Dialectical Behavioral Therapy (DBT) Program

Evidence-Based Treatment

The Heartwood Program offers comprehensive Dialectical Behavior Therapy (DBT) for adults and adolescents seeking support for intense emotions, impulsivity, and self-destructive behaviors. Backed by decades of research, DBT is an evidence-based treatment proven effective for a wide range of mental health challenges, including:

Suicidal ideation and self-harm
Borderline Personality Disorder (BPD)
Depression and anxiety
Post-Traumatic Stress Disorder (PTSD)
Substance use
Risky sexual behavior
Eating Disorders
Physical and verbal aggression
Other high-risk, impulsive, or emotionally dysregulated behaviors

DBT helps clients learn to regulate emotions, improve relationships, and manage stress, ultimately guiding them toward creating their own Life Worth Living.

Why Dialectical Behavior Therapy?

DBT is the gold standard treatment for Borderline Personality Disorder (BPD) and has also shown success in treating a wide range of emotional and behavioral issues in both adults and teens. It combines cognitive-behavioral therapy with mindfulness practices to help individuals understand and change unhelpful patterns of thinking and reacting.

For our adult clients, we follow the model as developed by Marsha Linehan and taught at her training institute, Behavioral Tech. For adolescent clients and their families, our adaptation follows the work of Alec Miller and Jill Rathus, who originally modified DBT for use with adolescents and young adults.

Some traits of borderline personality disorder that may be of concern include: an unstable sense of self, unstable interpersonal relationships, inappropriate or uncontrollable anger or other emotions, serious mood swings, recurrent self-harm or and/or suicide attempts, chronic feelings of emptiness, and impulsivity that puts the teen at risk. Clients referred to the DBT Program typically have many or all of the problems listed above, which can lead to difficulties fulfilling their obligations at work or in school, socially, and at home. This perpetuates their negative ideas about themselves.

*Our team has been intensively trained through the Behavioral Tech Institute.

For Adults

For our adult clients, we follow the model as originally developed by Marsha Linehan, Ph.D., ABPP. This program requires a minimum commitment of 24 weeks and consists of four components (individual therapy, skills group, phone coaching, therapist consultation team). 

Individual therapy (1 hr/week)– Clients work with their individual therapist to collaboratively develop treatment goals. Clients are expected to fill out a Diary Card each week to track emotions, problem behaviors to decrease, and use of more skillful behaviors. If a problem behavior comes up, therapists and clients utilize a behavior chain analysis to uncover what influenced a problem behavior to occur, and what skills/strategies could be used to avoid the problem behavior in the future.

Skills Group (2 hrs/week) – Clients participate in weekly skills groups to learn and practice acquisition of new coping skills. These skills fall into four different modules: Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
Phone Coaching (as needed) – Phone coaching allows clients to contact their therapist in-between sessions when they need help avoiding problem/crisis behaviors or using coping skills effectively. Phone coaching sessions are meant to be brief (5 to 15 minutes).
Therapist Consultation Team- Individual therapists and skills group leaders meet with other DBT therapists weekly to get support to provide the best DBT therapy possible. This is called ‘therapy for the therapists.’

For Adolescents

Our DBT for Adolescents and Families (DBT-A) program currently serves teens in high school. We follow the DBT-A model adapted by Jill Rathus, Ph.D. and Alec Miller, Psy.D. Our 24-week comprehensive program is delivered in a ‘multi-family’ format (caregivers and teens are both included in treatment and attend the DBT skills group together) and includes the components listed below. 

Individual therapy (1 hr/week)– Teens work with their individual therapist to collaboratively develop treatment goals. Teens are expected to fill out a Diary Card each week to track emotions, problem behaviors to decrease, and use of more skillful behaviors. If a problem behavior comes up, therapists and teens utilize a behavior chain analysis to uncover what influenced a problem behavior to occur, and what skills/strategies could be used to avoid the problem behavior in the future. 
Multi-Family Skills Group (2 hrs/week) – Teens and caregivers participate in weekly skills groups to learn and practice new coping skills. These skills fall into five different categories: Mindfulness, Distress Tolerance, Emotion Regulation, Interpersonal Effectiveness, and Walking the Middle Path (skills specifically developed to reduce caregiver-teen conflict and increase effective communication and collaborative problem-solving). 
Phone Coaching (as needed) – Phone coaching allows teens to contact their individual therapist in-between sessions when they need help avoiding problem/crisis behaviors or using coping skills effectively. Phone coaching sessions are meant to be brief (5 to 15 minutes). 
Family Therapy/Parent Coaching (as needed, typically weekly or every-other week) caregivers will receive guidance on how to apply DBT skills to effectively manage their own emotional responses, mindfully respond to their teens’ crisis behaviors, support and encourage their teens’ use of coping skills, and skillfully manage conflict/disagreements. Caregivers will also have access to phone coaching to support skillful responses to their teen’s behaviors. Family sessions that include caregivers and teens will be conducted as needed.  
Therapist Consultation Team– Individual therapist and skills group leaders meet with other DBT therapists weekly to get support to provide the best DBT therapy possible. This is called ‘therapy for the therapists.’

What is DBT for Adolescents?