Dialectical Behavior Therapy (DBT) in New Jersey

Dialectical Behavior Therapy is a type of talk therapy that uses elements of psychotherapy along with education. It’s designed to help people overcome strong emotional reactions, avoid destructive behaviors and improve interpersonal relationships. It’s used to treat certain psychiatric conditions, personality disorders and the inability to regulate emotions and emotional responses. Let’s take a look at how DBT helps with these conditions.

UNDERSTANDING DBT AND ITS RELEVANCE IN NEW JERSEY

According to NAMI, it’s estimated that 1,112,000 adults have a mental health condition in New Jersey. DBT can help with a myriad of mental health issues. Dialectical behavior therapy was developed in the 1970s by Marsha Linehan, an American psychologist. It was first designed to treat people with suicidal behaviors and borderline personality disorder (BPD), who are high-risk and hard to treat. The treatment focuses on four core beliefs, including:

1. Mindfulness – The foundation of DBT is practicing mindfulness. It involves actively developing an awareness and an acceptance of the present moment and not judging that moment. Instead, it teaches people how to live in the moment, engage with the experience and observe thoughts and emotions as they appear.
2. Distress Tolerance – The second part of DBT focuses on developing coping skills in order to deal with distressing situations. This can be helpful in dealing with situations that cannot be immediately changed and tolerating the emotions that the situation invokes without participating in self-harming behavior.
3. Emotion Regulation – The third part of DBT focuses on regulating one’s emotions. This part of DBT helps individuals identify their emotions, understand why they feel that emotion and how to manage the emotion.
4. Interpersonal Effectiveness – This part of DBT training helps individuals build healthy relationships. It teaches people how to communicate and be assertive without being offensive. It also teaches the individual how to set healthy boundaries, express their needs and how to navigate conflicts in a healthy and productive manner.

MENTAL HEALTH ISSUES AND DBT IN NEW JERSEY

In New Jersey in the last 12 months, 669 individuals have been admitted to a state psychiatric hospital. The five state hospitals in NJ saw 621 admissions due to mental health crises, according to the Department of Human Services, Division of Mental Health and Addiction Services. The most common types of mental health disorders in the state are mood disorders, which includes depression and anxiety. For children and adolescents, the primary mental health disorder is ADHD. The main goal of therapists who use dialectical behavior therapy (DBT) is to strike a balance between validation (acceptance) of who you are and your challenges and the benefits of change.

DBT can help treat borderline personality disorder, depression, PTSD, eating disorders (specifically binge-eating disorder and bulimia), self-harm, and suicidal behavior that may lead to suicide attempts. it is also the choice of treatment of borderline personality disorder, emotion dysregulation, and a growing array of psychiatric conditions. It does this by providing four distinct treatment modalities, including individual therapy, group skills training, phone coaching and consultation team services.

1. Individual Therapy – Helps individuals apply the skills they learn in their group dbt skills training to real-life situations. Individual therapy is usually an hour session once a week.
2. Group Skills Training – Focuses on teaching behavioral skills. It’s different than group therapy because the training class is structured like a college course where the instructor teaches a skill and then hands out assignments. These courses typically last 24 weeks and meet for 2.5 hours a week.
3. Phone Coaching – Used to enhance the training and individual therapy by providing the individual with a counselor for additional help during challenging situations.
4. Consultation Groups – This is professional therapy for the professionals, clinicians, counselors and therapists who are involved in the customers’ treatment. It’s designed to allow therapists and counselors to talk with each other while providing motivation and ideas on how to best treat severe, complex cases.

IMPLEMENTING DBT IN NEW JERSEY

There are mental health facilities that offer dialectic behaviour therapy in New Jersey. A few of those treatment centers include the DBT Center of NJ, DBT of South Jersey, the Princeton Center for DBT and Counseling and the Trinitas DBT Institute. When it comes to treating difficult mental health cases, DBT can be integrated into existing mental health programs in order to create a more comprehensive approach. In a case highlighted by Psychiatry Online, a community health program in Manchester, New Hampshire integrated DBT into their clinical case management model to better treat individuals with borderline personality disorder who regularly use a lot of mental health resources. The individuals in their case management program needed a lot of care, and the existing treatments didn’t seem to result in much of an improvement in their conditions. Once DBT was integrated into the programs, those difficult-to-treat cases improved dramatically. Studies have examined that patients in the DBT condition had greater reductions in suicide attempts, deliberate self harm, suicidal ideation, impulsivity and intense emotions.

HOW DBT IS INTEGRATED INTO MENTAL HEALTH TREATMENT PROGRAMS

DBT is a variation of CBT or Cognitive-behavioral therapy. Since Dialectical Behavior Therapy incorporates four treatment areas, including individual therapy, group skills training, phone coaching and consultation groups, it can comprise the majority of an individual’s therapy sessions. However, this does not prevent them from attending traditional group therapy, CBT or substance abuse treatment. Instead, DBT can be added to the individual’s existing treatment program in order to improve the outcome.

DBT can also be customized to the individual. When DBT is customized, the individual is evaluated to determine his or her problem areas. Then, during the course of the DBT treatment, each problem area is addressed, and the individual is given a set of skills to practice in order to better manage the areas of challenge. Overall, the goal of DBT is to help the individuals practice being mindful, regulate their emotions and learn how to tolerate stressful or undesirable situations so that they can react more evenly. The latter is sometimes referred to as walking the middle path.

TECHNIQUES AND STRATEGIES IN DBT

DBT is a therapy that is designed to help the individual stay in the present and be aware of their emotions, handle crises and rough patches without resorting to destructive behaviors, improve interpersonal effectiveness and regulate emotional reactions.

