You’re Not In DBT, part 2

In You’re Not in DBT, part 1, I gave a brief definition of Dialectical Behavior Therapy (DBT) and suggested your therapist may be engaging in dishonesty behavior if claiming to provide DBT services when they are not providing all modes of DBT service delivery.

Today we’ll talk about what to expect from DBT and how to find a provider.

What to Expect (Briefly)

  1. Providing a commitment not to kill yourself or engage in self-harm – and keeping that commitment.
  2. Avoiding psychiatric hospitalization like the plague.
  3. One hour of individual therapy and one to two hours of skills training per week, with homework.
  4. It’s behavioral, so you change your behavior – yes, that’s easier said than done, but the plus side is you get guidance on change.
  5. And there is a big emphasis on acceptance – you are where you are.
  6. Getting comfy with what seem like contradictions – dialectics.
  7. Tracking emotions, symptoms, and skills used on a diary card on a daily basis.
  8. Acronyms upon acronyms.
  9. Structure – all sessions have an agenda, starting with keeping you alive followed by sticking with therapy and ending with everything else. You don’t get much time to ramble.
  10. Being viewed as capable – which means you’re held accountable for your actions.
  11. Many, many “Assumptions,” a noteworthy one being the relationship between the therapist and client as a relationship between equal people. Yep, your therapist is a human, not unlike you.

Where do I find a DBT therapist?

Check the Behavioral Tech “Find a Therapist” directory

Also check the DBT-Linehan Board of Certification website

You can also ask your psychiatrist or get a referral from an inpatient program, if applicable. Chances are pretty good they’ll suggest it before you ask if there is a program close to you, and your risk of committing suicide is high.

Next in the series will feature alternatives to DBT, for those who find DBT ineffective, don’t have access to it, or just don’t plain care for it.

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Albert Ellis On Guilt and Shame

Albert Ellis is one of the most influential therapists, and he founded the first of the cognitive and behavioral therapies called Rational Emotive Behavior Therapy. This lecture (audio only) on guilt and shame is pretty fantastic.

As I was listening to it, I thought of the clients I’ve seen who feel guilt and shame regarding their obsessions and compulsions, e.g. “I’m a bad person for thinking [insert images or fears of murder, pedophilia, etc], and people will hate me if they find out about what goes on in my head.” And of course, “I have no reason to be depressed.” (I don’t need to expand on that one) Typically guilt and shame are not justified (meaning they fit the facts) in these sorts of cases. And if guilt and shame do fit the facts – you did in fact do something that went against your values (guilt) and you will be ostracized if anyone finds out (shame) – acknowledge it, make amends with yourself/those harmed/your higher power, accept what happened, and don’t do it again.