Dialectical Behavior Therapy (DBT): a Cognitive Behavioral Approach

Dialectical Behavior Therapy (DBT): a Cognitive Behavioral Approach

By: Jasmyn Cuate

Dialectical behavior therapy (DBT) is a combination of cognitive and behavior therapy, supported by empirical-based evidence that teaches patients skills to cope with and change unhealthy behaviors. The main goals of DBT are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.

DBT focuses on four key areas in therapeutic skills:

  • Mindfulness: focuses on improving your ability to accept and be present in the current moment, helping you use healthy coping skills instead of using negative impulsive behaviors
  • Distress tolerance: teaches you how to feel intense emotions without reacting impulsively or using self-injury or substance abuse to escape from it. Helping you prepare for intense emotions and cope with a more positive long-term outlook
  • Emotion regulation: teaches you how to identify, label, and change your emotions without judging them– learning how your emotions shape your behavior and what obstacles prevent you from managing your emotions, reducing your emotional vulnerability and helps you have more positive emotional experiences
  • Interpersonal effectiveness: allows you to communicate more effectively with others, become more assertive, maintain self-respect and respect for others, while keeping a relationship positive and healthy

DBT goes through a multistage approach where the therapist first treats the patient’s most self-destructive behavior followed by the therapist addressing quality-of-life skills, then focus on improving the patient’s relationships and self-esteem, with the last stage focusing on promoting more joy and relationship connections. Standard comprehensive DBT is often used in the following settings:

  • Individual therapy: with a trained professional, you learn how to apply DBT skills to specific challenges and situations in your life­– patients agree to do homework to practice new skills and fill out diary cards which are completed daily to keep track of their emotions, urges, behaviors, and skills used throughout the week and brought to weekly sessions for the therapist and client to discuss and see if there’s progress being made. Diary cards are designed to record instances of target behaviors, thoughts and urges, and the use of behavioral skills client’s applied to cope with the problem
  • Group skills training: patients have the opportunity to role-play new behavioral skills and interact with others
  • Phone coaching: with DBT, your therapist is available by the phone for in-the-moment support between sessions if you’re in a difficult situation and need guidance

While your therapist works with you through the DBT approach, it can be challenging to stay motivated. Therefore, therapists have consultation groups,which are a group of professionals who met regularly helping one another to navigate potential stressors, monitor their devotion to treatment, develop and increase their skills, and sustain their motivation to work with high-risk, difficult-to-treat clients.

DBT was developed by Marsha Linehan, originally intended to treat borderline personality disorder (BPD) and suicidal behaviors but has been modified to treat other mental health conditions and have been effective in treating:

  • Borderline personality disorder (BPD)
  • Bipolar disorder
  • Substance use or impulsive behaviors
  • Eating disorders
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Non-suicidal self-injury (NSSI) or suicidal behavior
  • Generalized anxiety disorder (GAD)
  • Attention-deficit/hyperactivity disorder (ADHD)

Overall, DBT offers validation for patients, helping them understand their actions within the context of their personal experiences without necessarily agreeing that their actions are the best approach to solving a problem. This helps patients become more likely to cooperate and work towards self-acceptance and change. The best way to find out if DBT is right for you is to talk with a professional. They will evaluate your symptoms, treatment history, and therapy goals to see if DBT is the best treatment option for you.

If you or someone you know is seeking for dialectical behavior therapy, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources: https://www.webmd.com/mental-health/dialectical-behavioral-therapy https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy



PTSD in First Responders

By Jillian Hoff

Post-Traumatic Stress Disorder is extremely common among first responders. This is because of their high exposure rate to traumatic incidents. Some of the common signs and symptoms for PTSD include flashbacks or dreams about the incident, losing interest in activities, refusing to talk about the event and sleep disturbances. Most first responders do tend to avoid seeking treatment for their PTSD. This typically is because of the stigma that surrounds mental health in general. These individuals might feel as though people will see them as weak for seeking the help they need, which is not the case. Often times when the individual does not treat their PTSD it will worsen, which since first responders do not get to just stop working makes their symptoms even worse.

Some ways that first responders can help their PTSD would be to have a support system. This especially could be the people who were also there during the traumatic event, this way they can talk about what happened and how it made them feel with an individual who was also there.  To gain positive coping strategies, it could be extremely helpful to engage in Cognitive Behavioral Therapy. This could help the person manage some of their stress that relates to the incident. Most importantly, the person needs to remember why they love being a first responder and all the positives that come from their job. While the negative times within this profession can be hard to handle, it is important to remember all the good that comes from what first responders do.

If you or someone you know is suffering from PTSD, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/





PTSD in Women

By: Catherine Cain

Experiencing trauma is common and sometimes it may develop into PTSD, or post-traumatic stress disorder. While PTSD does affect men and women, women are significantly more likely to experience it than men. So, what is PTSD?

