Dialectical Behavior Therapy DBT

DBT reduces the complex symptoms of emotion dysregulation and difficulties
with managing impulsive behaviors

It is a unique treatment that changes one’s personality and future
by building new positive behavior patterns with new DBT behavioral skills
Dr. Linehan’s dedicated clinical studies have proven that DBT skills are effective

However, DBT cannot cure all psychological disorders
It should only be applied to the symptoms in which therapeutic effectiveness
was proven at both research and clinical settings

Primary Symptoms

Borderline Personality Disorder/Emotional Dysregulation/Depression/Anxiety/Eating Disorders/Post-Traumatic Stress Disorder/Behavior Problems for Adolescents

Scientific Evidence & Benefits

Dialectical Behavioral Therapy (DBT) is a psychotherapy treatment that was developed by Dr. Marsha Linehan at the University of Washington to treat borderline personality disorder (BPD) and chronic suicidal behaviors. It is an effective treatment for people who have difficulties with regulating emotions, interpersonal issues, anger control, chronic self-destructive behaviors, and other related difficulties.

 

Through Randomized Clinical Trials, the effectiveness of DBT treatment has been compared to Treatment-As-Usual (TAU) for treating BPD and related symptoms. Cochrane Database of Systematic Reviews, an institution based in England, selected DBT as the only treatment that has been proven to be effective in treating BPD symptoms.

 

The DBT standard treatment consists of DBT individual therapy, DBT skills training group, skill coaching, and DBT team consultation. Scientific evidence shows that DBT has a lower relapse rate compared to other treatments because it helps the clients to learn and apply DBT behavioral skills successfully into their daily lives and to strengthen the skills to become their behavioral repertories that comprise the essential part of human personality.

 

Numerous studies show that DBT has significantly lowered anger outbursts, feelings of hopelessness, suicidal thoughts and behaviors in people with BPD and suicidal crisis compared to other treatment modalities.

 

Though DBT was initially developed for clients with BPD, its module-based system has made it applicable to treat other related symptoms. Recent studies have shown that DBT is effective for treating depression, PTSD, eating disorders, emotional and behavioral problems in adolescents, ADHD, impulsivity, as well as aggressive behaviors.

 

According to the 2007 study of Allec Miller, author of DBT Skills Manual for Adolescence, DBT is a very effective and inclusive treatment that can be applied to treat adolescents who are experiencing emotional and behavioral dysregulation regardless of their diagnosis.

Dr. Yong Cho’s Pledge with Dr. Marsha Linehan

Give the Best DBT services for English and Korean Speaking Population in Korea; Do DBT!

DBT Standard Program

DBT primarily focuses on reducing emotional distress by improving skills to regulate emotions and tolerate distress with the empirical framework of Cognitive Behavior Therapy and Mindfulness skills training. Since 2003, the Center for International Psychological Services at the Tree Group has been providing DBT services to people who are suffering from various disorders that include borderline personality disorder, post-traumatic stress disorder, eating disorders, chronic suicidal behaviors and emotion dysregulation related symptoms such as dissociation, depression, interpersonal difficulties, etc.

The DBT standard program has a very clear treatment structure with a weekly individual psychotherapy session and a skills training group session; the structure however could be varied depending on the urgent needs and/or complexity of the clients’ symptoms.  

 

During the DBT skills training group, clients learn to acquire mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress tolerance skills. They learn to apply these skills to their everyday lives in their DBT individual psychotherapy session, which is aimed to alter their unhelpful, negative behaviors into healthy, positive behaviors.  

 

For DBT to be effective and treat severe and complex symptoms, clients must participate voluntarily with full commitment as the skills must be learned and practiced for an extended period of time. The typical duration of DBT Standard Program is 12 months of one weekly individual psychotherapy session and one skills training group session. 

 

In the beginning of DBT individual psychotherapy sessions, clients will be given basic orientation and rational of DBT, an introduction to behavioral analysis and how to fill out a DBT diary card.  The clients will identify their own treatment goals and should make a full commitment to participate in the treatment.  

 

The primary target goals of Stage 1 treatment include life-threatening behaviors and treatment-interfering behaviors. Clients will learn to acquire positive behaviors that will reduce those problematic target behaviors and to help improve their quality of life. It is required to practice DBT skills to implement them in their real-life situations.  

 

Subsequent Stage 2 treatment goals focus on reducing trauma-related stress and symptomatic issues; Stage 3 treatments facilitate clients to solve life related difficulties and to achieve their own personal goals. In Stage 4, clinicians help solve the problems of human incompleteness and limitations. 

Now, I can manage my emotions
Impulsive behaviors no longer overwhelm me
With new behaviors and new ways of communicating with others,
I no longer hurt my beloved ones

I can change my behavior and mind with DBT skills!

I can meet new people with a mindful state of mind

New job, new school, new relationship and fresh new future!
It is the everyday that is happening in the world of DBT

DBT Program for Adults/Young Adults

DBT Program for Adults/Young Adults is for clients who experience extreme emotional dysregulation, have trouble managing interpersonal conflicts, and display self-destructive and impulsive behaviors that lead to negative consequences triggered by unstable emotional state.

