What Is Dialectical Behavior Therapy (DBT)?


What is Dialectical Behavior Therapy (DBT)?
A friend of mine is a therapist, working with adults/teens in the Greater Cincinnati area, and one of her specialties in DBT or dialectical behavior therapy. I decided an interview with her would be a great addition to this newsletter. Thank you, Lauren O’Keefe, MS, for sharing your brilliant DBT insights with us.

1) What exactly is DBT?

This is such a common question! My immediate thought, “Um, DBT is DBT, what do you mean!” But, in all seriousness, it refers to “Dialectical Behavioral Therapy.” It is a life changing treatment modality pioneered by the fantastic Marsha Linehan.

DBT focuses on high sensitivity and high reactivity to triggers. It focuses and can address so many things.The main focus is to target parasuicidal and suicidal behaviors. It’s also one of the only effective and research-based treatments for borderline personality disorder and eating disorders. It assists with allowing opposite and dialectical functioning to be true. For an example: “You can be scared AND strong.” Or, “ You can be trying your best AND still need to do better.” DBT is all about acceptance, peace and non judgment.

DBT is effective when the treatment as a whole is being followed. This treatment includes group therapy, individual therapy and phone coaching components.

2) Are therapists all trained in it or is it a specialized modality?

Like most modalities, you can do either. In order to specialize, you must demonstrate proficiency. This includes but not limited to: frequent trainings, research, frequent practice of the skills, etc.

If you decide to certify rather than specialize, the certification process is extensive for this modality. It is one personally I am preparing for. I currently identify as highly specialized, with over 2 years of DBT use and experience.

To certify you must complete all 4-5 separate trainings that are each 1-2 day trainings. You must read the CBT for Borderline Personality Book, and lead a year of DBT groups. Among this, you must ask participate in the DBT consult teams, acquire a letter of recommendation, and sit for the exam. These guidelines can change; but, when I last researched this, this is what I found. As extensive as it is, I respect it. It ensures the integrity of the treatment program and those practicing it.

3) Why should someone consider DBT?

Why wouldn’t you consider it? That’s the true question! Yes, it targets parasuicide and suicide behaviors. It also can address a slew of issues such as: interpersonal instability, distress tolerance, emotion regulation, anxiety of any degree, depression, bipolar disorder, eating disorders, obsessive compulsive disorder. It can also assist with trauma symptoms and providing a large amount of stability skills for those dealing with PTSD. The uses for this treatment are endless. It can be used for just about any clinical problem or concern.

4) How long does it take to notice a therapeutic impact?

This is a very hard question to answer for any counseling approach. The effectiveness and improvement times are determined by client commitment. If you work in sessions and are committed to progress- in and out of appointments- then one can see progress within a few months. But, this is highly dependent on the patient.

5) What is a typical session like?

A typical session is like a traditional therapy session, the only difference is we have a whole binder of skills we weave into the sessions and teach to assist the patient in acquiring, generalizing and strengthening. DBT differs in that it requires group therapy to be effective. The Groups assist with faster skill acquisition and they function as a skill classroom. Without the groups, progress can be slower in my opinion.

6) Do you assign homework to clients?

ABSOLUTELY!!!! DBT group and individual rely heavily on homework and patient accountability. If they don’t commit, progress is stagnant.

As a therapist, we have an easy job so to speak. We teach and guide. Patients have the hard job, they have to put it into action. You cannot expect things to get better if you do nothing to change the circumstances. Homework forces the circumstances to change— and boy do they! Trust the work!

7) What are some goals a client might seek to attain while utilizing DBT?  

One we use as a blanket goal is: “Create a life worth living.”  This leaves it up to the patient to self direct. Trouble with panic attacks? Trouble with maintaining friendships? Trouble with boundaries? Self harming? Done done done! DBT has got your back! You are the driver! You tell us what your perfect life would be, and we help you create and achieve it.

In order to get through hell, you have to go through hell, and once you’re free, you are free. Trust the journey.

Hope this helps!


Please remember:Healing is possible and you are so very worthy of that gift! 

Coming next month: What is Qigong?

