DBT Programs
Orange County
Do you struggle managing extreme emotions? Engage in self-destructive behaviors? Have extreme difficulty with relationships? Have you ever had thoughts of suicide or engaged in self-harming behaviors? Maybe you have a poor sense of who you are and low self-worth. Have you been in therapy before, but felt like you were not getting better? Maybe you have been diagnosed with Borderline Personality Disorder, but were not informed of an evidence-based treatment.
Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, PhD is an evidence-based treatment for Borderline Personality Disorder with adaptations for the treatment of adolescents who are suicidal, and co-occurring BPD and substance use disorders. DBT utilizes a dialectical stance to balance acceptance and change. In DBT we believe that individuals are doing the best that they can and they can do better. Individuals attend weekly individual sessions and DBT Skills group, as well as access to therapists between sessions for coaching calls. . Individual sessions focus on increasing motivation, skills acquisition and generalization, learning patterns of behavior and the consequences after engaging in more harmful behaviors and how to develop more effective patterns, with the goal of creating a life worth living. The group is didactic and contains four modules: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. DBT therapists coaching to the clients between sessions so that they can learn how to use skills specific to their own environment and circumstances.
In individual therapy, the therapist is validating, while taking a directive approach to assist the client with changing harmful behaviors, learning what emotions interfere with more skillful responses, as well as cognitions. Sessions focus on client targets begin with the higher order targets on the hierarchy. Life-threatening behaviors, such as suicidal attempts, ideation, and self-injury are addressed often with behavioral chains and teaching skills. Next, we address therapist interfering behavior of the therapist and client. Finally, we address severe quality of life interfering behaviors, such as homelessness, depression, anxiety, lack of support, and extreme relationship problems. Clients are given a diary card to track behaviors, urges, moods, as well as skills used or practiced. The diary card helps the therapist and client set the agenda for the session.
Finally, DBT therapists are part of a weekly consultation team. At the center for EBT we also meet with an expert supervisor who watches video recorded sessions and provides feedback. This is to ensure we are providing high fidelity DBT.
Our DBT Programs
Adult DBT Program
Individual Therapy
Individuals in our program attend individual therapy weekly.
Skills Group
- Our skills group meets weekly for two hours for 24 weeks.
- The group consists of four modules: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
Phone coaching
Individuals can contact their individual therapist in-between sessions for coaching.
If you are interested in registering or learning more about our program, please contact us at (949) 229-2589 or tara@centerforebt.com.
Adult DBT for SUDs Program
Individual Therapy
Individuals in our program attend individual therapy weekly.
Multi-family Skills Group
- Our skills group meets weekly for two hours for 24 weeks.
- The group consists of four modules: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
- Adolescents attend group with at least one parent.
Phone coaching
Individuals can contact their individual therapist in-between sessions for coaching.
Family therapy/Parent training
As needed
If you are interested in registering or learning more about our program, please contact us at (949) 229-2589 or tara@centerforebt.com.
Adolescent DBT Program
Individual Therapy
Individuals in our program attend individual therapy weekly.
Skills Group
- Our skills group meets weekly for two hours for 24 weeks.
- The group consists of four modules: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness, which include skills specific to substance use disorders.
Phone coaching
Individuals can contact their individual therapist in-between sessions for coaching.
Urinalysis is available on-site if needed.
If you are interested in registering or learning more about our program, please contact us at (949) 229-2589 or tara@centerforebt.com.
What skills do I learn in DBT?
Mindfulness
The skills group begins with the mindfulness module. Mindfulness, as defined by Jon Kabat-Zinn, means “paying attention in a particular way; On purpose, in the present moment, and nonjudgmentally.” The practice of mindfulness in DBT, teaches individuals allow to access their “wise mind” which is defined as the integration of emotion mind and reasonable mind. You cannot overcome emotions with reason mind and you cannot create emotions with reasonableness.
In DBT, we use “what” skills to practice mindfulness and “how” skills to learn to instruct us how to do it. “What” skills are: observe, describe, and participate. “How” skills are: nonjudgmentally, one-mindfully, and effectively. Clients are encouraged to develop a daily mindfulness practice by using the “how” and “what” skills daily, which can be incorporated in activities, such as walking, eating, and yoga.
Distress Tolerance
Distress tolerance skills are taught so that we are able to survive a crisis without making the situation worse or to accept reality when we cannot change our situation. In crisis, there are a variety of skills we can use to avoid dangerous behaviors, self-soothe, and improving the moment. Reality acceptance skills include radical acceptance, which means to accept something all the way and opening yourself to fully experiencing reality in the moment. We learn that live can be worth living even with pain.
Emotional Regulation
In DBT, emotional regulation skills are taught to decrease vulnerabilities, increase positive experiences and how to “treat” emotions in a variety of ways. The acronym, PLEASE, focuses on self-care to decreases vulnerabilities.
Physical illness (treat)
L
Exercise
Avoid drugs and alcohol
Sleep
Eating
To increase the likelihood of positive experiences, we learn to set goals and schedule pleasant activities, not just when we feel like it. In order to treat emotions, we must learn to identify our primary emotions, the function of emotions, and whether or not it is justified by checking the facts. Individuals can then use either opposite action to emotion or problem-solving skills. Individuals identify situations in the future that have the potential to be very emotional and “cope ahead” by identifying skills that can be used in the situation.
Interpersonal Effectiveness
In the interpersonal effectiveness module, individuals learn to identify factors which interfere with effectiveness, such as environment, emotions, and seeking to relieve distress for immediate relief, rather than stopping and looking at the bigger picture. Participants learn to ask for what they need and when to say no, improve current relationships, build relationships and end destructive relationships. In addition, walking the middle path skills help us validate self and others and to move away from extremes and towards interconnectedness and balance, as well as acceptance of change.
Adaptations
The DBT adaption for borderline personality disorder and substance use disorders include accessing “clear mind” which is the synthesis of “clean mind” and addict mind.” Individuals develop the ability to recognize their when they are in “clean mind’ and not aware of potential vulnerabilities which may lead to a relapse and that they must be aware of “addict mind” behaviors. Abstinence is encouraged dialectically, so that if individuals relapse, they learn to identify what events, thoughts, emotions, and actions lead to the relapse and learn how to use skills to address in the future such as burning bridges and riding the wave/urge surfing.
In DBT, we recognize how some individuals have a need to rebel, so alternate rebellion is encouraged as an acceptance strategy. Individuals are encouraged to find clothes, activities, or behaviors to rebel in a less destructive manner.