Dialectical Behavior Therapy Track

PB-17_web.jpgDialectical Behavior Therapy (DBT) is a research-supported cognitive behavioral psychotherapy that has been found to be effective in treating symptoms and behaviors related to emotion dysregulation. The treatment uses cognitive and behavioral strategies to help residents develop more adaptive ways of thinking and more effective behaviors. The Retreat delivers DBT in accordance with the scientifically-supported model, and all staff members at The Retreat are formally trained in providing DBT.

Residents are encouraged to practice their DBT skills in the milieu with supportive coaching from staff in order to help them generalize these new skillful behaviors into their natural environments. When residents are better able to manage difficult emotions, they are often also better able to do deeper psychotherapy work, leading to a more robust treatment outcome.

Emotion dysregulation is a common feature in a variety of psychiatric disorders such as borderline personality, bipolar, trauma-related, eating, and substance use disorders, as well as anxiety and depression. At The Retreat, DBT is integrated throughout the continuum of care as an integral component of state-of-the-art psychiatric care, and is infused into the milieu of our residential, group home, and outpatient treatment environments so that we are able to meet the needs of our clinical population as they progress through the stages of treatment.

DBT Skills Trainers

All staff members at The Retreat are formally trained to provide DBT and skills coaching on the milieu to enhance the use of this behavior in the resident’s natural environment. The DBT Skills Trainers at The Retreat form a coherent team under the leadership of our psychologist and DBT coordinator. The team works together to administer dialectical behavior therapy aimed at treating emotion dysregulation. This type of therapy combines cognitive behavioral therapy with meditative approaches and has been proven to effectively treat borderline personality disorder and other manifestations of emotion dysregulation.

The following staff members lead the skills training and therapy groups:

Don Ross, M.D.
Christine Liszewski, M.D.
Maria Mouratidis, Psy.D.

Five Functions of DBT

DBT is designed to address five essential functions of successful treatment, listed below.

• Capability enhancement
• Motivational enhancement
• Enhancement of generalizations of gains
• Enhancement of capabilities and motivation of therapists
• Structuring of the environment to support clinical progress 

DBT Skills

DBT skills focus on acceptance and change. Mindfulness and distress tolerance are acceptance skills. Emotion regulation and interpersonal effectiveness are change skills. The DBT skills groups are taught in six-week cycles. 

DBT Mindfulness

PB-25_web.jpgMindfulness is the core DBT skill; it is the foundation upon which all the other skills are built. It is the practice of being fully aware and present in the moment. In order to change one’s thinking or behavior, one must first be aware of their thoughts, feelings, and behaviors.

Mindfulness is also critical for relapse prevention. Relapse prevention is not limited to substance use problems; it is relevant to any problem behavior or symptom. The earlier one becomes aware that the vulnerability to negative emotion or behavior is emerging, the sooner one can practice skillful behaviors that may reduce potential consequences and unnecessary suffering.

DBT Resources

DBT in a Nutshell
Diary Card
Sleep Protocol
DBT Resources: Sheppard Pratt Health System


Linehan, M. (2014). DBT Skills Training Manual (2nd ed.). New York: The Guilford Press.