Defining Resilience Series: Step 6 – Find a Guiding Hand to Hold

Defining Resilience


Step 6: Find a Guiding Hand to Hold

Before diving into step 6, a reminder about resilience: it is defined as the ability to overcome adverse conditions; with healthy bonding relationships, guidance, support, and compassion as the catalysts. Basically, it entails having the capacity to bounce back from stressful or overwhelming experiences.

What are some steps we can take to ensure we are building resilience in our lives?

  1. Focus on the positives. 
  2. Seek out and nurture supportive relationships.
  3. Utilize self-care strategies. 
  4. Take action steps to create positive change.
  5. Work on healthy habit formation. 
  6. Find a guiding hand to hold.
  7. Learn to become our own hero. 
  8. Be gentle with ourselves.

Today we will cover Step 6: Find a guiding hand to hold.

I have been interviewing amazing guest after amazing guest on The Healing Place Podcast over these past few months. Insightful souls who offer coaching services, have created online courses, written books, host podcasts, offer presentations, run retreats, and so much more! All with the intent of helping others along their healing journey. I am in love with the idea of utilizing our own healing experiences to help those who are looking for guidance and a comforting hand to hold. I know when I was in despair, I was flailing in my efforts to find answers.

Finding both of my therapists (yes, I was seeing two at the same time at one point – one for talk therapy and another for EMDR therapy and trauma-processing work) was life-altering. I felt a sense of calm just knowing I had guidance as I started taking those first steps onto the healing path. However, I also started to reach out to coaches and non-traditional therapy professionals, as well. I attended a class on the Hawaiian healing technique, Ho’oponopono; had an EFT (emotional freedom technique) healing session conducted on two occasions in my home; started practicing yoga with a trained professional who had an understanding of trauma storage in the body; and other similar self-care strategies. Finding what works for YOU is the key to creating a plan and building your coping tool box.

Here are five suggestions for finding a guiding “hand to hold”:

  • Listen to podcasts or watch YouTube videos related to your needs: I am a researcher by nature. My favorite question as a child, according to my parents, was, “Why?” Understanding your habits, fears, concerns, solutions, and just having a feeling of connection through the power of “Oh my gosh, me, too!”, can empower your healing quest. The trick is to search for key words (try typing the following in a Google search ACEsEFT tapping, or Yoga YouTube . . . I personally LOVE Yoga with Adrienne!)  *Hint* My podcast has over 50 episodes filled with motivation, inspiration, and healing light and can be listened to at your convenience simply by visiting my website and scrolling to the bottom of the podcast page. If you have Bluetooth capabilities in your car, hit play and listen in while you drive!
  • Find an online course, webinar or summit: Some are free, some are free for a limited time and then available to purchase an access pass, some are fee-based and costs vary from minimal to what some may consider to be expensive. I know I recently watched a webinar and the presenter then offered me a package deal at the end for only two payments of $4,998.00. After I finished choking on my coffee, I exited out of the program a little wiser on my need to research before devoting an hour of my precious time. Make sure to review ratings and create a bookmark folder for yourself. I have folders labeled, “research”, “blogs”, “podcasts”, and so on. Some are geared toward professionals and others toward those seeking assistance. For example, an “addictions webinar” search will bring up both professional and personal webinar options.
  • Hire a therapist: This one can be tricky only because there are factors to consider such as insurance coverage, type of therapy, available providers in your area, and so on. Do not let it inhibit you, however. I promise you, the effort you put in to finding the right therapist will be worth it. I had searched for an EMDR therapist when my counselor first suggested I consider EMDR as a trauma-processing option and found someone close to home (I was experiencing pretty severe driving anxiety at that time). I did no further research before scheduling the appointment. And, wow, was THAT a lesson learned. He told me I was “cured” after three sessions and then advised me that the reason I had highway phobias was because “cars are big and scary”. Oh boy. Yes, I reported him. Yes, I stopped seeing him immediately. Then I searched again, researched the woman I found who most appealed to my needs, and promised myself I could drive the forty minutes to her office as I was so very worthy of the effort. Ninety-eight sessions and four years later, I was a new woman. It was truly a life-altering process and I am forever grateful to Dr. Barb Hensley of Cincinnati Trauma Connection. Find someone who specializes in your needs (if having someone who is LGBTQ sensitive is important, then specify that in your search, and/or perhaps you would feel more comfortable with a specific gender, or you would like to consider a therapy with minimal talking such as an art therapy modality). Again. . . do YOU and what works for your needs.
  • Secure a life-coach: This can also seem a daunting task. There are coaches for weight loss, general motivation (think Tony Robbins), relationship coaches, stress and mental health, career coaching, online coaching, Facebook coaching groups, coaches you can call or video-chat with weekly, and on and on. Many of my podcast guests offer coaching services. The key, again, is finding what works for you. Assess your needs and then research. Are you looking for someone who specializes in toxic relationships? Or maybe co-dependency? Perhaps you really want a guiding hand when it comes to emotional eating. Do you need time-management help? A goal of mine is to create a coaching plan for healing through the power of forgiveness. I look forward to creating a course and/or coaching plan in 2019!
  • Utilize the power of friendship and soul connections: I treasure those go-to peeps in my life that I can call at any time to cry, laugh, wallow, or celebrate. Whether it’s my sister or a close friend, my mom or my son who lives five states away, there is solace in connecting. As I discussed in my August, 2018 Hope for Healing Newsletter, make an effort to connect with others with similar interests and you will start to grow your support network. As I’ve stressed previously, however, be sure to reach for those who lift you up with positivity, avoiding (if not eliminating) those toxic relationships and the energy-vampires who will hinder your healing progress.
Coming up next month: Step 7: Learn to become your own hero.

