Dialectical Behavior Therapy (DBT) in Utah County

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy was developed in the late 1980s by psychologist Dr. Marsha Linehan, originally to treat individuals with borderline personality disorder (BPD) who were at high risk for self-harm and suicide. What began as a specialized treatment has evolved into one of the most effective therapies for anyone struggling with intense emotional experiences and difficulty regulating emotions.

The term "dialectical" refers to the integration of opposites—specifically, the balance between acceptance and change. DBT recognizes that you need both: acceptance of yourself and your current reality, AND commitment to making changes that improve your life. This both/and approach is fundamentally different from many therapies that focus solely on either acceptance or change.

According to research published by the National Institute of Mental Health, DBT has demonstrated effectiveness not just for BPD, but for a wide range of conditions including depression, anxiety, eating disorders, substance abuse, and PTSD. The American Psychological Association recognizes DBT as an evidence-based treatment with strong research support.

The Four Pillars: Core DBT Skills

DBT teaches four sets of skills that work together to help you manage emotions, navigate crises, and build meaningful relationships. Think of these as your emotional toolkit—practical strategies you can use anytime, anywhere.

Who Can Benefit from DBT?

While DBT was originally created for borderline personality disorder, it's now successfully used to treat many conditions characterized by emotional dysregulation. At Willow Therapy, we offer DBT-informed treatment for:

Signs DBT Might Be Right for You

Consider DBT if you experience:

• Emotions that feel overwhelming, unpredictable, or out of proportion to the situation
• Difficulty calming down once upset
• Impulsive behaviors you later regret
• Self-harm or thoughts of suicide as a way to cope with pain
• Fear of abandonment that affects your relationships
• Unstable sense of self or identity
• Difficulty maintaining relationships due to emotional intensity
• Feeling chronically empty or numb
• Black-and-white thinking about yourself or others

The DBT Treatment Model

Comprehensive DBT includes multiple components working together. At Willow Therapy, we offer DBT-informed individual therapy that incorporates these principles:

Individual Therapy

Weekly one-on-one sessions with your DBT therapist focus on:

• Reducing life-threatening behaviors (self-harm, suicidal behaviors)
• Addressing therapy-interfering behaviors (not attending sessions, not doing homework)
• Improving quality of life by working on your personal goals
• Developing and strengthening DBT skills

Your therapist uses a diary card to track your emotions, behaviors, and skill use throughout the week. This helps identify patterns and measure progress toward your goals.

Skills Training Group

In traditional DBT, clients attend weekly skills training groups where they learn the four skill modules systematically. While comprehensive DBT groups may not always be available, we integrate skills training into individual sessions and can connect you with community resources for group options.

Phone Coaching

Between sessions, DBT therapists are available for brief phone coaching to help you apply skills in real-time when you're facing a crisis or struggling situation. This bridges the gap between learning skills in therapy and using them in daily life.

Therapist Consultation Team

DBT therapists meet regularly in consultation teams to support each other in providing the best care. This ensures therapists stay motivated and effective, even when working with challenging situations.

DBT Skills in Action: Practical Examples

DBT isn't just theory—it's about practical skills you can use in real situations. Here are some examples:

Mindfulness: The STOP Skill

When you notice you're about to act impulsively:

• Stop – Freeze, don't move
• Take a step back – Get some space from the situation
• Observe – Notice what's happening inside and outside
• Proceed mindfully – Ask: "What do I want in this situation? What will help me get there?"

Distress Tolerance: TIPP Skills

When emotions feel unbearable, use temperature, intense exercise, paced breathing, or paired muscle relaxation to quickly reduce emotional intensity.

Emotion Regulation: Opposite Action

When an emotion doesn't fit the facts or isn't helpful, act opposite to the emotion's urge. Feeling like isolating when sad? Reach out to a friend. Feeling angry and want to yell? Speak gently.

Interpersonal Effectiveness: DEAR MAN

When asking for something you need:

• Describe the situation
• Express your feelings
• Assert what you want
• Reinforce why it matters
• Stay Mindful
• Appear confident
• Negotiate if needed

DBT vs. Other Therapy Approaches

DBT for Specific Populations

DBT for Adolescents and Young Adults

DBT has been adapted for teenagers and is highly effective for adolescents struggling with emotional intensity, self-harm, or behavioral problems. Our therapists working with teens in Orem and throughout Utah County can provide age-appropriate DBT skills training. We also work with BYU students and UVU students who benefit from DBT's structured approach.

DBT for Families

When one family member is in DBT, the whole family benefits from learning DBT skills. Family therapy incorporating DBT principles can improve communication and reduce conflict.

DBT for Couples

DBT skills are incredibly helpful for couples struggling with intense conflict or emotional reactivity. Our couples counseling can integrate DBT communication and emotion regulation skills.

DBT for Diverse Communities

DBT principles can be adapted for different cultural contexts. We offer terapia en español and practice culturally sensitive therapy to ensure DBT skills are delivered in a way that honors your background and values.

What to Expect in Your DBT Journey

Starting DBT is a commitment, but it's one that can truly change your life. Here's what the process typically looks like:

Phase 1: Pre-treatment and Orientation

Your therapist will explain how DBT works, assess whether it's right for you, and secure your commitment to the therapy process. You'll discuss target behaviors you want to change and establish treatment goals.

Phase 2: Stage 1 - Behavioral Control

The initial focus is on establishing safety and stability—reducing self-harm, suicidal behaviors, and other dangerous behaviors while learning basic skills for emotional regulation.

Phase 3: Stage 2 - Emotional Experiencing

Once behavioral control is established, therapy moves to processing traumatic experiences and addressing emotional pain that may have been avoided.

Phase 4: Stages 3 & 4 - Building a Life Worth Living

Later stages focus on increasing self-respect, achieving personal goals, and experiencing joy and connection in life.

Most clients work through Stage 1 over 6-12 months, though the timeline varies based on individual needs and progress.

Getting Started with DBT at Willow Therapy

Ready to develop the skills that can change your life? Here's how to begin:

1. Schedule a Consultation: Contact us to schedule an initial appointment with a DBT-trained therapist.
2. Choose Your Location: We offer DBT-informed therapy at our Pleasant Grove office and Orem location. You can also access DBT through telehealth therapy throughout Utah.
3. Verify Insurance: Check our insurance page to see if your plan covers DBT treatment.
4. Commit to the Process: DBT requires dedication—attending sessions, completing diary cards, practicing skills, and staying engaged even when it's hard. Your commitment is essential to success.
5. Be Patient with Yourself: Learning new skills takes time. Trust the process and celebrate small victories along the way.

Frequently Asked Questions About DBT

How long does DBT take?

Traditional DBT is typically one year, though many people continue therapy longer. Some clients see significant improvement in 6-8 months, while others benefit from ongoing support.

Is DBT only for borderline personality disorder?

No! While DBT was created for BPD, it's now used successfully for many conditions involving emotional dysregulation, including depression, anxiety, eating disorders, and substance abuse.

Do I have to do everything (individual therapy, group, phone coaching)?

Comprehensive DBT includes all components, but we can also offer DBT-informed individual therapy that incorporates the essential elements even if a full program isn't available or necessary.

Will I have to talk about trauma?

Initially, DBT focuses on building skills and behavioral control. Processing trauma comes later, once you have the skills to handle intense emotions that arise.

Can I do DBT online?

Yes! DBT adapts well to telehealth formats. Many clients successfully complete DBT through secure video sessions.

What if I can't stop self-harming right away?

DBT recognizes that change takes time. Your therapist will work with you to reduce the frequency and severity of self-harm gradually while you build healthier coping skills. The goal is progress, not perfection.