Dialectical Behavior Therapy in Baltimore

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) is a science-backed approach in the treatment of depression, binge-eating, bulimia, trauma, and post-traumatic stress disorder (PTSD), addiction, and substance abuse. DBT meets the “gold standard” of care in the eyes of the American Psychological Association.

Dialectical Behavior Therapy originated from Cognitive-Behavioral Therapy (CBT) with one major caveat: DBT focuses on validation, or accepting intense emotions, emotional vulnerability, and behavioral change. The four main DBT skills are core mindfulness skills, distress tolerance skills, interpersonal effectiveness, and emotional regulation. DBT was originally utilized to treat individuals with borderline personality disorder (BPD) at high risk of suicide. BPD is characterized by symptoms ranging from impulsive behaviors, drug use, and suicidal ideation to suicidal behaviors, including suicidal self-injury and nonsuicidal self-injury.

Over time, DBT has been adapted for different mental health settings. DBT aims to help individuals with mental health conditions, impulsivity, stress, and feelings of sadness by encouraging emotional regulation skills and mindfulness. DBT can also help those who struggle with emotional dysregulation or self-destructive behaviors, including eating disorders and substance use disorders. In some cases, DBT is also used to treat post-traumatic stress disorder. Through a collaborative approach, therapists help clients accept problematic thoughts, emotions, and behaviors.

With dialectical behavior therapy, clients can work with their therapist to create a recovery plan. Similar to CBT, DBT skills training helps individuals develop new skills, such as healthy coping mechanisms and mind-body practices, giving them the strength and power to challenge intense emotions, thoughts, and behaviors. DBT is available in used in three clinical settings:

  • Group therapy sessions, where individuals learn problem-solving and behavioral skills through homework assignments, role-playing activities, and group skills training.

  • Individual therapy with a trained individual therapist, where individuals learn new skills through a personalized treatment plan.

  • Phone coaching, where individuals call their DBT therapist between therapy sessions for guidance on coping with difficult situations.

Individual therapy, group sessions, and DBT phone coaching and may be used in combination with medication treatment or other forms of therapy.

Is Dialectical Behavior Therapy Effective?

Studies have confirmed the efficacy of DBT in treating a wide range of mental health diagnoses, including depression, bipolar disorder, BPD, substance use disorder, and PTSD, in adolescents and adults. In a systematic review by Panos et al., researchers confirmed the validity of DBT individual therapy sessions in reducing suicide attempts, impulsive behaviors, and symptoms of depression in adult patients with BPD in a clinical setting.

Over the course of treatment, DBT helps decrease the frequency and severity of mental health symptoms, utilizes positive reinforcement to promote behavioral change, and translates the problem-solving and behavioral skills learned during therapy sessions to the client's everyday life. While each practitioner has their own structure and goals, standard DBT generally involves the following goals:

  • Acceptance — You'll learn new coping skills to accept and tolerate difficult situations, emotions, and thoughts.

  • Behavioral change — You'll learn problem-solving skills to analyze problems and replace destructive and self-injurious behaviors with healthier alternatives.

  • Cognitive change — You'll learn how to identify and change problematic thoughts, behaviors, and actions.

  • Collaboration — You'll learn how to communicate effectively and work collaboratively with a team, whether it's your individual therapist or group therapy members.

  • Support — You'll learn how to recognize your individual strengths and use them effectively.

Despite our recognition that DBT is a highly effective treatment, we would be remiss if we did not mention that Dialectical Behavior Therapy is not the only scientifically proven approach to treatment. The American Psychological Association has also given its stamp of approval to other approaches to mental health treatment used by the Baltimore Therapy Group's therapist consultation team, including Cognitive Behavioral Therapy, Emotion-Focused Therapy, Interpersonal Process Therapy, and Psychodynamic Psychotherapy.

Meet the Baltimore Therapy Group’s
Dialectical Behavior Therapy Experts

While therapists in the Baltimore Therapy Group use a variety of empirically supported treatments including Cognitive Behavioral Therapy, Interpersonal Process Therapy, Psychodynamic Psychotherapy, and Emotion Focused Therapy to help clients overcome the struggles that bring them to therapy, two of our therapists specialize in Dialectical Behavior Therapy or “DBT”. Meet Andrea Castelhano, PsyD and Rachel Greenberg, LCPC.

Andrea Castelhano, PSy.D.
Licensed Psychologist in Baltimore

Andrea is a Dialectical Behavior Therapist who uses DBT to help clients overcome disordered eating and exercise behavior, anxiety, depression, gender and sexual identity concerns, and cultural stress. Prior to joining the Baltimore Therapy Group, Andrea was the DBT Program Coordinator for the Eating Recovery Center of Maryland (formerly The Center for Eating Disorders at Sheppard Pratt). In that role, she was responsible for training staff in DBT and conducting program evaluation of the Center’s DBT interventions.

Rachel Greenberg Larson, LCPC
Licensed Counselor in Baltimore

Rachel uses Dialectical Behavior Therapy or “DBT” to work with those who come to therapy wanting to improve anxiety, depression, emotion regulation and recover from addiction. Prior to joining the Baltimore Therapy Group, Rachel worked with the Carroll County Youth Services Bureau where she provided DBT-informed outpatient psychotherapy to adults, teens and children.