Podcast Episode 47: Sarah Guilfoy – Heart to Heart

Welcome to The Healing Place Podcast! I’m your host, Teri Wellbrock. You can listen in on iTunes, Blubrry or directly on my website at www.teriwellbrock.com/podcasts/
I thoroughly enjoyed my connection and laughter shared with my guest Sarah Guilfoy – founder and managing director of the non-profit, Heart to Heart. Sarah’s background includes teaching, a degree in Psychology, and a personal ACEs score of 8/9 (so very similar to my own background!). Please join us as we discuss Sarah’s beautiful passion of providing a parent support line via phone, text, and email as a way of offering free emotional support for caregivers. Heart to Heart is partnered with Healthy Beginnings in the state of Oregon.

As shared from the Heart to Heart website:

“Heart to Heart is a free telephone, text, and email service for parents and others experiencing family life or parenting challenges.

This nonjudgmental service provides a listening ear, support and guidance to parents and caregivers who are upset or troubled about a family issue, or just need someone to talk to. Heart to Heart is staffed by parent volunteers. As parents, they truly understand that parenting is hard work! They are available to help ease some of that workload, by offering support.

LEARN MORE AT 541-322-2019″

Thanks for tuning in!

You can also watch our interview on YouTube. So exciting!

Being Mindful in Nature

 Being Mindful in Nature
My elderly mother has been experiencing health issues over the past few months, with various hospital and rehabilitation facility stays. My oldest son, who lives five state away from me, was involved in a serious car accident. My podcast has started to explode (in a good way!) leaving me scrambling to stay on top of the interview, editing and publishing schedule. All of this is stress-inducing. But, that’s life . . . crazy and fun and chaotic and messy at times. However, it’s how we handle the chaos and resulting stress that determines whether we feel overwhelmed or calm in the moment.

Today I hit the trails at Cincinnati Nature Center for some self-care soul work. I practiced mindfulness exercises as I hiked, listening to the sounds of nature, taking in deep breaths of the forest scents, and allowing the cool morning air to embrace me. Nature is my reminder to stay grounded. As I focused on the little bee, asleep on a  flower, I allowed myself peace. Right there in that moment. No decisions about nursing homes or insurance policies, no scheduling conflicts or malfunctioning recordings. Just me, a bee and a flower.

I wish you serenity in nature. Here is a little collage of some of my favorite photos I have snapped while hiking at our local nature preserve. Enjoy!