DBT – Dialectical Behavior Therapy

Why Dialectical Behavioral Therapy?

Dialectical behavioral therapy (DBT) is an effective recovery tool that helps women realize their potential to create a meaningful life for themselves, regardless of challenges they have experienced in the past. They are supported in this pursuit through education and practice of recovery skills when confronted with:

  • difficult, overwhelming emotions
  • invalidating environments
  • problematic thinking patterns
  • old, destructive ways of living

Dialectical behavioral therapy is a form of integrated treatment combining behavioral, cognitive, and supportive therapies. Developed by Dr. Marsha Linehan of the University of Washington, DBT emphasizes teaching each woman how to experience her emotions and create a life worth living. Developed to address complex mood and personality disorders, DBT is especially effective in treating persons who have suffered repeated relapses of self mutilation, eating disorders, co-occurring psychiatric illnesses, or addiction.

There are four primary aspects of DBT skills training that a woman will learn and practice throughout her treatment in our therapeutic living environment:

  • Mindfulness. Learning to control your mind so it does not control you.
  • Distress Tolerance. Learning how to make it through crisis situations without making matters worse (without engaging in self harm).
  • Emotion Regulation. Learning how to tolerate and regulate your emotions in productive ways.
  • Interpersonal Effectiveness. Learning how to be more effective in communicating with others, and being aware of your own limits in relationships while also observing the limits of others.

What Are The Goals Of DBT?

DBT works to replace an “either/or” perspective (e.g. either experience emotional chaos, or attempt to manage it through a destructive behavior) with a perspective that allows the resident to develop a “both/and” approach to life.

DBT emphasizes a woman’s ability to replace destructive thought and behavior patterns with healthy, adaptive choices. DBT first helps women to decrease destructive behaviors like:

  • Patterns of intense and unstable relationships
  • Extreme vulnerability to emotions
  • Impulsiveness- self harm, cutting, drinking, binging, purging, and restricting
  • Confusion about self, getting stuck in ruminative thoughts, memories, emotions.

Simultaneously, women learn skills that promote healthy thoughts and behaviors such as:

  • Living in the present moment
  • Living through distress
  • Living with emotions as our ally
  • Living with others effectively
  • Living in balance between acceptance and change

How Does Timberline Knolls Integrate DBT into Treatment?

Timberline Knolls Residential Treatment Center combines dialectical behavioral therapy (DBT) with recovery principles into an integrated, holistic treatment program for women suffering with eating disorders, substance abuse, and co-occurring psychiatric and addictive disorders.

Residents work in groups to learn the skills of DBT and practice mindfulness. Groups emphasize real-life examples and role-playing exercises that complement other core groups. Group practice helps women make their feelings speakable while simultaneously teaching emotional regulation. DBT also promotes shame-reduction related both to eating disorders and addictive diseases, and to unresolved trauma.

Outside of the structured DBT group setting, women are encouraged to practice each of the DBT skills daily. Because DBT is fully integrated into the residential living environment, trained staff are always there to help women in crisis to apply DBT skills for self-soothing. This helps women move beyond symptoms and other self-harming behaviors, and builds confidence in recovery. Many women also choose to practice mindfulness exercises independently and in groups during free time on the lodge.

DBT is also integrated tightly into experiential and expressive therapy activities. Particularly for younger women, games, art projects and other hands-on activities can reinforce a women’s freedom of choice and bolster self-esteem

Every member of our clinical staff, including nursing and support staff, receives training in dialectical behavioral therapy. Therapists are under continuing clinical supervision to further their development as advanced DBT practitioners. As a result, residents know they are surrounded by a supportive team, each of whom understands the struggle to change her way of thinking and surrender to a new way of living. Combined with awareness of 12 Step Recovery Principles, DBT provides women with a solid foundation to accept their feelings and experiences, and to exercise their power to change the things they can.

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