Fall 10-1-2015 Dialectical Behavior Therapy Skills Training Core. Which makes them more likely to behave in ineffective and harmful ways. Dialectical Behavior Therapy (DBT), with its emphasis on mindfulness, aims to help individuals break automatic. Mindfulness skills taught in three separate DBT skills training groups at Wayne Behavioral. The Behavioral Health Training & Education Network (BHTEN) is committed to supporting DBHIDS and other human service systems by planning, coordinating, and providing quality learning experiences in behavioral health and related topics. Our training audiences include providers and administrators of services, individuals engaged in services. What is Dialectical Behavior Therapy? Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy that focuses on the psychosocial aspects of therapy, emphasizing the importance of a collaborative relationship, support for the client, and the development of skills for dealing with highly emotional situations (Psych Central, 2016). Behavioral training: Behavioral training teaches you to apply skill and acquired knowledge in all sorts of situations. Let us continue with the example of driving; driving styles can vary between drivers. Even though the skill and knowledge is theoretically the same, there can be a significant difference in driving behavior, i.e. Program consists of 12 sessions with the goal of training the individual to use active behavioral or cognitive coping methods to deal with prob-lems, rather than relying on alcohol as a maladaptive coping strategy. The skills also provide a means of obtaining social support critical to the maintenance of sobriety. Twelve-Step Facilitation Approach.

Time to turn off the commute music, name your emotions, practice active listening and ask yourself if it is really worth the pain for a healthier and happier day.

Dialectical Behavior Therapy (DBT) is an effective treatment for PTSD, depression, anxiety, and personality disorders. However, many skills within the treatment can apply to everyone, and I meaneveryone, with major benefits to day-to-day life. Here are some suggestions on how to become more engaged, emotionally regulated, and present with four simple ways to practice DBT techniques.

What is DBT?

Dialectical Behavior Therapy is a treatment originally developed by Marsha Linehan in the 1980s-1990s to treat Borderline Personality Disorder. Since that time, research has proven its efficacy with nearly all types of mental health disorders.

Dialectical Behavior Therapy should not be confused with Cognitive Behavioral Therapy (CBT). DBT has four components:

1. DBT Individual Therapy – Weekly therapy with a DBT therapist where skills learned in DBT Skills Group are reinforced and significant work is done on commitment to treatment.
2. DBT Skills Group – Occurring weekly, this group is more psychoeducational in nature and is run similar to a classroom, where participants are taught skills using a Socratic style method and assigned homework which is reviewed during the following week's group.
3. DBT Phone Coaching – Patients are able to call their therapist during times of crisis to receive help in applying skills they are trying to learn to manage symptoms.
4. DBT Consultation Team – Therapists practicing DBT meet weekly to receive support in practicing a difficult, intense treatment and in maintaining competency.

DBT teaches four categories of skills:

• Mindfulness – Developing an awareness of the present moment, without judgment or attachment, in a way that allows you to be more aware of and more effectively manage emotions, thoughts, feelings, etc.

• Emotion Regulation – Improving awareness of emotions, causes, and consequences, in a way that allows us to choose how to manage them and improve the effectiveness of the way that we manage them

• Distress Tolerance – Practicing tolerating, rather than avoiding or changing extreme and/or distressing emotions

• Interpersonal Effectiveness – Learning how to advocate for yourself and improve management of relationships and relationship issues

Clearly the treatment, with so many parts and in depth skills training, is intense. However, as you read more about it, you will inevitably find that anyone can benefit from it. Who hasn't done something they regret in the heat of the moment? Who hasn't felt overwhelmed and unsure of what to do? Who hasn't been so caught up in their head that they miss the turn off the expressway?

Whether you are in intense crisis or an average healthy individual, the knowledge that comes from receiving Dialectical Behavior Therapy can improve your everyday functioning. But if you aren't someone who is in or hasn't received DBT treatment, what do you do? How do you get these benefits?

Well, below you can find a few easy ways to start using aspects of DBT skills daily.

• Turn Off The Music During Your Commute

One of my favorite past times is jamming out to my favorite tunes on my way to work. Unfortunately, this is the opposite of what I should be doing. Distraction can be fun, but it also sets us up to miss something important or get caught off guard. What's the harm, though? Well, a public service announcement might tell you that listening to music during your commute can lead to more car crashes. On the less dramatic side of things, it keeps you from taking in and being mindful of everything that is going on around you (which I guess would also lead to more car crashes).

When you are juggling multiple things at once it inherently means you aren't doing any one thing as well as you could be if you were only doing one thing at a time. It cuts you off from what is going on around you. If you aren't aware of what is going on around you, then you aren't able to effectively deal with it. On the flip side, by committing to whatever you are doing fully, without distractions, you not only improve the way you do it, but you flex and build your Mindfulness muscles. This idea applies to everything from driving to parenting and from washing dishes to shopping. Once you start working on being more mindful in these smaller arenas, you will be able to eventually do it when it matters. To start, though, just practice turning off your music during your commute and just travel.

