Dialectical Behavior Therapy and Treatment

Potomac Programs is one of the only therapy services in the Washington D.C. metro area whose services are covered by insurance.

Leading the Way

Potomac Programs is considered to be one of the leading dialectical behavioral therapy (DBT) treatment centers in the Washington D.C. area.

If you are a teenager, young adult or family who think DBT may be an effective treatment for you, consider meeting with a DBT or mental health therapist in D.C. at Potomac Programs, which offers DBT intensive outpatient programs (IOPs) for mental health illnesses or issues like:

  • Addiction issues
  • Anxiety
  • Depression
  • Emotional and mental health issues
  • Substance abuse
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An Introduction to DBT

DBT is a type of cognitive-behavioral therapy, also known as talk-therapy, that tries to identify negative thinking patterns and pushes for positive behavioral changes in individuals. DBT was developed by American psychologist Marsha Linehan, Ph.D., in the 1970s, to help those struggling with borderline personality disorder (BPD). The therapy is known as the gold-standard treatment for this population today.

In short, DBT provides individuals with a mental health illness or issue with a set of core skills that can enable them to work through difficult emotions as well as manage their relationships. This set of skills has been used to treat self-destructive and even suicidal behaviors, but research has shown that they can be beneficial for everyone, not only those struggling with mental health.

Acceptance and validation fosters healing.

The History of DBT

Linehan, Ph.D., developed DBT in the 1970s while using cognitive-behavioral therapy (CBT), or, talk therapy, techniques. She began to see intense emotions and problems arising in her patients when using CBT, as they would often become frustrated and later quit therapy, due to a lack of validation from their therapist.

Building on CBT principles, Linehan, Ph.D., developed what is now known as DBT. With the addition of acceptance and validation, DBT allows patients to first accept that the feelings they have are real, then establishes trust and validation with their individual therapist, which is essential for change.

The 4 Components of DBT Treatment

Although there are several types of DBT that are specialized according to the mental health illness or issues being treated in an individual, the four components of comprehensive DBT treatment include:

  1. DBT Individual Treatment: This component of DBT consists of individual treatment between a patient and therapist. Throughout these types of individual treatment sessions, the patient and therapist could discuss any issues that arose throughout the week, as well as how to improve them while learning new skills, like problem-solving.
  2. DBT Phone Coaching Treatment: This component of DBT consists of phone coaching between a patient and therapist. Once the patient has learned and practiced their DBT skills and is ready to integrate those skills into their day to day life, they can receive coaching treatment from a therapist.
  3. DBT Skills Training Group Treatment: This component of DBT consists of group treatment and skills training therapy that focuses on individuals learning and practicing their DBT skills together. Throughout these types of group treatment and skills training sessions, patients could be assigned homework from their therapists to practice DBT skills in their everyday lives.
  4. DBT Therapist Consultation Team Treatment: This component of DBT consists of support and therapy for the therapist, so that he or she may continue to focus on providing the best treatment possible for his or her patients. Throughout these therapist consultation team treatment sessions, the therapist is provided with the motivation and support he or she needs to continue to treat the often complex and severe illnesses and issues of their patients.

These four components of DBT treatment are instrumental in helping patients find their own path of emotional and mental healing.

The Top 4 DBT Skills

DBT is separated into four skill groups, which focus on two acceptance-oriented skills (mindfulness and distress tolerance) and two change-oriented skills (emotion regulation and interpersonal effectiveness). These four DBT skills are defined as:

  1. Mindfulness: A DBT skill that focuses on the practice of being fully aware and present in each moment.
  2. Distress Tolerance: A DBT skill that shows individuals how to work on tolerating pain in difficult situations, instead of changing it.
  3. Interpersonal Effectiveness: A DBT skill that focuses on individuals asking for what they want and practicing saying “no,” while maintaining their self-respect and their relationships with others.
  4. Emotion Regulation: A DBT skill that shows an individual how to change emotions and decrease their own vulnerability to the painful emotions that they want to change.

These skills allow an individual to learn how to cope and work to handle a stressful situation rather than responding in a negative or self-destructive way, especially those patients who may have a tendency to self-harm, or who are suicidal.

4 DBT Treatment Targets

Individuals who receive DBT treatment often have multiple issues that require help from a therapist, so DBT uses a hierarchy of treatment targets which helps a therapist determine the specific order that an issue or problem needs to be addressed. These DBT treatment targets, in order of priority, are:

  1. Life-threatening behaviors: If there are any behaviors that arise that could result in a patient’s death, these issues are targeted with DBT treatment, first and foremost.
  2. Therapy-interfering behaviors: If there are any behaviors that could interfere with a patient’s therapy, like canceling sessions or not being open to working towards treatment goals, these issues are singled out with DBT treatment next.
  3. Quality of life behaviors: If there are any behaviors that could result in patients having a lack of quality of life, like crises or disorders, these issues are targeted with DBT treatment next.
  4. Skills acquisition: If there are any behaviors that patients can learn to achieve their goals and replace any that are unsuccessful, these are singled out with DBT treatment last.

