What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a form of behavioral therapy that teaches specific skills to help patients manage emotions, communicate with others, handle stressful experiences and be more mindful of their thoughts, feelings and environment.

Though it was originally designed to treat Borderline Personality Disorder (BPD) and self-harming behaviors, DBT is an evidence-based treatment for a variety of issues including depression, anxiety, substance abuse, eating disorders and family conflict. While Cognitive Behavioral Therapy (CBT) focuses on the relationship between how you feel, think and act, DBT is about learning tools to be more effective in the world around you.

About the DBT Program

We offer both individual and group DBT skills training. Due to the nature of DBT therapy, you must be in individual therapy in order to join the group.  Our DBT skills groups are being offered virtually at this time. Current patients are also able to join DBT group if they are working with an individual therapist in the office. However, depending on the case, patients may be able to join our DBT group while working with an outside therapist or Psychiatrist. We do have a Psychiatrist on staff for cases that need on-site medication management. Before starting individual and/or group DBT training, you must first complete an initial consultation with Natalie Wallace, LCSW, Director of DBT Services. Juliana Graham, LMSW, will be hosting the weekly DBT skills group.

DBT Skills Training Groups

Adult DBT Group

• We are now accepting members for the Adult DBT Group beginning November 8th. This group will meet on Tuesdays from 5:30-7pm.

About the DBT Curriculum

The four major components of DBT therapy include mindfulness, interpersonal effectiveness, distress tolerance and emotion regulation.

1. Mindfulness

The essential part of all skills taught in skills group are the core mindfulness skills. Observe, Describe, and Participate are the core mindfulness “what” skills. They answer the question, “What do I do to practice core mindfulness skills?” Non-judgmentally, One-mindfully, and Effectively are the “how” skills and answer the question, “How do I practice core mindfulness skills?”

2. Interpersonal Effectiveness

The interpersonal response patterns –how you interact with the people around you and in your personal relationships — that are taught in DBT skills training share similarities to those taught in some assertiveness and interpersonal problem-solving classes. These skills include effective strategies for asking for what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict. This module focuses on situations where the objective is to change something (e.g., requesting someone to do something) or to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.

3. Distress Tolerance

Most approaches to mental health treatment focus on changing distressing events and circumstances. They have paid little attention to accepting, finding meaning for, and tolerating distress. Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.

4. Emotion Regulation

Individuals living with depression, anxiety, borderline personality disorder and more may have difficulty effectively regulating their emotions. Dialectical behavior therapy skills for emotion regulation include:

• Learning to properly identify and label emotions
• Identifying obstacles to changing emotions
• Reducing vulnerability to “emotion mind”
• Increasing positive emotional events
• Increasing mindfulness to current emotions
• Taking opposite action
• Applying distress tolerance techniques

How do I get started?

All new patients must first complete a 30 minute initial consultation with the current DBT Coordinator, who will help determine if our program is the right fit for you. Please call the office at (212) – 860 8500 for more information about DBT therapy or to schedule the intake.

If this is a medical emergency, please dial 911 or head to the nearest emergency room. You can also call 1-800-NYC-WELL (692-9355). which is a confidential crisis hotline available 24 / 7.