There are many different approaches that we use as therapists, and most of us use more than one to make sure that our clients get the treatment that is the best fit for them. You may have heard some of the many acronyms – CBT, DBT, ACT, MI, MBSR, TF-CBT, RO-DBT, EMDR, ERP, SFBT, IPT – to name a few. For many years CBT (Cognitive Behavioral Therapy) has been the modality of choice and the basis for most therapists’ education.
When Marcia Linehan published a book on DBT (Dialectical Behavior Therapy) in 1993, it was part of the first wave of different therapies based on “evidenced based practice” that has become the gold standard for treatment of mental health disorders since. DBT incorporates cognitive behavioral therapy with elements of mindfulness and acceptance from Zen Buddhist practice. The goal of DBT is to help the most difficult clients and situations feel better and to learn skills that manage reactivity more effectively. Originally developed for borderline personality disorder or highly suicidal clients, it has found to be effective amongst a much wider variety of populations and concerns.
The Mindful Living Group at Chrysalis is based on DBT, but also builds in concepts from ACT (Acceptance and Commitment Therapy) such as values identification and acceptance. The goal of group is to teach skills to clients, but also give them a framework for communication and problem solving that they can use throughout their lives.
The different skills of Mindful Living and DBT are Distress Tolerance, Mindfulness, Emotion Regulation, and Interpersonal Effectiveness. Each of these builds on and overlaps with the other skills sets. Distress Tolerance helps you develop skills that let you make decisions about what you want to do instead of reacting to situations. Mindfulness helps you be aware of what is going on with yourself and the world in a way that is non-judgmental. Emotion Regulation helps you identify and manage your emotions effectively. Interpersonal Effectiveness helps you be assertive and set boundaries with others so that you can negotiate and get your needs met in all of your relationships.
Using DBT as a therapy or going to Mindful Living Group does not mean that you have borderline personality disorder. The therapy has expanded over the years to treat eating disorders, depression, and any kind of negative reactivity. There is even a subset of DBT called Radically Open DBT that was developed specifically for working with anorexic and anxious clients.
I choose DBT as my primary modality because it emphasizes the importance of genuineness, openness, and honesty in the client/therapist relationship and those values are incredibly important to me in both my professional and personal life. Sometimes, this makes for a more confrontational or directive relationship, but I find that most clients appreciate a direct approach. DBT pushes you to challenge yourself and your beliefs about the world so you do not get stuck in a rut.
The Mindful Living groups at Chrysalis run for 12 consecutive weeks. Building upon the curriculum, we also offer an 8 week Advanced Mindful Living group. If you are interested in joining one of these groups, please call to find out more about the schedule.
Kendra is a Senior Staff Therapist and soon to be Clinical Director of Chrysalis’s new Intensive Outpatient (IOP) program, where Mindful Living will be one of the groups offered. She is currently completing her DBTNCAA certification and has been working in this modality since 2004.