DBT at Trilogy
What is DBT?
DBT stands for Dialectical Behavioral Therapy. It was originally developed by Marsha Linehan at the University of Washington for clients who were frequently hospitalized for suicidal ideation or behavior. DBT is a combination of eastern zen meditation practices and western psychological theories.
Why we offer DBT
The ultimate goal in DBT is to live a life worth living, however clients choose to interpret that. Since its development, DBT has been used to treat many diagnoses and disorders including Borderline Personality Disorder, Substance Abuse, Obsessive Compulsive Disorder, Self-Injury, Bipolar Disorder, Depression, and Anxiety. There is a significant amount of evidence that suggests that DBT is effective, though the amount of evidence varies by population.
How we use DBT
Trilogy’s DBT Program upholds and employs all 4 pillars of the evidence-based practice.
Pillar 1: Group Skill Building Sessions
Our DBT Skills Groups are offered in cycles and build skills such as mindfulness, dialectics, distress tolerance, emotion regulation, and interpersonal effectiveness. Each group meets once per week for 90 minutes with a short break. Group activities include mindfulness practice, diary card and homework review, and introduction of skills. Each group member is paired with an individual skills builder in order to cement their understanding of these new skills and to work towards incorporation of those skills into their lives.
The DBT Skills Integration Group follows the DBT Skills Group and is intended to support clients in actively and meaningfully applying DBT skills to reduce target behaviors and to build a life worth living. The DBT Skills Integration group focuses on finding freedom from overwhelming stress and learning to accept current problems through the use of mindfulness and other skills. This group places emphasis on building mastery with skills to handle difficult and stressful situations by gaining insight into the effectiveness of using skills to cope with emotional distress. In addition to daily mindfulness practice, group members will be expected to practice the skills throughout the week and meet with an individual DBT skills trainer outside of group to further enhance and generalize skills. Group members should have familiarity with the DBT skill modules, though proficiency in every skill is not required.
Pillar 2: Individual Sessions
In individual skills training, DBT clients will be assigned an individual skills trainer to meet with once a week. They will collaboratively decide on the best use of this time. Many DBT clients use their sessions to ask additional questions, review and expand on information learned in groups, review their homework and diary card, or continue developing skills. While most DBT clients engage in both group and individual skill building at Trilogy, it is possible for clients to participate in individual skills training without attending groups.
Pillar 3: Phone Coaching Line
Not all DBT treatment can be done within the context of individual and group sessions, which is why Trilogy provides on-call services after regular business hours for DBT Program clients. This option ensures that DBT clients have access to a DBT skills trainer when they need to practice DBT skills in everyday life. DBT phone coaching is especially useful in situations when clients' urges to engage in target behaviors are very high.
Pillar 4: Staff Consultation Team
Trilogy’s DBT staff work in a collaborative manner to ensure the therapeutic relationships througout the program are consistent and high-quality. This approach balances clinicians' own individual behaviors and interactions with the expectations of the evidence-based Linehan model. Consultations seek to assure effective treatment for individuals with high levels of emotion dysregulation, interpersonal chaos, and life-threatening and self-injurious behaviors.