Mindfulness

The goal of the mindfulness portion of Dialectical Behavior Therapy is to help the individual stay in the present and be aware of their current situation. It’s designed to teach the individual to be aware of how they feel and any thoughts that might occur to them. It also teaches how to separate their emotions and the sensations from their thoughts. In short, it’s designed to help the individual better balance their rational thoughts with the emotions that they are feeling. It also places emphasis on being accepting of one’s self so long as what’s being accepted isn’t harmful and teaches how to take action that is effective.

Distress Tolerance

Not every situation is comfortable or even desired. However, all humans go through rough patches. Distress tolerance helps individuals find ways to distract themselves so that they can calm down and relax. It also teaches the individual ways in which they can improve their currently distressing situation and cope with that situation by listing the various pros and cons.

Interpersonal Effectiveness

When an individual has rapid mood swings and intense outbursts of emotion, it can make forming and keeping relationships and relating to others extremely difficult. Interpersonal effectiveness teaches the individual how to ask for what they want and how to take steps to achieve what they want in a productive manner. It instructs individuals on how to deal with challenges and conflict in relationships, and it helps the individual build self-respect.

Emotional Regulation

Individuals with certain mental health conditions may feel emotions more deeply than others and be more prone to react with extreme emotion. This part of the treatment helps the individual understand how they are feeling and why they are feeling that way. It helps them overcome any barriers they might have to positive emotions, It helps reduce the individual’s emotional vulnerability and volatility while teaching them how to increase their good emotions. It also teaches restraint when it comes to giving in to their emotional urges.

COMBINING DBT WITH OTHER TREATMENT MODALITIES

DBT treatment can be combined with other treatment modalities, including medication management, group therapy and complementary or holistic treatment options.

Medication Management

DBT can be combined with medication management. Over the last few years, there’s been an increase in the available medications to treat borderline personality disorder, depression and anxiety. In fact, combining medication management with DBT may be able to improve the outcomes.

Group Therapy and Support Groups

DBT can be combined with more traditional group therapy sessions and support group sessions. DBT therapy focuses on staying in the moment, being mindful and being aware of one’s emotions. Being in a traditional group setting can help the individual by allowing them to listen to other people’s stories and how they deal with issues that come up in their very lives. It also gives the individual the opportunity to practice their mindfulness and emotional regulation in a group setting.

Incorporating Complementary Therapies

DBT therapy can be used with complementary and holistic treatment therapies. Holistic treatments, like art therapy, mindfulness classes, journeying, nature walks and even massage therapy can help the individual relax, process their emotions and lower their levels of stress so that they feel more harmonious and in sync with the world around them.

BENEFITS AND CHALLENGES OF DBT IN NEW JERSEY

DBT often takes a multi-step approach to treatment.

• Stage 1 seeks to treat the most destructive behaviors, like suicide and self-injury.
• Stage 2 begins the process of developing skills that can improve the individual’s quality of life. This often includes interpersonal effectiveness, distress tolerance and emotional regulation.
• Stage 3 focuses on improving the individual’s self-esteem and their personal relationships.
• Stage 4 focuses on bringing more joy into the person’s life and enjoying relationship connections.

Benefits of DBT

DBT offers many benefits across all age brackets, genders, races and sexual orientations in New Jersey.

• Increasing the individual’s feelings of self-worth.
• Access to after-hours care with phone coaching.
• The ability to practice their new skills in a supportive and controlled setting.

Challenges of DBT

While DBT is beneficial, individuals may find certain aspects of the treatment challenging.

• It requires a large time commitment.
• It can seem overly complex when the individual is learning all of their new skills modules.
• Participating in DBT may feel like more school since it involves homework.

ACCESSING DBT SERVICES IN NEW JERSEY

The state of New Jersey provides a Directory of Mental Health Services for each county. To use it, all you have to do is open the directory and choose the county where you would like to receive mental health treatment. Additionally, the Department of Human Services offers a webpage where you can find various mental health services. There is also an online webpage where individuals can find community support groups, programs and wellness centers.

SUPPORTING LOVED ONES UNDERGOING DBT

DBT can help individuals who have severe mental health issues that have been resistant to past treatments. This helps improve the individual’s life as well as their family members’ lives and their relationships with each other. Family members can help support the individual by encouraging them to attend all their treatment sessions. Family members can also attend family DBT sessions. These sessions focus on the same core principles as the individual DBT therapy. The difference is that it’s designed for the family group. Attending these sessions can help the family members understand what their loved one is going through while learning new dbt skills themselves.

DBT therapy, whether as a stand-alone treatment or as part of a more comprehensive program, can help individuals who have treatment-resistant depression, post-traumatic stress disorder (PTSD) and borderline personality disorder as well as several other mental health issues. It’s effective in teaching an individual how to be mindful and stay in the present, avoid destructive behaviors, regulate emotions, develop self-esteem and set boundaries in their daily lives. They learn skills to live a ‘life worth living’.

If you or someone you know might benefit from DBT, don’t hesitate to reach out to one of the many treatment centers with DBT therapists in New Jersey. If you need substance abuse treatment or dual diagnosis treatment, call us today. At Garden State Treatment Center, our healthcare providers can help you overcome addiction, even if you also have a mental health disorder. You can start your search with the Clinical Resource Directory, which is maintained by Behavioral Tech (an organization founded by Dr. Linehan MM to train mental health professionals in DBT), For DBT resources and more information, check out the resources and references section below.

Resources and References

1. DBT Center of NJ
2. DBT of South Jersey
3. Princeton Center for DBT and Counseling
4. NJ Center for Cognitive & Dialectical Behavior Therapy
5. Dialectical Behavior Therapy (DBT) Skills Group of New Jersey
6. New Jersey Mental Health Fact Sheet
7. Dialectical Behavior Therapy (DBT)
8. Community Mental Health Services in New Jersey
9. NIH Dialectical Behavioral Therapy