About

This is a peer-created (non-professional) resource to supplement a professional Dialectal Behavior Therapy (DBT) Program, or provide information to someone still trying to access Professional DBT Therapy. This is not a replacement for professional DBT Therapy.

DBT is a therapy that has been proven effective for numerous disorders, but was designed specifically for Borderline Personality Disorder (BPD), which had no proven treatment at the time. It was designed by Dr. Marsha Linehan, a licensed psychologist who had once been diagnosed with BPD herself. Dr. Linehan found relief from a combination of Zen Buddhism and Cognitive-Behavioral Therapy (CBT). DBT is the result of her merging the mindfulness practices of Zen Buddhism with the modern psychology concepts of CBT. Professional DBT Therapy has been proven effective for numerous disorders since, but takes a long time for a professional to learn and become certified in. This means DBT can be difficult to access for people living rurally and/or in poverty.

Who am I? No one really, and I'm only partly saying that because half of this is pirated. I'm a licensed health professional with my own history of mental illness, and going back even further a strong family history of mental illness. Which license I hold specifically doesn't really matter since it's not like it's one of the cool or important ones anyway. Most of my personal experience is with DBT and that's what I use with patients so that's the main focus of this notebook. Basically I'm working under the assumption that either you can't afford better, or you need some help finding mental health resources, which I'm also happy to help with.

Accessing Formal Therapy Resources

Finding a Therapist

• Linehan Institute Listing of DBT Certified Therapists (They can be hard to find, like I said, so if you don't absolutely need dbt specifically it may be easier to find a different type of therapist).
• Psychology Today also has a general therapist search option, and there is a search filter for DBT specifically (And also lots of other great options!)
• If you have health insurance, their website or phone lines may have a directory of covered providers.

Find Support Groups to connect with others working towards or living in recovery.

Finding a Workbook and Other Resources

• Workbook: Here is the official, up-to-date published version from the Linehan Institute and here and here are some older / out-of-date pdf versions if you can't afford that.
• There is an official Online Course
• There are plenty of local and other online mental health resources, and I encourage you to use a discerning eye when deciding how trustworthy things are.

Start Recording Your Mood and Behavior Daily

A big part of DBT is something called a "diary card," which is a daily log of moods and emotions in relation to the person's own behaviors as well as environmental conditions. There is usually a combination of numeric ratings (x number of times, 0-10 scales, etc) and brief qualitative / free text entries to provide details about the events of the day. Traditionally a single sheet of a diary card covers a 7-day week so that it can be reviewed in a weekly individual therapy appointment. It allows for a sort of "meta-mindfulness" where you become more aware of how your overall environment and activities affect your internal mood and vice-versa.

• [[Diary Card - UWash.pdf]]
• [[Diary Card - Beaches Therapy.pdf]]
• Diary Card - Note Template - to use within the obsidian vault.
  These two apps have functions to track items very similar to a diary card:
• Daylio
• Moodpress

Start going through the DBT Modules / Core Skills

Different programs have different numbers of or names for the sub-skills within each of these, but the four main modules or core skills are always the same. I've made a note for each one with the sub-skills I learned as completable checkboxes, but ultimately just do whatever works best for you.

Each week you choose a skill or set of skills from one of the modules / core skills, of which there are 4. You usually spend more than one week on each core skill learning multiple smaller sub-skills each week. Because mindfulness is the most important module, it's meant to be done in it's entirety first, but It's also meant to be repeated for at least one week between each of the other modules / core skills.

If you are in a particularly turbulent time in your life and need immediate help getting your head back above water, you could do Distress Tolerance first, but I would recommend at least taking one week to do Cheat Day Mindfulness first.

• Mindfulness is the hippie Buddhist monk shit and unfortunately also the most important module in DBT and one of the hardest to master. It can be hard for beginners, so if you’re having a lot of trouble, watch one of the meditation videos the first week then skip to distress tolerance.
• Distress Tolerance are the emergency skills. These skills are for when you are panicking or on the verge of doing something that you really shouldn't. They're the "rescue inhaler" or "epi-pen" of the psych world. You have to be careful not to over-use them! Just like rescue medications, rescue skills can lose effectiveness and start having weird side effects if you're using them too much or when you shouldn't be.
• Emotion Regulation is a set of good every day habits to help you live your best life. Distress tolerance is to get you out of a bad situation, but with emotion regulation, you focus on not getting into trouble to begin with.
• Interpersonal Effectiveness is how to manipulate people correctly. That's not even a joke; one of the core concepts of DBT is that the problem is NOT that the person is manipulative. In fact, the issue is usually that they're not manipulative enough! Properly manipulative people don't get caught and wind up in psych wards and therapy. Properly manipulative people are CEOs and Politicians. Here's how to properly manipulate people.