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Dialectical behavior therapy (DBT) is an empirically based, highly practical, and structured therapy that is founded on the principals of cognitive behavioral therapy (CBT) and rooted in mindfulness practices based on Zen Buddhist teachings. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Its efficacy has since expanded to a wide range of other mental health disorders. DBT is a multifaceted approach that is comprised of weekly individual psychotherapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching to provide additional support between weekly individual and group sessions. Dialectical behavior focuses on teaching behavioral skills in four key areas, called the  four modules of DBT. Each module highlights distinct and specific skills, including the following examples:

  • Core mindfulness: This module focuses on teaching skills related to remaining fully aware and accepting of the present moment; examples include:
    • The observe skill: collect emotional data by simply observing or attending to thoughts, feelings, events, and behaviors without trying to change them.
    • The describe skill: use words to describe your internal experience, and when a thought or feeling arises, acknowledge it.
    • Focus on the five senses: an effective grounding technique and a quick way to bring one’s attention to the present moment is to actively engage all five senses. Try this by naming 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.
  • Distress tolerance: The skills in this module help individuals learn various techniques for handling crisis; examples include:
    • Radical acceptance: accepting the state of things as they are, without working to change them.
    • TIPP skills: TIPP is an acronym for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation. TIPP skills quickly calm the limbic system and lower the state of emotional arousal. 
    • Distraction: in moments of intense overwhelm, temporary distractions (e.g., calling a friend, reading a book, watching TV, etc.) can provide brief relief from the distressing situation. 
  • Emotion regulation: This module focuses on teaching skills related to managing and dealing with primary emotional reactions to avoid distressing secondary reactions; examples include:
    • Opposite action skill: as the name suggests, individuals are taught to act the opposite of how they feel. First, individuals are encouraged to identify how they are feeling and then instructed to do the opposite (e.g., if you are feeling sad and want to withdraw from loved ones, make plans to spend time with them instead).
    • Positive self-talk skill: positive self-talk encourages self-confidence, effective coping, achievement, and a general feeling of well-being. Individuals may select a few affirmations, or positive statements, that resonate and then repeat them regularly.
  • Interpersonal effectiveness: This module focuses on teaching skills related to effectively interacting with others and advocating for one’s needs within a relationship in a way that is non-damaging and productive; examples include:
    • DEAR MAN skill: DEAR MAN is an acronym for Describe the current situation, Express your opinions and feelings, Assert yourself by asking for what you want or saying no, Reinforce and reward the person by explaining the positive effects of getting what you want or need, be Mindful and keep your focus on your goals, Appear confident, effective, and competent, Negotiate and be willing to give to get.
    • FAST skills: FAST is an acronym for be Fair to yourself and the other person, no Apologies when you have not done anything wrong, Stick to your values and stand up for what you believe in, be Truthful and honest with yourself and others.

It would be impossible to suggest any specific DBT skill to use, as the applicability of each skill will depend on a variety of contributing factors (e.g., personal preference, circumstance, severity of the situation, etc.). The American Psychological Association (APA) explains that DBT “establishes a ‘dialectic’ between helping individuals to accept the reality of their lives and their own behaviors on the one hand and helping them learn to change their lives, including dysfunctional behaviors, on the other.” Dialectical behavior therapy aims to teach individuals healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options. 

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

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