Individual DBT Therapy

In the individual sessions, the therapist and client contract to work on specific goals for a specific period of time. Emphasis in the first part of the DBT therapy is on application of DBT skills to the client's life.

The most important of the overall goals in DBT is helping clients create"lives worth living." What makes a life worth living varies from client to client. For some clients, a life worth living is getting married and having
kids. For others, it's finishing school and finding a life partner. Others might find it's joining a religious or spiritual group and buying a house near a place of worship. While all these goals will differ, all clients have in common the task of bringing problem behaviors, especially behaviors that could result in death, under control. For this reason, DBT organizes treatment into four stages with targets. Targets refer to the problems being addressed at any given time in therapy.

Here are the four stages with targeted behaviors in DBT:

Stage I: Moving from Being Out of Control of One's Behavior to Being in Control

Stage II. Moving from Being Emotionally Shut Down to Experiencing Emotions Fully
The main target of this stage is to help clients experience feelings without having to shut down by dissociating, avoiding life, or having symptoms of post-traumatic stress disorder (PTSD). In DBT, we say that clients entering
this stage are now in control of their behavior but are in "quiet desperation." Teaching someone to suffer in silence is not the goal of treatment. In this stage, the therapist works with the client to treat PTSD and/or teaches the client to experience all of his or her emotions without shutting the emotions down and letting the emotions take the driver's seat.

Stage III. Building an Ordinary Life, Solving Ordinary Life Problems
In Stage III, clients work on ordinary problems like marital or partner conflict, job dissatisfaction, career goals, etc. Some clients choose to continue with the same therapist to accomplish these goals. Some take a long break from therapy and work on these goals without a therapist. Some decide to take a break and then work with a different therapist in a different type of therapy.

Stage IV. Moving from Incompleteness to Completeness/Connection
Most people may struggle with "existential" problems despite having completed therapy at the end of stage III. Even if they have the lives they wanted, they may feel somewhat empty or incomplete. Some people refer to this as "spiritual dryness" or "an empty feeling inside."

Although these stages of treatment and target priorities are presented in order of importance, we believe they are all interconnected.