Finding Dialectical Behavior Therapy (DBT) Options

At times, the thoughts, feelings, and behavioral patterns you experience may benefit from outside support and professional treatment. With over 400 modalities of therapy available, there are many options for addressing these concerns, including dialectical behavior therapy (DBT), which targets distressing emotions and how they can connect with patterns of behavior. Through weekly individual therapy sessions using DBT, clients can learn healthy coping mechanisms for emotion control like mindfulness, acceptance, and relationship skills. Learning how to find DBT near you can help you find a provider quickly and efficiently.

What is dialectical behavior therapy? How can I find a DBT therapist near me?

Developed in the treatment of borderline personality disorder (BPD), DBT helps clients accept and control intense emotions and the reactions that may result by allowing them to increase self-compassion and practice research-backed coping skills. 

The word "dialectic" refers to analytical reasoning in pursuing knowledge and truth in conflict. Through interpersonal effectiveness skills, individuals can develop important skills that allow them to see the facts of a situation before reacting to a conflict with another individual. 

DBT was developed by Dr. Marsha Linehan, Ph.D., a psychologist who developed the therapy modality due to her diagnosis of BPD. Since its development, DBT has become a widely used modality by many of those involved in mental health fields, including individual therapists, counselors, clinicians, and psychologists, for numerous mental health diagnoses and challenges. You do not need to have a mental illness to use DBT, as it can be an effective treatment for managing emotions and overall well-being.

Studies, including one from 2006, have shown DBT's effectiveness since its development in the 90s. The criteria outlined by Dr. Linehan for effective DBT practice include the following: 

• Enhancing your capability to increase skilled behavior
• Improving and maintaining your motivation to induce a state of change
• Ensuring the generalization of change through treatment
• Enhancing the motivation of therapists to deliver the best treatment
• Assisting you in changing or restructuring your environment to support and maintain progress towards goals, with or without medication

The key elements of dialectical behavioral therapy

Four critical elements of dialectical behavior therapy are often used to help clients assess their needs, manage painful emotions, and decrease relationship conflicts. The elements covered in DBT programs include:

• Interpersonal Effectiveness: Skills focused on healthy communication, relationships, and self-respect to build and maintain advantageous connections
• Emotional Control: Strategies focused on helping clients control, change, and understand their intense emotions
• Distress Tolerance: Skills focused on increasing the acceptance and tolerance of unwanted or painful emotions instead of trying to escape or ignore them
• Mindfulness: Skills related to being present at the moment and accepting emotions and facts without judgment using a wise mind 

These modules also emphasize the development of DBT skills for long-term emotional control. DBT may involve a workbook that clients can use to learn the skills from the above four modules with the help of a DBT therapist. The workbook is designed to support ongoing skills training, providing practical exercises for clients during and after therapy. Often, therapists actively partake in roleplay and activities during a therapy session to help clients learn these modules. 

Who can benefit from DBT?  

Although DBT was developed to treat BPD, anyone can benefit from its teachings. As DBT occurs in a class format, it is a structured form of therapy that involves various skills and worksheets. Anyone looking for a structured form of therapy with lesson plans and interactive activities may enjoy this form of treatment. These modules also emphasize the development of DBT skills for long-term emotional control. DBT can also benefit the following: 

• Substance use disorders 
• Bipolar disorder
• Depressive disorders
• Eating disorders 
• Post-traumatic stress disorder
• Schizophrenia
• Anxiety disorders
• Attention deficit hyperactivity disorder (ADHD) 
• Behavioral concerns
• Relationship conflicts 
• Antisocial personality disorder (ASPD) 
• Narcissistic personality disorder (NPD) 
• Histrionic personality disorder (HPD) 
• Executive functioning difficulties
• School challenges in children and teens 

How DBT teaches acceptance

One of the primary themes in DBT is the concept of radical acceptance, which is also a skill and worksheet from the distress tolerance section of the workbook. Rather than teaching you to avoid or eliminate challenges, DBT helps you cope with challenges by showcasing that life can be worth living and that you can still make changes while feeling immense emotional pain. The radical acceptance skill teaches clients how to accept situations that cannot be changed, even when they are challenging to accept. It may be used in the loss of a relationship, during an inevitable transition, or when you believe a situation is out of your hands. 

