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Dialectical Behavior Therapy (DBT) is a treatment that is designed to help those who have difficulties with:

  • Extreme emotion dysregulation

  • Interpersonal difficulties

  • Impulsivity

  • Rigid and inflexible ways of thinking and acting

  • Deficits in mindfulness (or awareness of what is happening in any given moment, both internally and externally)

For some, this represents a diagnosis of Borderline Personality Disorder (BPD), although those who do not meet criteria for BPD may benefit from DBT if at least 3 of the above 5 areas of dysregulation are met as outlined above.

Modes of Treatment:

Full, comprehensive, outpatient DBT requires participation in ALL of the following modes of treatment:

  • Individual therapy- once or twice weekly

  • Skills training group- once weekly for about 6-7 months, sometimes repeated. 

    • If an adolescent, this group will include your parents or guardians.

  • Telephone consultation- as needed, brief calls with your individual therapist in moments of difficulty in order to guide you through skills application

  • Therapist team consultation- weekly meeting for all of the therapists who are on the treatment team that functions as "therapy for the therapists"

  • Family sessions (as/if needed)

DBT therapy often progresses through various stages of treatment:

  • Pre-treatment- 4-6 weeks at the outset of therapy to ensure that there is a commitment to engaging in the therapy and to reducing/eliminating identified target behaviors

  • Stage 1- This is the main phase of treatment that can last anywhere from 6 months to a year or more. Primary targets for treatment are identified and progress towards goals monitored. 

  • Stage 2- This stage focuses primarily on emotional experiencing (i.e., decreasing the intensity with which one experiences emotions such as anxiety, sadness, and shame).

  • Stage 3- Living life, trusting self, reaching individual goals

  • Stage 4- Achieving deeper meaning through spritiual existence

*The main stages of DBT are stages 1 and 2 and have been the most developed/researched. Dr. Bonavitacola focuses primarily on these phases of DBT therapy. 

*For more information about DBT, including video explanations of the various modes of treatment and the philosophical underpinnings of the therapy, click here.

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