Adult DBT Therapy in Louisville, KY

Wise Mind Behavioral Health offers adult DBT therapy in Louisville, Kentucky, for people who experience intense emotions, impulsive behaviors or recurring relationship difficulties. Dialectical Behavior Therapy combines acceptance with practical strategies for changing behaviors that interfere with daily life.

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About DBT

Acceptance and change

At the core of Dialectical Behavior Therapy (DBT) is the balance between acceptance and change. DBT teaches individuals how to acknowledge and accept their thoughts, emotions, experiences, and circumstances while developing the skills needed to change ineffective behaviors and improve their quality of life.

“Dialectical” means two opposing things being true at once. In DBT, the dialectics are Acceptance and Change. DBT focuses on helping people accept the reality of their lives and behaviors AND helping them learn to change their lives and their unhealthy behaviors.

The goal is to move from “either/or” to “both/and.”

Skills

Four DBT Skills for Managing Emotions and Relationships

Mindfulness

Teaches clients to live ‘here and now’ and not stay in the past or worry about the future.

Emotion Regulation

Teaches clients how to detect and reflect a person’s emotions without judgment and determine what role those emotions play in our bodies and minds.

Distress Tolerance

Teaches clients how to tolerate strong emotions that usually send the person into a whirlwind of emotions and thoughts, often leading to destructive behaviors.

Interpersonal Effectiveness

Teaches clients to ask for what they need from themselves and others while keeping calm if things don’t go as desired.

Treatment

Comprehensive DBT has four components

Comprehensive DBT brings together individual therapy, DBT skills training, between-session skills coaching and a therapist consultation team. These components help connect what you learn in treatment with situations you face outside sessions.

1

Individual therapy

Supports the learning of skills, provides time to troubleshoot learning, provides much-needed validation, and models a healthy relationship.

2

DBT skills group

Once a week (90 minutes). Teaches the four skills modules within a 24-week period. Typically, clients need 2 rounds of skills group, totaling 1 year.

3

Phone coaching

Used to support the use of skills in the moment.

4

Therapist consultation

Provides a space for therapists to discuss cases to ensure they are providing the best therapy possible.

*If the treatment has 1–3 of these components, it is considered DBT-informed.

History

Origins of DBT

Dialectical Behavior Therapy was developed in the 1980s by Marsha Linehan, a behaviorist and psychologist. Her early experiences and treatments were the driving force behind her becoming the creator of DBT. Linehan described her struggles with mental illness as “Hell” and vowed that once she got out, she would return to get others out as well. Her journey was to develop a treatment specifically for people who were chronically suicidal.

In the 1970s, Linehan began researching chronically suicidal patients. She initially tried behavior therapy alone and learned quickly that many patients found it strongly aversive, leading them to get angry and quit treatment. Patients often reported feeling “invalidated.” She then tried a Humanistic approach, which could be described as the opposite of behaviorism, and found it did not work with these patients either.

So she combined the two approaches, moving back and forth between acceptance (Humanism) and change (Behaviorism). Dialectics helped to balance those two seemingly opposite theories. Over the years, the therapy has been proven effective for many other mental health and behavioral conditions.

Who it helps

Who can benefit from DBT?

DBT is especially effective for people who have difficulty managing and regulating their emotions. It has proven effective for treating and managing a wide range of mental health conditions, including:

Borderline personality disorder (BPD)

Post-traumatic stress disorder (PTSD)

Self-harm

Suicidal behavior

Substance use disorder

Anxiety

Eating disorders, specifically binge and bulimia

Depression

DBT has proved effective for these conditions because each is thought to be associated with unhealthy or problematic efforts to control intense, negative emotions. Rather than depending on efforts that cause problems for the person, DBT helps people learn healthier ways to cope.

