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Dialectical Behavior Therapy, commonly
known as DBT, was originally developed by Marsha Linehan, PhD
to assist individuals diagnosed with Borderline Personality Disorder
(BPD) create a life worth living. DBT is a broad-based cognitive-behavior
treatment program that has been clinically proven to be effective
in treating BPD by assisting clients to learn and apply coping
skills that improve their overall quality of life. The skills
developed throughout treatment include:
- Handling feelings
- Dealing with other people
- Developing the support of friends,
families or helping professionals
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DBT skills have also proved to be effective
in helping individuals with other personality disorders, eating
disorders, substance abuse issues, and anxiety and mood disorders
be more successful in managing their lives.
Individuals with a high need for emotional regulation often deal
with a variety of symptoms which create conflict and interfere with
their ability to handle daily situations. Symptoms often include:
• Recurring suicidal behavior or threats
• High risk self-harm behaviors
• Quick and intense mood changes
• Harmful impulsivity, such as:
- illegal activities
- sex
- substance abuse
- reckless driving
- binge eating
- intense and complicated relationships
- destructive anger
- spending money
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Treatment
Modalities
Treatment
includes an hour of individual psychotherapy and two hours of psycho-educational
skills training group on a weekly basis. Additional services include:
- Telephone skills coaching.
- Case management with other service
providers, physicians, and clinicians.
- Medication management with psychiatrists
or primary care physicians.
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| The Four Modules
of DBT |
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Skills training
groups are offered in four modules: Core mindfulness, Distress tolerance,
Emotional regulation and Interpersonal effectiveness. New participants
are enrolled at the beginning of each module.
Each of the modules starts with the 2 week
Core Mindfulness module. The class teaches six core skills that
focus on learning how to focus attention; being mindful of information
the client chooses to focus on and unmindful of information that
is not helpful or effective in meeting their goals. |
| In the Interpersonal
Effectiveness module, participants are taught how to formulate and
prioritize specific goals in interpersonal interactions. Clients learn
about factors that reduce interpersonal effectiveness. They learn
useful methods for saying no and asking for what they need; including
ways to express themselves in a gentle, interested and easy manner
while appearing confident. Participants are taught a system for negotiating
their wants and presenting their point of view to build strong relationships
and self-respect. |
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In the Emotional Regulation
module, participants learn how to be aware of, define, and use private
emotional experiences as valuable information in making decisions
and communicating with others. They are taught the invaluable role
that emotion plays in interpersonal interactions and are coached in
methods to reduce emotional vulnerability, increase positive emotions
and be unmindful of worries. |
| In the Distress Tolerance
module, participants are taught how to manage anxiety and delay immediate
behavioral responses when faced with high stress or crisis situations.
We teach relaxation skills, self-soothing with the five senses, distraction,
improving the moment, and radical acceptance. |
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| Individual
Therapy |
Each of our DBT
Mid-Peninsula Team clinicians is also available for weekly individual
DBT psychotherapy sessions where clients learn to integrate and
apply the teachings and skills from the skills training groups into
their daily lives. For clients that
are not actively suicidal and do not exhibit dangerous self-harm
behaviors we also work collaboratively with out-of-team therapists
if their clients wish to continue weekly individual therapy with
them while participating in our DBT skills training groups. The
primary therapist must be willing to accept calls for emergency
phone consultations and check client’s diary cards weekly to assist
clients in managing their target behaviors. Handouts of client’s
weekly skills training materials will be made available to out-of
team therapists upon request. |
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| DBT Treatment
Goals |
Once an individual
enters our DBT program a treatment plan is developed with the therapist
and individual target behaviors are identified for each client.
The first stage of treatment involves achieving client stability,
connection and safety, resulting in:
- Decreased suicidal behaviors
- Decreased self-harm behaviors
- Decreased therapy interfering behaviors
- Decreased quality-of-life interfering
behaviors
- Increased behavioral skills, including:
- core mindfulness
- interpersonal effectiveness
- emotional regulation
- distress tolerance
- self-management
The second stage of the program focuses
on exposure and emotionally processing the past with the goal
of decreasing posttraumatic stress.
The third and final stage of the program
focuses on increasing respect for self and setting individual
goals.
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| Commitment
of Participants |
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To participate in the DBT program and create
a life worth living an individual must:
- Be willing to work hard
- Be committed to actively participate
- Be prepared to make difficult but healthy changes in their life
- Be willing to complete all 4 modules (about 8 months)
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Those accepted must
also have:
• Transportation to and from program (and backup plan)
• Day care arrangements (and backup plan)
• Telephone (or 24-hour access to phone – important for telephone
coaching))
• Willingness to obtain one support person |
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DBT Mid-Peninsula Team
A Group of Independent Clinicians
- All team members have been intensively trained in Dialectical
Behavior Therapy by Behavioral Tech, LCC of Seattle, WA
Team Leader:
Helen Selenati, LMFT (MFC 41355)
Skills Trainers:
Karen Kasch, PhD (PSY 20154)
Tricia Mlnarik, MFT (IMF 51244)
Mary Reed, Trainee
Tami Schmalz, MFT (MFC 46061)
Margo Thienemann, MD
Betty Wu, Trainee
Adult
DBT skills training groups in Redwood City
Tuesday evening 7:00 - 9:00pm
Wednesday evening 7:00 - 9:00pm
Thursday Morning 10:00 - 12:00noon
Teen
DBT skills training group in Redwood City
Tuesday afternoon 4:30 - 6:00pm
611 Veterans Blvd, Suite 109
Redwood City, CA 94065
Helen Selenati at 650-596-0807
Also visit our website
www.midpeninsuladbt.com
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