What we treat
DBT Therapy in Natick, MA
DBT (Dialectical Behavior Therapy) at Aurora Counseling Associates is for clients whose emotions feel bigger than they can manage, whose relationships keep getting derailed by intense feelings, who find themselves doing things they regret to cope with how bad it gets, and who want skills that work in the moments that matter.
What DBT is
DBT is a skills-rich, evidence-based therapy originally developed for clients with intense emotional dysregulation and self-harming behavior. The research base has since expanded to include effectiveness for depression, anxiety, trauma, eating concerns (note: we do not treat eating disorders as a primary diagnosis), and adolescents with high emotional intensity.
Mindfulness
building the capacity to notice what is happening in your mind and body without immediately reacting. The foundation of the other three.
Distress tolerance
what to do in the moments when emotion is too big to think through, when something has to get you to the other side of the wave without making things worse.
Emotion regulation
identifying emotions accurately, understanding what they are telling you, and reducing vulnerability to extreme emotional swings over time.
Interpersonal effectiveness
asking for what you need, saying no, maintaining relationships and self-respect through the requests and the pressures of close relationships.
The "dialectical" part of DBT is the working stance: holding two things that seem to contradict at once. The most important one: I accept you exactly as you are, and we are working on change. Both are true at the same time.
A note on DBT format
Full standard DBT (sometimes called "adherent DBT") is a comprehensive program that includes individual therapy, a weekly skills group, phone coaching between sessions, and a clinician consultation team. Some clinical situations need this full structure, particularly clients with chronic suicidal behavior or who meet criteria for borderline personality disorder.
At Aurora, what we offer is DBT-informed individual therapy. This means we use the DBT framework and teach the skills within individual sessions. We are not currently a full DBT program with a skills group and phone coaching.
For some clients, DBT-informed individual therapy is the right match. For others, especially clients whose clinical picture calls for full DBT, we will refer to a comprehensive DBT program. We will be straight with you at intake about which is the right fit for your situation.
Who DBT is for
DBT-informed work tends to fit clients who experience:
- Emotional intensity that feels disproportionate to the situations triggering it
- Difficulty regulating after something has set off a strong feeling
- Interpersonal patterns that involve intense closeness and intense conflict
- Self-harm urges (cutting, burning, hitting, other forms)
- Suicidal thoughts that come and go
- Impulsive behavior used to cope with feelings (substance use, spending, sexual behavior, eating patterns that are not yet at the level of an eating disorder)
- Difficulty trusting their own perceptions, often in the context of having been chronically invalidated growing up
- Borderline personality patterns or traits, with or without a formal diagnosis
DBT is also useful, often in modified form, for many people who do not fit the above but who want better emotion regulation and interpersonal skills.
DBT for teens
DBT for teens (DBT-A) is an adaptation of the framework for adolescents. The skills work tends to involve parents when possible, since the family system is part of the teen's environment and the skills work better when caregivers also know them.
We can offer DBT-informed individual work with teens. For full DBT-A programs, we will refer to a teen DBT program when that is the right level of care.
What to expect
The first phase of DBT work is about understanding your patterns and starting to learn the skills. You will likely get reading or worksheet material between sessions. The pace and depth of the skills work will depend on what you are working on.
Most DBT-informed work at Aurora is medium- to longer-term: 6 months to a couple of years, depending on the goals. Some clients use DBT-informed work for a focused stretch and then move into other forms of therapy; some do extended DBT-informed work.
Therapists at Aurora who use DBT
DBT for teens (DBT-A) is an adaptation of the framework for adolescents.
Who you would work with
Clinicians who offer DBT Therapy
Read how each person works before you reach out. If you are not sure who to ask for, we will help you choose.
These clinicians list this as a specialty. Most of our team works with it in some form, so if you have someone in mind, ask and we will tell you whether the fit makes sense.
Questions
Common questions
Do you offer a full DBT program with skills group?
Will DBT work for borderline personality disorder?
Will DBT work for me if I do not have BPD?
Is DBT different from CBT?
Will I have to do worksheets?
Can my teenager do DBT?
Does insurance cover DBT?
Where to next
Related areas we work in
Get started
Ready when you are
If DBT-informed work sounds like what you are looking for, request an appointment or call (508) 650-0991. We will talk through your situation and figure out the right fit.