DBT in Los Angeles: Exploring Your Treatment Options

At its core, DBT is a support-oriented, cognitive-based therapy that helps you “identify thoughts [and] beliefs that make life harder” and reimagining those thoughts and beliefs to increase emotional and behavioral harmony. Working closely with a therapist and peers, DBT seeks to increase mindfulness, augment distress tolerance, enhance emotional regulation, and develop interpersonal effectiveness. Rather than simply gaining insight into your emotional and behavioral state, DBT allows you to create change through concrete skill-building, opening the door to true transformation even when other therapies have failed. Will Lippincott knows this well.

“In January 2012, two weeks after my discharge from a psychiatric hospital in Connecticut, I made a plan to die,” writes Lippincott in a moving essay for The New York Times. It wasn’t the only time Lippincott had planned his death; his first hospitalization for suicidal ideation had come when he was only a teenager. But he wasn’t a teenager anymore; he had entered middle age and was still reeling emotionally despite three decades of treatment, re-evaluations, and second opinions. Now he felt he had hit the end of the line. “Nothing was working, so what was the point?”

But in the midst of making his final plans, his brother sent him an email that read: “You must not leave us!” According to Lippincott, “His message confused me. I wanted to die, but I did not want to inflict suffering on the people I loved most.” His confusion opened up a window of opportunity, and Lippincott finally agreed to enter long-term residential treatment. And for the first time, he tried DBT.

“Learning DBT is like learning a new language. [It] provided me with a rubric for figuring out what was causing my anxiety, anger, or sadness—and new options for how to behave in light of that,” Lippincott says.

The interpersonal effectiveness training helps me ask for what I need in relationships and to manage conflict positively, and to do both while preserving my self-respect. Emotional regulation teaches me how to identify and understand the functions of my emotions, and how to decrease my historic vulnerability to extreme moods. If I’m aware of how I feel physically when I’m sad, or how my speech pattern changes when I’m angry, I can recognize where I am and change course before the intensity of emotion gets too high.

For Lippincott, like so many others, this ability to understand and change emotions, thoughts, and behaviors in the moment is tremendously empowering and essential to the healing process. At the same time, the self-acceptance DBT engenders allows you to develop a new, more compassionate relationship with yourself that translates into increased well-being.

Most DBT treatment takes place on an outpatient basis. In fact, traditional articulations of DBT are organized in a highly structured fashion that involves a minimum of 12 months of weekly treatment sessions. In Los Angeles, you can find a wide variety of individual psychotherapists specializing in DBT treatment as well as dedicated outpatient DBT treatment centers that offer DBT skills training groups.

While a full course of outpatient DBT treatment can be remarkably effective for many, it’s a long-term commitment that requires consistent meeting attendance even when your symptoms may interfere with your functionality, making you vulnerable to premature discontinuation. In a city like Los Angeles, this may be particularly difficult for people balancing demanding jobs with long commutes and competing obligations. With only weekly therapeutic involvement, progress can also be slow, leaving you to struggle with painful symptoms as you go through the long-term treatment process. As such, people struggling with acute psychiatric distress, low function, or who are otherwise severely impacted by their mental health disorder may require more intensive care and rapid results than outpatient DBT treatment can provide.

The extraordinary potential of DBT, combined with the shortcomings of outpatient treatment, has spurred some facilities to incorporate DBT treatment within residential treatment programs. These programs draw on the teachings of the DBT curriculum to provide a condensed and intensified format for people seeking rapid healing within a holistic treatment environment. As Lippincott notes, research has confirmed that these “more streamlined” articulations of DBT treatment can be “remarkably effective.”

But the benefits of DBT within residential treatment environments aren’t limited to the intensity of treatment and rapidity of results. Rather, the residential milieu allows you to immerse yourself in a well-rounded, personalized treatment process to ensure the full scope of your needs is addressed. DBT, after all, is only one treatment modality. While it can be pivotal for healing, the best outcomes are achieved through a variety of therapeutic interventions that allow you to explore, experiment, and engage on multiple levels. By combining DBT with a broad spectrum of other therapies, you are able to draw on the best of each modality to develop the most effective and transformative treatment plan possible.