Dialectical Behavior Therapy
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Dialectical Behavior Therapy (DBT) was developed by Marsha M. Linehan, PhD. Early in her career, she treated many clients with problems related to impulsivity, unsatisfying relationships, and suicidal behavior.  In an effort to better treat these common, but poorly understood problems, Dr. Linehan combined the proven principles of cognitive-behavior therapy with strategies to communicate and help clients cultivate acceptance. 

An important feature of DBT is its emphasis on behaviorism - the study of how behaviors are learned and maintained.  In DBT, clients learn a range of skills to replace ineffective patterns of behavior. DBT is thus often referred to as a "doing" therapy, as opposed to a "talking" therapy.  The treatment is oriented around helping clients solve problems, rather than simply providing a space in which to discuss them.   

DBT in NY Times

To read the front page NY Times article about Dr. Linehan, click on the image.

​Who It Helps
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The question of who should pursue DBT is one that continues to be explored in research. Studies have consistently shown DBT to be effective in treating borderline personality disorder (BPD) - a condition characterized by extreme mood swings, problems with impulse control, feelings of emptiness, and intense relationships.

The latest findings suggests that DBT is effective for conditions such as substance abuse, suicidality, self-injurious behaviors, binge eating, as well as problems related to anger.  

What it Entails


​Clients in DBT participate in individual therapy, as well as a skills training class, each week. This dual focus is designed to optimize opportunities for learning new skills, while also providing a space in which to discuss how to effectively use these skills to resolve problems as they arise. 
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Individual Therapy

• Weekly, 45-60 minute individual therapy sessions
• Clients tracks their progress towards certain therapy goals, as well as relevant thoughts, emotions, and behaviors each week
• Sessions are organized around treatment priorities
• Clients experiment with using the skills they are learning to more effectively manage common symptoms and problems

Skills Training

• Weekly sessions that are didactic in nature, like a class
• Typically provided in a group format. 
• Skills taught pertain to: emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness
• Clients receive handouts and assignments to help them master the skills

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Additional Information
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For more DBT resources including recommended reading, smartphone apps, videos, and links, please click check out our resources. If you are considering DBT and would like to speak with Dr. Fleck, or to schedule an appointment, please click here. Dr. Fleck carries a limited number of DBT clients at a time and meets weekly with a team of other DBT therapists for consultation as is required. If her caseload is full, she can provide you with referrals for other local DBT providers.

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