What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) combines traditional Cognitive Behavioral Therapy methods with mindfulness and acceptance practices to treat emotional and behavioral problems and help people create a more meaningful and fulfilling life.

DBT teaches practical skills for clients to utilize in moments of crisis, difficult interpersonal situations, and problems of everyday living. Typically, individuals participating in dialectical behavior therapy feel more in control of their emotions and are less likely to let their emotions control them.

What credentials should I look for in finding a DBT therapist?

It is essential that you find a therapist who has been expertly trained in DBT.

The DBT board has recently implemented certification for therapists to ensure that DBT treatment is provided as was designed. Our team lead is certified by the DBT-Linehan Board of Certification, and all members of our team are in the process. We strongly encourage you find a program with DBT-Linehan Board Certified therapists.

As well, the premier training organization for DBT is Behavioral Tech, LLC. We recommend you find a DBT therapist that has this training, at a bare minimum. Our team lead participated in the intensive six-month training with Marsha Linehan herself, the creator of DBT. The remaining team members have also been trained in DBT by Behavioral Tech.

Why choose the Awake DBT program?

Awake DBT has a very relaxed atmosphere and approach. We believe a sense of connection and humor are important to balance the challenging work we ask of program participants. We believe our staff are very approachable, welcoming, and open to all. When you come to meet with us for the first time, you will get a sense of our down-to-earth but professional style.

How long is treatment?

When people first come to treatment we initially require a six-month commitment. It takes us 24 weeks (six-months) to deliver all the skills a single time. Most people choose to participate in a second round of group, to more fully integrate the skills into their lives.

As a participant approaches the initial six-month mark, we will assess what stage of treatment they are in (dependent on the severity of symptoms). When members are in Stage 1, they participate in group. Once a person is through Stage 2 (if doing prolonged exposure therapy), they may transition to individual therapy alone.

Treatment continues as long as the individual has specific and concrete goals in which to work. Once these goals have been achieved, we work toward ending treatment. We are not an ongoing treatment modality. If the individual wants ongoing support, we will refer to a different type of therapy, such as psychodynamic.

What happens in skills group?

Awake DBT is a psycho-educational and experiential group. Each group begins with a mindfulness exercise. We debrief of how each participant experienced the practice for that day. We segue to homework review, in which each shares for 5-6 minutes how they practiced the skills and what questions remain about the skill. We then take a short break. The second hour is dedicated to teaching new skills. We finish with an explanation of what the practice will be for the coming week .How long is treatment?

Will my insurance cover the treatment?

Each person’s insurance is unique. The Awake DBT program is out-of-network. Most individuals with PPO plans will have some level of coverage from their insurance (usually 50-70%). We recommend you call to determine if you have an out-of-network deductible. Also, we encourage you to determine exactly what your insurance will cover.

The procedure code for individual therapy is 90834 and the procedure code for skills group is 90853. The insurance carriers typically ask for our license level (which is MFT) and our zip code (which is 95125). We encourage you to determine what the what the maximum coverage will be for each of these codes. Carriers usually quote the reimbursement as a percent of their ‘Reasonable and Customary” or maximum reimbursable amounts for each service.

We typically ask for payment weekly and provide a superbill at the end of each month for you to submit to your insurance company for reimbursement.

If I am recommended to do DBT, does this mean I have BPD?

Many people come to our treatment with a variety of symptoms. We treat people with anxiety, depression, bi-polar disorder, trauma, substance abuse and eating disorders, as well as those with borderline personality disorder.

If you do fit the criteria for BPD (5 of the 9 criteria must be met to have the diagnosis), understand that many people who participate leave treatment with fewer than the five criteria. To achieve this this means working really hard, learning the skills, and integrating them into your daily life for this to happen.

What does multi-family adolescent treatment mean exactly?

We want to help adolescents and their families learn and benefit from DBT. Each adolescent therefore comes to weekly individual DBT therapy and also attends weekly skills training group with a parent or caregiver. The parent/caregiver is also required to participate fully, including doing homework to learn and practice the skills. We essentially want to change the whole family system by having members learn and use the skills in their everyday lives. We also have a monthly family session where caregiver attends with the adolescent to strengthen communication.

May I join your DBT skills group and keep my non-DBT therapist?

Ethically, a person in any form of therapy can only have one primary therapist who is responsible for their treatment. Given the symptoms and struggles many people have when they come to our program, we want the responsibility to manage the treatment following formal DBT protocol which we know has been researched and proved effective. We are open to our participants having continued communication and support from a non-DBT therapist to retain the relationship. To us, this means having a session perhaps one in every five or six weeks with your non-DBT therapist.

If we get a referral for someone who does not have any life-interfering behaviors (e.g. suicidal/homicidal ideation, urges, planning, or self-harm behavior, urges or planning), and has only one problem in only a single area of life, we could consider them attending skills group only. We will have to assess this on a case-by-case basis. If a person has multiple problems in multiple areas of their life, research demonstrates that the person will need and thus we require comprehensive treatment.

What are your policies regarding medications?

We believe that the right combination of medications could greatly help our clients to be in the mind space to best learn, practice, and integrate skills. What we have seen over time is that the dosage amounts and the quantity of meds often decrease over time. We want to empower you to advocate your needs with your psychiatrist to collaborate and determine what will work best for you. Sometimes we do require medication adherence in order to do DBT treatment for those who have thought disorders.

I’ve never been in therapy before. What should I expect during our first appointment?

In the first session, we want to learn about you and understand what brings you to DBT, as well as start to orient you to our treatment. It takes three or four individual sessions to complete the orientation and assessment process. We want to make sure you are absolutely comfortable with the structure and expectations before you make the formal commitment to begin treatment.

I’m concerned about having to receive a diagnosis. Is this required?

This question comes up a great deal. If you are submitting a superbill to insurance for reimbursement, you will need to include a diagnosis code, as it is required by insurance. We will discuss diagnoses you may have received previously or discuss whether you fit criteria for diagnosis. Nothing will be documented for insurance without your knowledge.