Dialectical means “the existence of opposites.” In DBT, people are taught two seemingly opposite strategies: acceptance (i.e., that their experiences and behaviors are valid), and change (i.e., that they have to make positive changes to manage emotions and move forward).

DBT is divided into four stages of treatment. The stages are defined by how severe a person’s behaviours are.

• In Stage 1, the person is often miserable and their behaviour is out of control. The goal is for the person to move from being out of control to achieving behavioural control.
• In Stage 2, the person may feel they are living a life of quiet desperation: their life-threatening behaviour is under control, but they continue to suffer. The goal is to help the person move from quiet desperation to full emotional experiencing.
• In Stage 3, the challenge is to learn to live: to define life goals, build self-respect and find peace and happiness. The goal is for the person to lead a life of ordinary happiness and unhappiness.
• For some people, Stage 4 is needed. The goal is to find a deeper meaning through a spiritual existence.

Individuals in our group program will attend a weekly meetings. Exercises are provided for people to practice skills between sessions. The purpose is to help people introduce effective and practical skills into their lives, which they can use when they are distressed. These skills are meant to replace other unhealthy and negative behaviors. 

• Mindfulness: the practice of being in the present and acknowledging thoughts, feelings and behaviours as they happen, without trying to control them
• Distress tolerance: the process of learning how to cope during a crisis, especially when it is impossible to change, and accepting a situation as it is, rather than how it should be
• Interpersonal effectiveness: the ability to ask for what a person needs and to say no when necessary, while still maintaining self-respect and relationships with others
• Emotion regulation: the ability to manage emotions so that they do not control thoughts and behaviours.