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Dialectical Behavior Therapy

Dialectical Behavioral Therapy (DBT) is a cognitive behavioral therapy developed by renowned psychologist, Marsha Linehan in the 1980’s. Although it was originally developed to treat individuals with borderline personality disorder who were chronically suicidal, research has shown DBT is also effective for a variety of other mental health disorders including substance use, anxiety and eating disorders.

The goal of DBT is to provide patients with the skills necessary to regulate emotions, control self-destructive behaviors and improve interpersonal relations. Dialectical refers to integrating opposites; in this case it is finding balance between acceptance and change. Some people experience difficult situations in life and move forward with life despite the hardships. Others experience similar situations and feel intense negative emotions and don’t fully accept their reality. DBT helps a person accept distress in life by providing them with the tools to make positive behavioral changes in order to feel at peace with their reality.

The Five Core Modules of DBT

1. Mindfulness
Mindfulness is the foundation of DBT; it is the practice of living in the present moment and being fully aware of the situation at hand. This skill teaches a person to observe their thoughts and feelings, while realizing they have a choice in how to respond.

2. Emotion Regulation
Emotion regulation is learning how to more effectively control one’s emotions and become less reactive to people and situations. This skill focuses on how to recognize and label feelings and then learn how to let them go so the emotion doesn’t take control and interfere with the rational thought process.

3. Interpersonal Effectiveness
Interpersonal effectiveness teaches people how to maintain relationships, while meeting personal needs and preserve self-respect. It helps a person approach a situation objectively rather than reacting to emotions.

4. Distress Tolerance
Distress tolerance is an “acceptance strategy” to help a person find healthy ways to tolerate intense emotions without trying to change them or engage in problematic behaviors.

5. The Middle Path
The Middle Path is all about balancing acceptance and change. It emphasizes that things aren’t always black and white or right and wrong. This skill helps a person more effectively manage extreme patterns of thought and behavior to achieve greater balance in life.

How is Dialectical Behavior Therapy Different from Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy (CBT) is the most common form of psychotherapy. It focuses on helping patients identify negative thought patterns and the effect that they have on other aspects of their life. DBT builds on CBT, but focuses on the psychosocial aspect; how people interact in different environments and relationships. DBT equips a person with the skills needed to accept painful realities and emotions, while empowering them to change negative or self-destructive behaviors. Another distinction between the two is DBT treatment typically incorporates weekly group therapy sessions to give a person the opportunity to practice the skills they learn.

Dialectical Behavior Therapy at Silver Hill

The DBT program at Silver Hill is one of the very few residential programs in the country. We offer several programs for patients with a demonstrated history of poor emotional control, impulsivity, self-damaging behaviors and interpersonal disorganization. They are highly structured, intensive programs for patients who do not need close inpatient supervision, but are not able to manage successfully in an outpatient setting. Patients reside on campus, which allows them to “live” the skills and coping strategies that they learn, under the guidance of DBT-trained staff. The specialized, DBT-trained team consists of psychiatrists, social workers, nurses and counselors. Treatment focuses on DBT skills training groups and coaching that teach patients how to better regulate their emotions and how to replace dysfunctional coping strategies with more adaptive behaviors.

In addition to the residential program, Silver Hill offers a number of Intensive Outpatient Programs (IOP) for DBT; the DBT Skills Group, Women’s DBT and Safe Relationships IOP and the Adolescent IOP. Learn more about each program.

Getting to Know Silver Hill Hospital

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Levels of Care

Silver Hill offers three levels of care: inpatient, transitional living and outpatient treatment. Take a look at these programs to see where you might fit in.

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Therapies & Services

Our broad range of services and therapies allow flexible treatment planning specific to each patient’s needs.

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