conditions involving difficulty regulating emotions and developing effective interpersonal skills.

At Helios West Palm, DBT is commonly an integral part of treatment plans for patients with complex co-occurring diagnoses, provided as an adjunct to cognitive behavioral therapy (CBT), trauma-informed care, medication management, and individual therapy services.

 

The Efficacy of DBT

DBT has an impressive body of research supporting it. Since Linehan first published her randomized controlled trials in the early 1990s, DBT has consistently produced evidence of success across behavioral health. 

Important research findings include:

• DBT produces significant reductions in suicidal thoughts and self-harming behaviors, as well as a reduction in the need for psychiatric hospitalizations for people with borderline personality disorder.[8]
• DBT produces significant improvements in emotional regulation, interpersonal effectiveness, and overall quality of life for people with a variety of diagnoses.
• Even in the absence of a full DBT program, DBT skills training has been shown to work independently, highlighting the importance and value of the skill modules.
• DBT delivered in more intensive treatment formats, such as in a residential treatment setting, has been associated with faster skill acquisition and more successful short-term results than traditional outpatient programs, due to both greater frequency of sessions and opportunities for daily practice.[9]

At Helios West Palm, we place a high value on delivering DBT with fidelity to the model — applying clinically rigorous methods as the evidence supports, while remaining flexible enough to meet the individual needs of each patient.

What to Expect from DBT

DBT is significantly different from most other types of psychotherapy in that it is skill-based and requires active practice. Patients will learn, practice, and apply concrete skills to manage their experiences rather than simply talk about them. 

It may vary slightly depending on treatment environment, but patients can expect:

• Group therapy sessions — Clinician-led groups organized to teach and practice the four DBT skill modules sequentially.
• Individual DBT therapy sessions — One-on-one sessions with a therapist, applying DBT skills to specific challenges in the patient’s daily life and reinforcing what was learned in group.
• Progressive skill acquisition — DBT skills are introduced progressively, with each module building on the foundation of prior ones
• Daily practice — In a residential setting, especially, patients will have the opportunity to apply the skills they learn in everyday interactions
• Visible and measurable progress — Because of the focus on skill development, many patients feel their progress is easily recognizable compared to less structured therapeutic methods; many notice a significant change in their emotional responses within weeks of starting DBT.

DBT requires an active commitment on the part of the patient — it is not a passive therapy. However, for those who make that commitment, the skills developed through DBT will transform the way they navigate their everyday lives.

DBT at Helios West Palm

Helios West Palm offers dialectical behavior therapy as part of a comprehensive treatment program. Our DBT-trained clinicians work with the rest of the treatment team to ensure that the skills learned in DBT sessions are reinforced and applied across all areas of the patient’s care.

In Palm Beach County and throughout South Florida, Helios West Palm offers DBT at an intensity and consistency that outpatient programs cannot match. For those whose emotional lives have been difficult for a long while, our program provides the time, structure, and clinical expertise necessary to make meaningful change.