 

Most of them have not had the opportunity to learn effective behaviors that can replace their problematic behaviors. During the individual psychotherapy sessions, clinicians identify unhelpful/problematic behavior patterns via behavioral analysis and assist the individuals to create positive behavior patterns with DBT skills.

In the DBT for Adults/Young Adults Skills Training Group, clients learn the four primary DBT skills training modules that help them manage their emotional and behavioral patterns: Mindfulness skills, Interpersonal Effectiveness skills, Emotion Regulation skills, and Distress Tolerance skills.

 

Mindfulness skills help clients be aware of their own emotions, thoughts, physical sensations, and behaviors as well as recognize their negatively distorted thinking patterns and impulsivity.

 

Interpersonal Effectiveness skills are for maintaining stable and healthy relationships and reducing chronic feelings of emptiness.

 

Emotion Regulation skills assist clients to understand the functions of emotion, change unwanted emotional responses and improve emotional resiliency by reducing vulnerability to emotional turbulence and managing difficult emotions.

 

And Distress Tolerance skills are to reduce mood-dependent and impulsive behaviors and learn to accept reality as it is. The clients learn to adopt alternative behavior skills instead of negative cognitive, emotional, behavioral patterns by learning and practicing DBT skills every week.

DBT Individual Psychotherapy (once a week)

 

DBT Skills Training Group (once a week)

  1. Core Mindfulness Skills
  2. Interpersonal Effectiveness Skills
  3. Emotion Regulation Skills
  4. Distress Tolerance Skills

 

Between sessions consultation with a DBT individual therapist

 

DBT consultation team

 

* The frequency of DBT clinical sessions can be adjusted depending on the severity of symptoms and clients’ needs.

DBT for Adolescents & Families

DBT for Adolescents & Families program is designed to help adolescents and their families who have experienced difficulties regulating emotions and behaviors. Adolescents with emotional and behavioral problems often have conflicts with their family members due to their problematic behaviors, such as impulsive and avoiding behaviors.

 

They will learn DBT skills to create balanced self-esteem, to build effective interpersonal relationships with their family and friends, and to maintain stable emotional state.

DBT for parents and guardians

Forming a new family culture by learning to adopt validating behavioral patterns

In an individual DBT for Adolescent Psychotherapy session, it is important to identify the ineffective behavioral patterns in the family, particularly between the parents/guardians and adolescents. Learning DBT behavior skills, such as ‘validation skills’ helps to form positive behavioral patterns within the family.

 

As the role of parents and guardians is very important to adolescents/children, separate treatment session for parent/guardians can be offered to change their relationship that has been created with negative verbal/non-verbal behaviors and learn to respond effectively to their adolescent children.

 

In DBT Adolescents & Families Skills Group, clients learn five primary DBT skills training modules that help to adopt new behavior skills: Mindfulness skills, Distress Tolerance skills, Emotion Regulation skills, Interpersonal Effectiveness skills, and Walking the Middle Path.

 

Mindfulness skills help adolescents lower their negative emotional state while increasing their positive state of mind and be aware of their own emotions, thoughts, and urges. It helps them to recognize their negatively distorted thinking patterns and impulsivity.

 

Distress Tolerance skills help adolescents reduce impulsive behaviors and learn to accept reality as it is.

 

Emotion regulation skills improve positive emotion while reducing the negative emotion of adolescents.

 

Interpersonal effectiveness skills help adolescents, and their families build healthy relationships, validating each other using the ‘Walking the Middle Path skill’.

In DBT Adolescents & Families Skills Group, parents/guardians not only learn about the concept of dialectics and validation, but also behavioral modification theories including reinforcement, shaping, extinction, and contingency. Understanding and applying the theories and skills to adolescents who have difficulty regulating their emotions help the parents/guardians promote effective and consistent parenting skills. Adolescents also learn to reduce interpersonal conflicts within the family through this skills module.

DBT Individual Psychotherapy (once a week)

 

DBT Skills Training Group (once a week)

  1. Core Mindfulness Skills
  2. Interpersonal Effectiveness Skills
  3. Emotion Regulation Skills
  4. Distress Tolerance Skills

 

Between sessions consultation with a DBT individual therapist

 

DBT consultation team

 

Parent consultation session (if required)

 

* The frequency of DBT clinical sessions can be adjusted depending on the severity of symptoms and clients’ needs.

DBT- IOP (Intensive Outpatient Services)

DBT Intensive Outpatient Services (DBT-IOP) is an intensive treatment with the format of DBT Standard Treatment Program that offers 6-20 hours of DBT individual psychotherapy and DBT skills training group per week. The treatment duration is around 3-6 months depending on individual circumstances and treatment goals.

DBT-IOP is recommended if a client meets the following criteria:

 

– Experiencing severe emotion regulation issues / complex and chronic difficulties / depression, anxiety, eating disorder, substance abuse issues that impairs daily functioning; and the typical frequency of DBT

 

– Standard program does not meet the needs of the clients

 

– Expected to go back to school/work after the intensive treatment

 

– Intensive outpatient services required after inpatient stays

 

– Intensive DBT skills training needed within a limited time frame

 

– Difficult to participate in the DBT standard program due to environmental limitations including time, length, and geographic distance