Borderline personality disorder

DBT for Borderline Personality Disorder

There are nine symptoms associated with borderline personality disorder (BPD), according to the DSM-5. A person needs to meet five or more of the following to be diagnosed:

Five areas of dysregulation

BPD is most often associated with emotion dysregulation. According to Marsha Linehan, there are five areas of dysregulation experienced by people with BPD:

1

Emotion

Not managing your emotions in context: reducing or escaping emotions without regard to consequences. This can look like rage, anxiety, depression, and not feeling validated.

2

Interpersonal

Indicated by chaotic relationships and fear of abandonment.

3

Self

An unstable sense of self and a sense of emptiness.

4

Behavioral

Characterized by self-injury and impulsive behaviors, such as substance abuse and promiscuity.

5

Cognitive

Indicated by paranoia and dissociative responses made worse by stressful situations.

Common thoughts and behaviors

Black-and-white thinking, called splitting: people or situations are either good or bad, with no in-between
Thinking friends or partners will leave you, so you must reject them first
Getting very frustrated with others
Changing jobs, goals, plans and hobbies often
Quitting before failing
Feeling no one can understand you
Having thoughts of self-harm or suicide

Having BPD is usually associated with instability in relationships, self-image and emotions. Often, this instability stems from a fear of abandonment. Through the skills learned in DBT, individuals can learn to better control all of these areas by taking a step back, being more mindful, analyzing what works, and acquiring new behaviors.

Comprehensive DBT is the gold-standard treatment for BPD.

One year of comprehensive DBT has been shown to significantly reduce the severity of BPD symptoms. While there’s no “cure” for BPD, many people go into “remission,” meaning their symptoms become less intense to the point where they no longer meet the diagnostic criteria.

Neurodivergent clients

DBT with autistic individuals

Looking for adult DBT therapy in Louisville? Review what to expect at your first appointment, explore DBT skills groups, or contact Wise Mind Behavioral Health with questions about referrals.

References

Belcher, H. (2022). Taking off the mask: Practical exercises to help understand and minimize the effects of autistic camouflaging. Jessica Kingsley Publishers.
Bemmouna, D., Coutelle, R., Weibel, S. et al. (2022). Feasibility, acceptability and preliminary efficacy of Dialectical Behavior Therapy for autistic adults without intellectual disability: A mixed methods study. J Autism Dev Disord 52, 4337–4354. doi.org/10.1007/s10803-021-05317-w
Chapman, A. L., & Gratz, K. L. (2007). The borderline personality disorder survival guide: Everything you need to know about living with BPD.
Cheney, L., Dudas, R. B., Traynor, J. M., Beatson, J. A., Rao, S., Choi-Kain, L. W. (2023). Co-occurring autism spectrum and borderline personality disorder: An emerging clinical challenge seeking informed interventions. Harv Rev Psychiatry 31(2), 83–91. PMC9997622
Chabrol, H., Raynal, P. (2018). The co-occurrence of autistic traits and borderline personality disorder traits is associated to increased suicidal ideation in nonclinical young adults. Compr Psychiatry 82, 141–143. PMID 29486417
Dudas, R. B., Lovejoy, C., Cassidy, S., Allison, C., Smith, P., & Baron-Cohen, S. (2017). The overlap between autistic spectrum conditions and borderline personality disorder. PLoS ONE 12(9), e0184447. PMID 28886113
Huntjens, A., van den Bosch, L. M. C. W., Sizoo, B. et al. (2020). The effect of dialectical behaviour therapy in autism spectrum patients with suicidality and/or self-destructive behaviour (DIASS): Study protocol for a multicentre randomised controlled trial. BMC Psychiatry 20, 127. doi.org/10.1186/s12888-020-02531-1
Ritschel, L., Guy, L., & Maddox, B. (2022). A pilot study of dialectical behaviour therapy skills training for autistic adults. Behavioural and Cognitive Psychotherapy 50(2), 187–202.
Vegni, N., D’Ardia, C., Torregiani, G. (2021). Empathy, mentalization, and theory of mind in borderline personality disorder: Possible overlap with autism spectrum disorders. Front Psychol 12, 626353. PMC7909009