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Overview - The Four DBT Skills - Target Population

Overview: Dialectical Behavior Therapy (DBT) is a treatment approach developed by Dr. Marsha Linehan to treat clients with suicidal and self-harming behavior. Often these clients were diagnosed with Borderline Personality Disorder. Over the past decade, clinicians and researchers have determined that the strategies, techniques and theory which comprise DBT are effective in working with a variety of clients who have mood, anxiety, eating, substance abuse and personality disorders. This treatment approach is effective both with adolescents and adults.

DBT traditionally includes both individual therapy and group therapy components. Individual therapy consists of clients completing a diary card each day to track their target behaviors and working with the individual therapist using a variety of cognitive-behavioral techniques and concepts to help alter behavior patterns and extinguish self-harm behaviors. Group therapy consists of a psycho-educational skills training group where facilitators teach clients information and lead clients in exercises around the four skill sets of mindfulness, emotion regulation, interpersonal effectiveness and distress tolerance.

The original DBT model includes separate individual and group therapists who work together as a treatment team. For many adolescents and young adults in New Hampshire, a DBT program is not available. Young people often engage in outpatient individual therapy in their community and attend the skills training session as adjunctive treatment..

The Four DBT Skills:
Interpersonal Effectiveness is the skill set which provides clients with the understanding and skills to function more effectively in their interpersonal relationships. These skills help clients get their needs met more often within relationships.

Mindfulness is the skill set which helps clients decrease confusion about the self and increase the capacity to focus attention and awareness in the present moment.

Distress Tolerance skills are crisis skills. Clients learn how to tolerate painful emotions without giving in to behavioral urges which cause self- harm or create longer term negative consequences.

Emotion Regulation skills provide clients with an understanding of how emotions function, the purposes they serve, and how to increase positive emotional experiences and decrease negative emotional experiences.

Target Population: DBT is useful for people who struggle with emotion dysregulation and /or have difficulty coping with urges to engage in behaviors that are not in their best interest.

Teens and young people who attend DBT groups often struggle with one or more of the following: suicidal thoughts or behavior, cutting or other self harm, panic attacks, impulsive drug or alcohol use, school avoidance, angry outbursts, chronic anxiety or depression, or attentional issues. Younger teens who do not have self-harming or impulsive behaviors but instead struggle with coping and intense emotions are very good candidates for the Young Teen DBT group. This group is often viewed as a preventative option for younger teens- to help them develop the skills needed to avoid developing more negative behaviors or thinking patterns.