What is CBT?

Cognitive behavioral therapy (CBT) is a comprehensive system of psychotherapy that involves a combination of understanding the self, symptom and problem resolution, improving quality of life, and working towards life goals.

Clients learn a range of strategies and are given assignments between sessions to help them to generalize skills into their daily life. Treatment is time-limited, varies in length depending on the presenting problem, and involves one or more of the following modalities: individual therapy, family therapy, group therapy, and parent training.

CBT is an evidenced based treatment addressing a wide range of problems in children, adolescents, and adults.

This approach is based on a theoretical model, which states that thoughts, feelings, and behaviors influence each other, and contribute to the development and maintenance of psychological disorders.

Cognitive behavioral approaches treat psychological problems by intervening in three areas: 1) assisting clients with increasing their self-awareness of thoughts and, when necessary, restructuring errors in thinking, 2) identifying and labeling emotions and learning strategies to improve emotion regulation, and 3) examining and modifying patterns of behavior that cause and maintain problematic thoughts and emotions.

The CBT model has been applied with success in the treatment of a wide range of disorders and problems, including depression, anxiety (e.g., social anxiety, specific phobias, OCD, generalized anxiety disorder), anger, impulsive behaviors, ADHD, behavioral problems, social skills deficits, and family/relational problems. Importantly, this therapy approach has demonstrated success both alone, and in combination with medication. Research has demonstrated maintenance of treatment gains over time. Each client participates in individual CBT therapy for 45 minutes 1-2 times/week.

What is DBT?

Dialectical Behavior Therapy (DBT) is a compassionate, evidence-based type of cognitive behavioral treatment for individuals who have significant difficulty regulating emotions and behaviors.

Developed by Marsha Linehan, Ph.D., DBT was first introduced in 1991 as a treatment for suicidal and self-injurious individuals diagnosed with Borderline Personality Disorder (BPD). Individuals with BPD are extremely sensitive and reactive to their emotions which often lead to actions such as self-injury, angry outbursts, or impulsively ending important relationships. Although these actions temporarily reduce emotional pain they often wind up causing other problems that can make life even more difficult.

Many national and international research studies have demonstrated that DBT is an effective treatment for multi-problem individuals. Both the American Psychological Association and the American Psychiatric Association currently consider DBT to be a first-line treatment for BPD. As a result of DBT’s success in treating adults with BPD, Dr. Alec Miller and his colleagues have spent over a decade researching and adapting DBT for suicidal and self-injurious multi-problem adolescents and their families.

DBT has also been modified so that it can be used with other psychological problems such as eating disorders, substance use, and anger management. DBT strategically blends behavior therapy (change orientation) with validation (acceptance orientation), teaching us that we are doing the best we can AND at the same time we need to learn alternative ways to manage our problems more effectively.

Learning how to think and act dialectically helps individuals achieve a more balanced lifestyle which ultimately helps people move toward having a life that feels more meaningful and worth living.

Distress, emotional pain, interpersonal difficulties, impulsivity, and behavioral problems such as using substances, self-injuring, losing emotional and behavioral control, socially withdrawing, can make it incredibly difficult to function normally and lead a life that feels meaningful and worthwhile.

DBT targets the issues that cause these problem areas and teaches skills to deal with them without having to resort to problematic and ineffective behaviors.

Each client participates in three modalities of treatment: 1) individual therapy (one to two times per week for 45-minute sessions), 2) skills training groups (once weekly), and 3) telephone coaching, as needed. Clients learn new skills in group each week in order to move closer to their life goals and the individual therapy focuses on helping the client generalize and apply those skills to their daily experiences. Skills coaching is encouraged for the clients to utilize when urges arise to engage in maladaptive behaviors.

For more information about DBT, please visit www.behavioraltech.org.