Comprehensive DBT vs. DBT-Informed Therapy
DBT is a form of cognitive-behavioral therapy (CBT) developed by psychologist Marsha M. Linehan in the late 1980s. It was initially designed to treat borderline personality disorder (BPD) but has since been adapted and applied to a variety of psychological issues. DBT combines standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice.
Comprehensive Dialectical Behavior Therapy (DBT)
Comprehensive Dialectical Behavior Therapy (DBT) is a well-structured, multifaceted therapeutic treatment program designed to treat individuals with severe emotional dysregulation and disorders related to it, such as borderline personality disorder (BPD). Comprehensive DBT is distinct in its systematic approach to treatment, consisting of several key components that work together to support the client. These components include:
Individual Therapy: Clients receive one-on-one sessions with a trained DBT therapist. These sessions are typically held once a week and focus on enhancing motivational aspects and applying DBT skills to specific challenges and events in the client's life.
Group Skills Training: Clients participate in weekly group sessions, which are educational in nature and focus on teaching and practicing DBT skills. The four main modules of skills taught are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Phone Coaching: Clients have access to their therapist outside of scheduled sessions for in-the-moment coaching. This component is designed to help clients apply DBT skills to real-life situations as they occur.
Therapist Consultation Team: DBT therapists participate in regular consultation team meetings. These meetings provide therapists with support, ensure adherence to the DBT model, and discuss client care and progress. This component is crucial for maintaining the quality and integrity of the therapy.
Comprehensive DBT is evidence-based and has been found effective in treating a wide range of disorders beyond BPD, including depression, bipolar disorder, post-traumatic stress disorder (PTSD), eating disorders, and substance use disorders. Its comprehensive nature addresses the complexities of severe psychological disorders, offering a holistic approach to treatment that emphasizes both acceptance and change.
The effectiveness of comprehensive DBT lies in its structured approach, which systematically addresses the psychological needs of individuals. By teaching practical skills, it empowers clients to manage their emotions, navigate interpersonal situations effectively, and make life-affirming decisions. Comprehensive DBT requires a significant commitment from both the client and the therapist, but its benefits can be life-changing, offering hope and improved quality of life to those struggling with severe emotional dysregulation.
Dialectical Behavior Therapy (DBT) Informed Therapy
What is Dialectical Behavior Therapy (DBT) informed therapy? This refers to a therapeutic approach that incorporates some key principles and strategies of Dialectical Behavior Therapy, but does not strictly adhere to the comprehensive, standardized DBT program. In other words, DBT-informed therapy is any therapy that uses elements of DBT that fails to include all the elements of comprehensive DBT.
There is a wide-range in what may be considered DBT informed therapy. This may include therapy that uses DBT's core principles to guide treatment, but with some modifications. For example, in one common modification DBT skills are taught one-on-one during individual sessions, without the use of seperate skills group. This “almost comprehensive” approach can be useful in settings where implementing a full DBT program is not feasible due to resource constraints, or when treating clients with needs that do not require the full DBT model.
At the other end of the spectrum, DBT informed therapy can also include therapy with very little actual DBT. This may include therapy with a provider that likes to teach a few DBT skills when it seems appropriate, but without any of DBT’s guiding principles and guidelines. This approach may or may not be a problem, as long as the clients aren’t in need of comprehensive DBT, and the treatment isn’t being presented as “DBT” in a way that is misleading.
While DBT informed therapy borrows from the DBT framework, it's important for clients and practitioners to understand that it does not offer the comprehensive scope of standard DBT, which includes individual therapy, group skills training, phone coaching, and a therapist consultation team.