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• Practice Naming Emotions In Everyday Conversation

Everyone has had the experience of being upset but not quite being sure why. Unfortunately, when you don't know why you're upset, there is often very little you can do about it. That's where DBT comes in. One of the best things about DBT is that it encourages patients to improve their ability to be more aware of their emotions, thoughts, behaviors, etc. in such a way that it empowers them to be able to manage more effectively. Sounds pretty complicated but in all actuality it doesn't have to be. Being able to name your emotions is a great place to start and what better place to practice doing that than in every day conversations? For example, 'I'm so happy you came over for dinner!' or 'It irritates me when you come home late without calling.

• Listen To The Person You Are Talking To

Sounds easy enough. But how often have you found yourself thinking about what to say before the person has even finished their sentence? We are all guilty of this. Sometimes it's because the conversation is heated or we are anxious. Either way, it rarely ends well. You usually say something you regret or ultimately wind up not getting what you wanted.

You don't have to agree with what the person is saying and you don't have to ultimately change your tune. But actually listening improves your odds of accomplishing your goals in dealing with someone (i.e. improves interpersonal effectiveness). When you actually listen to someone, it increases the likelihood that the other person feels heard and will give you what you want. It also increases the effectiveness of your eventual response because that choice will be based on a more fully informed assessment of the situation.

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Conclusion: You should actually listen to the person you are talking to (even if you don't want to).

• Asking Yourself 'Is This Really Worth It?'

Spinning your wheels. It's a phrase meant to recall images of gerbils hopelessly running in circles in their cage wheel. They aren't going anywhere, but continue to run none-the-less. When you're upset, you sometimes find yourself spinning your wheels. Or maybe more appropriately, you find yourself banging your head against a wall being upset about something that isn't really worth it.

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Unfortunately, in the moment, we aren't always thinking about whether it is worth it. We are usually obsessing over whatever we are upset about and making ourselves miserable in the process. We are tolerating distress poorly.

When we find ourselves here, we almost never actually do anything to make it better. Often times we make it worse and the cycle continues. By ourselves in the moment, it is hard to see the ineffectiveness of this pattern. But one of the easiest ways to try to cut this cycle off at the pass is to, when you notice you are really upset about something, ask yourself: 'Is this really worth it?', 'Is anything here actually in my control?', or 'Is my reaction making this situation better for myself?' (hint: the answer is usually no).

Overall, the DBT message is relatively consistent and clear: it is important to take ownership over our lives and we have an inherent ability to effect change for ourselves. Receiving adherent treatment from a certified DBT therapist and/or program is always recommended. But that doesn't mean that you can't benefit from some of the concepts without being in or having completed a full course of DBT treatment.

Many of the people I treat with Dialectical Behavior Therapy (DBT) have accidentally referred to it as DIABOLICAL Behavior Therapy. I can't tell you how many times other therapists at conferences or staff meetings have re-counted a story where a patient has referred to the treatment this way.

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When re-telling this type of story, it usually ends with resounding laughter at what is perceived as a Freudian slip. Why, you ask? Well, because while receiving DBT treatment has been known to change your life, it also requires hard work from the person receiving it. DBT may not quite be diabolical or hellish, but it's certainly not a cakewalk. But these four ways to use DBT daily are certainly a good place to start.

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Date of original publication: September 21, 2015

Updated: January 25, 2016

Dialectical behavior therapy (DBT) training is education for mental health professionals interested in offering DBT to their clients. It provides information for experienced care providers on how to use this therapeutic approach, and is typically aimed at care providers who are already qualified and practicing. Numerous trainings and seminars for dialectical behavior therapy training can be found around the world in settings like educational institutions, research centers, and psychotherapy programs.

In dialectical behavior therapy training, care providers learn how to use DBT to work with clients who have borderline personality disorder (BPD), although it can also be applied to the treatment of other personality disorders. This approach to therapy has its roots in cognitive behavior therapy, an approach that works on modifying harmful behaviors to help patients manage their mental illnesses. Patients with BPD often have a history of invalidation and rejection, and DBT provides validation and acceptance as part of the practice to keep patients in therapy, rather than making them feel invalidated by the therapy, which can force them to drop out.

There are two different components to DBT, and both are covered in dialectical behavior therapy training. The first is psychotherapy, in the form of individual sessions with patients and their care providers, both in person and over the phone. Patients typically keep diaries and charts, set goals, and work with their therapists to identify and modify behaviors. The first priority is a reduction in self-harming behaviors, followed by those which are considered therapy interfering, and then work on improving the patient's quality of life.

This is paired with regular group sessions for skills training in different areas of life. Dialectical behavior therapy training emphasizes the team nature of the treatment by working with therapists in groups as they start to develop strategies for working with patients in groups and one-on-one. Patients and therapists work cooperatively in an allied relationship in DBT. This can differ from some other kinds of therapeutic relationships where the therapist may be an absolute authority, rather than a cooperative partner.

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Therapists in dialectical behavior therapy training learn about the issues specific to caring with patients who have BPD, and discuss ways to avoid and minimize problems that may arise during therapy. Therapists assume the best about their patients and stress that all patients are working on self improvement. Their patients cannot fail at the therapy as a whole although they may have off days or weeks. The therapists also stress affirmation and support through techniques like meditation and mindful thinking, to help their patients deal with the sometimes overwhelming emotions associated with BPD.