The Top 4 DBT Treatment Stages

DBT treatment is divided into four stages of treatment that are defined by a patient’s behaviors. These DBT treatment stages include:

  1. Stage 1: In Stage 1 of DBT treatment, a patient may be out of control or engaging in things like alcohol, drugs, self-harm or self-injury. The goal of therapy in this stage is for a therapist to move a patient to a state where they are more in control.
  2. Stage 2: In Stage 2 of DBT treatment, a patient may have a behavior that is more in control, but their emotional and mental experience may be inhibited due to a past trauma. The goal of therapy in this stage is for a therapist to move a patient to a healthier setting where they can have complete healing.
  3. Stage 3: In Stage 3 of DBT treatment, a patient may face the challenge of acting on the behavioral skills that they have learned, like learning to live with happiness, more defined life goals, self-respect, etc. The goal of therapy in this stage is for a therapist to move a patient to happiness.
  4. Stage 4: In Stage 4 of DBT treatment, a patient may need to find a deeper meaning or a sense of fulfillment. The goal of therapy in this stage is for a therapist to move a patient towards a life that offers joy and meaning.

The Effectiveness of DBT

According to the National Institutes of Health (NIH), DBT “has been proven to be an efficacious treatment” in “several randomized controlled trials” and is known as the gold-standard form of treatment for several mental health conditions today.

More than 30 randomized controlled trials produced by over 20 independent research groups have shown how effective DBT has been at treating conditions like BPD, eating disorders and post-traumatic stress disorder (PTSD), as well as issues like:

  • Anger
  • Depression
  • Hopelessness
  • Self-harm
  • Substance use
  • Suicidal attempts or thoughts

In addition, DBT has been found to decrease suicide attempts by 50% as well as hospitalizations for suicide by 73%, according to the NIH.

The impact of DBT on patients has also been recognized by Time Magazine, who recently named the therapy “one of the top 100 new scientific discoveries.”

Is DBT the Right Treatment for You and Your Family?

DBT has been found to be beneficial for many individuals and populations across the world, but if you are wondering if DBT is the right treatment for you and your family, it’s important to consider the following factors:

  1. Is DBT or another therapy right for you? DBT is derived from CBT, a type of talk therapy, but it is focused on an individual trying to cope with, and ultimately change, any negative behaviors and patterns. If you are more interested in speaking with an individual therapist about your issues and understanding where they came from, then another type of talk therapy might be a better fit for you.
  2. Is changing a behavior your priority? DBT treatment focuses heavily on helping an individual change their behaviors and any patterns that might be problematic. If changing these behaviors is not what you want out of treatment, then another therapy might be best for you.
  3. Is group therapy right for you? Both individual and group therapy play roles in DBT, so it is important to consider if you are okay with both settings or not. Would you prefer to meet with a therapist one-on-one or are you more comfortable working alongside other individuals who are experiencing similar issues or problems?
  4. Will you be able to put the work in? Finally, DBT can be a lot of work, and therapists often ask patients to practice the new behaviors and skills that they are learning as a form of homework. If you will be unable or unwilling to put in that effort or work, then DBT may not be the right treatment for you.

DBT Treatment in Washington D.C.

DBT treatment can easily be located by patients in the Washington D.C. area, with more than 200 DBT therapists in Washington D.C. and over 25 residential treatment centers that offer comprehensive and specialized DBT programs to patients in the region.

In addition, for adolescent and young adult patients, Potomac Programs offers both comprehensive and specialized DBT treatment to patients and families in the Washington D.C. metro area.

DBT Treatment at Potomac Programs in the D.C. Metro Area

Potomac Programs is one of the premier therapy services that offers DBT treatment to young adults living in the Washington D.C. area.

The programs allow for patients to see therapists in the D.C. area at times that work for the patient – whether that is during the day, at night or at the patient’s home, apart from traditional one-hour therapy sessions.

In addition to comprehensive DBT, Potomac Programs also offers patients DBT-focused group therapy for specific mental health issues, like:

  • Addiction issues
  • Anxiety issues
  • Depression-related issues
  • Substance abuse issues

Potomac Programs consist of both intensive outpatient programs (IOP) as well as partial hospitalization programs (PHP), in order to meet a patient at the level of care that he or she may need.

In Potomac’s IOP, for instance, all four DBT mindfulness skills are taught in approximately 14-16 weeks, with patients meeting four days per week for experiential activities, process groups and skills groups. Included in the program is individual therapy once per week, as well as family therapy and multi-family skills groups every other week.

In Potomac’s PHP, a more intensive DBT schedule is employed, with an emphasis on DBT skills five days per week in a variety of different groups, as well as individual therapy and family support groups.

Finally, Potomac Programs also offers a First Step program that focuses on CBT and DBT skills, in addition to “Seven Challenges” which incorporates DBT as a way to address substance abuse and other problematic behaviors.

Potomac Programs’ treatment model and services provided help patients and families learn how to generalize DBT skills in their day to day environments and within their family system, in addition to seeing the function and effectiveness of a behavior chain analysis so they can use the skills to work towards their life worth living goals.

Most importantly, Potomac Programs is one of the only therapy services in the Washington D.C. metro area whose services are covered by insurance.


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It might be hard to believe, but people who emerge from Potomac Programs enjoy the experience. They tell us we are warm, welcoming, and our favorite – non-institutional. We don’t feel like a hospital because we are NOT a hospital.

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