According to Dr. Linehan, learning the skills to manage these feelings can change your life dramatically, making it possible for you to enjoy your relationships that have formerly been defined by conflict. DBT is more than a way to change your behaviors; it is a tool that helps an individual learn skills to use their emotions and feelings in a more productive way that serves them. 

How does DBT work?

DBT is a form of cognitive-behavioral therapy that a therapist can use to teach clients to accept themselves as they are without judgment while learning skills that have been studied to work. DBT involves four modules with various skills and worksheets throughout. When you first get to your sessions with your therapist, you may start at the beginning of the DBT workbook and work your way through learning and practicing each skill. Your therapist may participate in the practice, modeling how these skills can be used. 

In addition, DBT can be practiced in an individual or group environment. People can partake in DBT independently, with a partner, with their family, or in a group of strangers. In a group environment, everyone in the group starts the treatment together in the first module, often focused on mindfulness. After going through all four modules, those who have successfully completed the modules may graduate from therapy and have a ceremony. In some cases, this might look like a quick ceremony with treats and music or a session where other group participants offer handmade gifts and goodbyes at the end.  If you're concerned about your personal details, therapists usually close doors once sessions begin. This ensures that conversations remain discreet and participants feel comfortable in their surroundings.

Graduating DBT doesn't necessarily mean you no longer would benefit from using the skills and meeting with a DBT therapist. Instead, it means the DBT therapist likely believes you've learned the skills sufficiently and can practice them independently. You might still supplement these skills with talk therapy sessions. Normally, your therapist will apprise you of any areas where additional support for DBT could be helpful and recommend strategies to reinforce your progress.

How can I find a DBT therapist near me?

Many therapists are trained in DBT. If you're looking for official DBT therapists, classes, or groups, look for a therapist who has graduated with courses in teaching DBT and isn't only offering it as a side service to CBT or another treatment. To get the full benefit from DBT, you may want to search for a specialist or a dialectal behavioral therapist. You may be able to find a therapist by asking your primary care physician for a referral. If you have a personal therapist already and would like to participate in a DBT group, ask them where you might be able to find one in your city that could be a good fit for you. You may also ask them to refer you to an online directory that lists local DBT groups. 

Many therapists accept insurance, but if you do not have insurance or can't find a provider that offers coverage for this treatment, group DBT sessions may be more affordable than individual therapy. There are more slots offered for the session time, allowing therapists to cut down on the session costs or distribute the cost of their services between multiple clients in one therapy session. 

DBT through the Linehan Board of Certification

The Linehan Board of Certification is one of several organizations that provides a public online tool to help potential clients identify providers trained in and offering DBT therapy supported by evidence-based research. Those listed with the Linehan Board of Certification are vetted and proven to have the requisite skills and knowledge to deliver DBT and adhere to the therapy model Dr. Linehan and her colleagues created. 

Alternative DBT therapy options: Online mental health tools 

An online mental health tool like BetterHelp can provide a flexible and convenient way to receive DBT. Although you may be responsible for downloading or purchasing the DBT workbook, your online DBT therapist can provide free worksheets and offer the same structure and lessons as an in-person therapist. Many therapists working on online platforms practice DBT and other forms of cognitive-behavioral therapy. 

Additionally, studies have found that internet-based DBT was as effective as in-person therapy for those who completed the program. A DBT therapist who works online is a mental health professional that has received the same training as a DBT therapist who works in an office setting. Attendance in the online therapy group was also higher than in in-person therapy groups, showcasing the availability of online formats. When you use an online platform for therapy, you can match with a DBT therapist and choose to meet over the phone, via video chat, or through a live chat session with a licensed therapist from any location with an internet connection.