Post-traumatic stress disorder develops after someone experiences or witnesses a traumatic event, and the symptoms caused by this trauma continue for more than a month. While PTSD usually develops in the month following the event, it may develop months or even years after. Symptoms of PTSD include intrusive memories, avoidance of anything or anyone that reminds them of the trauma, changes in mood or thinking, and changed in behavior.

Females are twice as likely to experience PTSD as men. Why is that? While exposure to trauma is lower for women than men the type of trauma is significant in the development of PTSD. Men experience traumas that result in injuries or death, such as accidents, combats, and physical assaults. Women, however, experience childhood abuse, rape, and sexual assault. The effects of sexual assault are so detrimental that in the 2 weeks following an incident of sexual assault, 94% of women experienced symptoms of PTSD.

Another key reason for this difference is the difference in coping strategies. Everyone has heard of the “fight or flight” response to dangerous situations, but it is found that women often use the “tend and befriend” response following an event. “Tending” is taking care of those around you, while “befriending” is reaching out to others for support. Because of this reliance on others, women become more vulnerable to PTSD symptoms if their support system fails them.

If you or someone you know is struggling with Post Traumatic Stress Disorder, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/

Sources: https://www.nami.org/Blogs/NAMI-Blog/October-2019/PTSD-is-More-Likely-in-Women-Than-Men https://www.womenshealth.gov/mental-health/mental-health-conditions/post-traumatic-stress-disorder

PTSD Researcher Finds Link between Stress and Trauma

By Diana Bae

Rachel Yehuda, PhD, is a distinguished researcher and Director of Traumatic Stress Studies Division at the Icahn School of Medicine of Mount Sinai. She has conducted numerous prominent post-traumatic stress disorder (PTSD) studies and treatment. One of her most well-known studies researched Vietnam War combat veterans with PTSD and found that they had significantly lower cortisol levels than veterans without PTSD. Cortisol is a hormone that controls stress and although it is thought that more cortisol resulted in more stress, Dr. Yehuda showed that that is not the case. Thus, there needs to be a sufficient amount of cortisol to handle stress and reduce the risk of developing trauma. Now, Dr. Yehuda plans to test a drug, oral hydrocortisone, to see whether it can replicate the cortisol naturally produced in the body. If this drug is successful, it may prevent PTSD and other similar disorders.

Arista Psychological and Psychiatric Services understands the problems caused by PTSD and are dedicated to provide proper attention and treatment. If you or someone you know would like to set up an appointment for our counseling services, contact us at our offices in Paramus, NJ (201) 368-3700 or in Manhattan, NY (212) 996-3939. For more information, please visit our website https://www.counselingpsychotherapynjny.com/

Source: Inside, a publication of the Mount Sinai Health System, Issue: November 25 – December 15, 2019;  Picture Source: http:// www. thesuburban.com/life/lifestyles/can-trauma-be-transmitted-intergenerationally-oct-dawson-college-peace-centre/article_ea2d7bb0-b063-11e7-aee3-5b0d013065f7.html, https:// askopinion.com/how-to-deal-with-ptsd-aka-post-traumatic-stress-disorder

Post-Traumatic Stress Disorder


By: Cassie Sieradzky

Post-Traumatic Stress Disorder (PTSD) is classified in the DSM-5 as a trauma and stress related disorder. PTSD is commonly triggered after a traumatic event, such as violent personal assaults, natural or unnatural disasters, accidents, or military combat. PTSD is frequently comorbid with depression, substance abuse, or anxiety disorders. For PTSD to be diagnosed, symptoms must be present for at least 1 month and they must create distress in the individual and impact daily functioning.

First, an individual must be exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way: direct exposure, witnessing the trauma, or learning that a relative or close friend was exposed to a trauma.

One intrusion symptom must also be present. The intrusion symptoms include unwanted upsetting memories, nightmares, flashbacks, emotional distress after exposure to traumatic reminders, and physical reactivity after exposure to traumatic reminders. Avoidance of trauma-related stimuli after the trauma occurred is also a symptom of PTSD. For example, an individual may avoid trauma-related thoughts or feelings or situations that remind them of the trauma. Two symptoms of negative changes in thought are also required for a diagnosis. An individual with PTSD may experience an inability to recall key features of the trauma, overly negative thoughts or assumptions about oneself or the world, exaggerated blame of self or others for causing the trauma, negative affect, decreased interest in activities, and/or feelings of isolation. Lastly, to be diagnosed with post-traumatic stress disorder, the individual must experience alterations in reactions and behaviors, such as irritability/aggression, risky or destructive behavior, hypervigilance, heightened startle reaction, difficulty concentrating, or difficulty sleeping.

If you or a loved one appears to be suffering from post-traumatic stress disorder, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

DSM-5 Criteria for PTSD. (2018, March 14). Retrieved April 02, 2018, from

Post-Traumatic Stress Disorder. (n.d.). Retrieved April 02, 2018, from https://www.psychologytoday.com/us/conditions/post-traumatic-stress-disorder