DBT
FAQ
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What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy, originated by Marsha Linehan, Ph.D. in 1991, is a
type of therapy that is designed to help individuals who have difficulty in regulating their emotions.
What does DBT treatment at The Koch Center entail?
At The Koch Center, we offer the protocol originally designed by Dr. Marsha
Linehan. "Full" DBT therapy
means that an individual is in: 1) one (or more) weekly DBT skills group(s),
and 2) weekly individual
DBT Therapy.
However, we recognize that each person's situation is unique. As such, we create
an individualized
treatment plan for each patient. We offer several DBT services including: group
DBT skills training,
individual DBT therapy or skills training, diary card review, family or parent
skills training (individual or
group), family therapy, and medication management. For those who need a higher
level of support,
we have an adult intensive DBT program and an adolescent intensive DBT program.
We also offer
standalone DBT groups (daytime and evening).
In some cases, a person may only be in a once-weekly DBT skills group at The
Koch Center, while
continuing with his/her outside therapist. In other cases, a patient may require
more extensive support
throughout the week. That patient may be in multiple DBT groups as well as
individual DBT therapy.
What are the Four DBT Skills?
There are four skill areas in DBT:
Core Mindfulness: These skills teach patients to retrain their focus to the here
and now in order to help
them attain attentional and emotional control.
Distress Tolerance: Tolerating distress is one of the most difficult tasks
people need to learn. This skill
set teaches individuals how to cope with and distract themselves during moments
of overwhelming
emotion and during a crisis.
Emotion Regulation: Individuals are taught the basic components of feelings, as
well as means to
enhance and more fully enjoy positive emotions, while concurrently decreasing
and tolerating negative
feelings.
Interpersonal Effectiveness: The aim of this set of skills is to teach
individuals the basics of interpersonal
interactions including how to ask for help and reassurance from others, how to
assert one's needs, and
how to express one's self in a manner that others can readily respond to.
What is a Diary Card?
A diary card is a grid-like form that helps patients track target symptom
occurrence(s) and DBT skill use.
Together a patient and his/her group or individual therapist tailor the diary
card to address specific
targets for change.
Where can I find a Diary Card?
You can print blank diary cards from here:
www.kochcenter.com/dbt.zip.
What does "dialectical" mean?
Essentially, "dialectical" means that two things (even opposites) can exist at
the same time. While the
term "dialectics" may seem difficult at first, the concept is fairly
straightforward. Dialectical means that
absolute "truth" is never a certainty. In fact, the world is full of paradox and
contradiction. Dialectics
as they're used in DBT help people "live in the gray." For example, DBT assumes
that even though
someone is struggling with a symptom or problem, that person is doing the best
s/he can. The goal in
DBT is to learn new skills to live a better life.
Why do some people struggle so much to manage emotions and other people
don't?
DBT proposes that emotion dysregulation results from both
biological and environmental influences. Biology may predispose individuals to
experience emotion at a certain intensity. DBT helps people better understand their emotions and
offers concrete
coping skills.
My therapist suggested that I do DBT. Does that mean I have Borderline
Personality Disorder (BPD)?
While DBT was originally designed for those individuals diagnosed with
borderline personality disorder,
it has since been shown to be effective in helping people with a wider range of
issues
The efficacy of DBT with patients with BPD led Dr. Linehan and her colleagues to
apply and research
the use of DBT with other populations (including substance abusers, depressed
patients, those with
anger management difficulties). Current research is ongoing with still other
populations (including
patients with eating disorders, anxiety, adolescent issues). At The Koch Center,
we have found that
DBT is helpful for individuals with a wide range of issues and diagnoses, not
only those diagnosed with
borderline personality disorder.
What are the requirements for being in a skills training group?
We require each group member to be in weekly individual therapy, either at The
Koch Center or with a
therapist outside of our center. If a patient is working with an outside
therapist, we will ask the patient
to consent to us speaking with the outside therapist. By coordinating with an
outside therapist we are
better able to provide maximum cohesion and continuity in treatment.
What happens in the skills training group?
The agenda of a skills group might entail: 1) a brief check-in from each group
member; 2) a group
mindfulness exercise; 3) homework review; 4) new skill learning and discussion;
5) homework/practice
assignment for the week; and sometimes 6) another mindfulness exercise.
How many group members are in each group?
Most Koch Center groups are small -- typically from 4 to 8 members.
What if I don't like being in therapy groups? Is there some other way to do
DBT?
If you've determined that you don't like therapy groups based on past
experience, you might be
surprised at how different a DBT group is. Unlike groups where members discuss
whatever topics are
on their minds, DBT groups are highly structured. The goal of each skills group
is the acquisition and
practice of the DBT skills. While being in a group is the most traditional way
to learn DBT skills, in
certain circumstances, individual skills coaching or family skills training is
available.
How long will it take?
It takes about 5½ months to complete the four modules of skills in the DBT
group. Some clients choose
to repeat the skills group in order to solidify skills acquisition. Others stop
after one round of skills
training.
What is a Parent/Family Group?
Within the context of DBT, parent groups at The Koch Center extend skills
teaching to parents and
family members. Parents and family members learn the same tools that their loved
one is learning in
DBT. This permits a common language that can facilitate reinforcement of skill
use and better coping at
home.
I like my individual therapist; do I have to switch in order to be in your
DBT program?
No, but you must be seeing your therapist weekly. We also must be able to speak
with your outside
therapist to provide maximum cohesion and continuity in treatment.
What will happen at my first appointment?
The first appointment is referred to as the "initial assessment." At this first
appointment, a therapist
will ask you questions about your situation, types of problems you are
experiencing, your personal and
family history and other relevant information. After your assessment, our
treatment team will devise
an individualized treatment plan based on the information obtained during the
assessment, as well as
information provided by (with your consent) other (current or past) treatment
providers.
What should I do if I experience a crisis while in treatment?
Please call 911 in an emergency/life threatening situation. In Bergen County,
you can call (201) 262-
HELP if you are experiencing a mental health crisis. We do not offer 24 hour
coverage or support.
Where can I learn more about DBT?
Dr. Marsha Linehan's book, Skills Training Manual for Treating Borderline
Personality Disorder, is
considered the "gold standard." You may order a copy through Amazon by clicking
here:
http://www.kochdbt.com/booklist.html (each group member is expected to have
a copy of this book).
How does insurance and payment work?
The Koch Center is considered an "out-of-network" treatment provider with
insurance companies. As
such, payment is due at the time of each session. At each session, we will
provide you with an itemized
bill that you can submit to your insurance carrier for reimbursement based on
your particular plan's
policies.
How do I find out how much my insurance company will reimburse me for your
service?
If you would like to find out how much your insurance company will reimburse,
you should contact
your insurance carrier and ask how much they will reimburse for the specific
services you are seeking
(i.e., initial assessment (cpt code 90801), individual psychotherapy (cpt code
90806), and group
psychotherapy (cpt code 90853). Be sure to ask the following: the percentage the
insurance company
will reimburse, whether or not you have a deductible, if there is a maximum
allowable amount per
service, and whether or not you need preauthorization or precertification before
beginning treatment.
Some insurance companies require the patient to get preauthorization or
precertification (by phone).
Other insurance companies require us (The Koch Center) to get the necessary
preauthorization or
precertification.
I called my insurance, but the information they gave me is confusing. Can you
help?
For questions related to payment or insurance, please contact our office
manager, Rifka Kreiter, at 201-
670-1066 ext. 4.
How do I get started?
To make an appointment, please call Dr. Cyndi Koch at (201) 670-6450 ext. 1 or
email us at
info@thekochcenter.com.
