The 4 Stages of Treatment in Dialectical Behavior Therapy

We hear a lot about learning skills in DBT and a lot about learning to manage intense emotions and the problem behaviors that are often maladaptive attempts to manage those emotions.  These are primary targets of the first stage of DBT.  Often, we don’t hear much about the other 3 stages.

In stage 1 of the treatment, therapy is focused on getting behavioral control.  People who enter treatment at this stage are actively struggling with life threatening behaviors (e.g. cutting, suicide attempts, excessive drinking), treatment interfering behaviors (e.g dropping out of treatment, hostility towards therapist, skipping therapy) and major quality of life interfering behaviors (e.g. risk of losing housing, being expelled from school, losing marriage, custody of children).

The rationale for focusing on gaining behavioral control at this point is that it is assumed that a life lived out-of-control is excruciating.  Progress cannot be made on underlying emotional issues until you have the skill to manage emotion without engaging in dangerous behaviors and are committed to the process of therapy. Continue reading “The 4 Stages of Treatment in Dialectical Behavior Therapy” »

Exercises For Non-judgmental Thinking

Cultivating non-judgmental thinking is taught in Dialectical Behavior Therapy (DBT) Skills Groups as a part of the Mindfulness Training.  Mindfulness teaches individuals to observe and describe their own behavior, which is necessary when any new behavior is being learned, when there is some sort of problem, or a need for change.

In DBT mindfulness skills are intended to improve an individual’s abilities to observe and describe themselves and their environment non-judgmentally, which enhances the ability to participate in life effectively.

Continue reading “Exercises For Non-judgmental Thinking” »