Common Questions

How can therapy help me?
A number of benefits are available from participating in therapy. Therapists can provide support, problem-solving skills, and enhanced coping strategies for issues such as depression, anxiety, relationship troubles, unresolved childhood issues, grief, stress management, body image issues and creative blocks. Many people also find that therapists  can be a tremendous asset to managing personal growth, interpersonal relationships, family concerns, marriage issues, and the hassles of daily life. Therapists can provide a fresh perspective on a difficult problem or point you in the direction of a solution. The benefits you obtain from therapy depend on how well you use the process and put into practice what you learn. Some of the benefits available from therapy include:
  • Attaining a better understanding of yourself, your goals and values
  • Developing skills for improving your relationships
  • Finding resolution to the issues or concerns that led you to seek therapy
  • Learning new ways to cope with stress and anxiety
  • Managing anger, grief, depression, and other emotional pressures
  • Improving communications and listening skills
  • Changing old behavior patterns and developing new ones
  • Discovering new ways to solve problems in your family or marriage
  • Improving your self-esteem and boosting self-confidence
How do I know if a therapist does DBT?
These are the questions you should ask:
Have you completed a 10 day intensive DBT training ?
Are you a member of a DBT consultation team ?
Have you been supervised by an expert DBT therapist?
Are you familiar with the main sets of DBT strategies
(cognitive behavioral therapy, validation, dialectics)
Do you teach skills, practice behavior analysis, review diary cards,?
Do you do phone coaching?
How many clients have you treated using DBT?

The answer to these questions should be yes. You have a right to check on the therapist’s credentials; to know if the therapist is licensed in his/her state; to know the extent and nature of the therapist’s education and training; the extent of the therapist’s experience in treating clients with similar problems; the therapist’s arrangements for coverage or emergency contacts.

Why is it important to see a trained DBT therapist?

DBT may be the most hopeful and helpful of any new therapy available for people with BPD. Many people with BPD have problems trusting others, have “failed in treatment” or have been dropped by former therapists. When DBT is not done as designed, the results may not be the same, causing the person with BPD to lose hope and trust and then be reluctant to ever try DBT again. If DBT is not practiced according to the research model that produces effective change but is practiced “my way” by a therapist without adequate training, it probably won’t produce the same kind of results as the research programs. Outcomes from this kind of DBT will not justify additional DBT training or new DBT programs in the community. Currently. Dr. Linehan is working on a way to certify therapists who practice DBT so that people can determine if a therapist is truly qualified to practice DBT.

What does "dialectical" mean?

The term "dialectical" means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).

How effective is DBT?

Research has shown DBT to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, and depression and improving social and global functioning. For a review of the research on DBT, click here. In this video , DBT Developer and Behavioral Tech founder Dr. Marsha Linehan describes the amazing changes she's seen in people who have received DBT and gotten out of hell.

Do I really need therapy?  I can usually handle my problems.
Everyone goes through challenging situations in life, and while you may have successfully navigated through other difficulties you've faced, there's nothing wrong with seeking out extra support when you need it. In fact, therapy is for people who have enough self-awareness to realize they need a helping hand, and that is something to be admired. You are taking responsibility by accepting where you're at in life and making a commitment to change the situation by seeking therapy. Therapy provides long-lasting benefits and support, giving you the tools you need to avoid triggers, re-direct damaging patterns, and overcome whatever challenges you face.


Why do people go to therapy and how do I know if it is right for me?

People have many different motivations for coming to psychotherapy.   Some may be going through a major life transition (unemployment, divorce, new job, etc.), or are not handling stressful circumstances well.  Some people need assistance managing a range of other issues such as low self-esteem, depression, anxiety, addictions, relationship problems, spiritual conflicts and creative blocks.  Therapy can help provide some much needed encouragement and help with skills to get them through these periods.  Others may be at a point where they are ready to learn more about themselves or want to be more effective with their goals in life.   In short, people seeking psychotherapy are ready to meet the challenges in their lives and ready to make changes in their lives.
What is therapy like?
Because each person has different issues and goals for therapy, therapy will be different depending on the individual.  In general, you can expect to discuss the current events happening in your life, your personal history relevant to your issue, and report progress (or any new insights gained) from the previous therapy session.  Depending on your specific needs, therapy can be short-term, for a specific issue, or longer-term, to deal with more difficult patterns or your desire for more personal development.  Either way, it is most common to schedule regular sessions with your therapist (usually weekly).
It is important to understand that you will get more results from therapy if you actively participate in the process.  The ultimate purpose of therapy is to help you bring what you learn in session back into your life.  Therefore, beyond the work you do in therapy sessions, your therapist may suggest some things you can do outside of therapy to support your process - such as reading a pertinent book, journaling on specific topics, noting particular behaviors or taking action on your goals. People seeking psychotherapy are ready to make positive changes in their lives, are open to new perspectives and take responsibility for their lives.
What about medication vs. psychotherapy?
It is well established that the long-term solution to mental and emotional problems and the pain they cause cannot be solved solely by medication. Instead of just treating the symptom, therapy addresses the cause of our distress and the behavior patterns that curb our progress. You can best achieve sustainable growth and a greater sense of well-being with an integrative approach to wellness.  Working with your medical doctor you can determine what's best for you, and in some cases a combination of medication and therapy is the right course of action.
Do you take insurance, and how does that work?
To determine if you have mental health coverage through your insurance carrier, the first thing you should do is call them.  Check your coverage carefully and make sure you understand their answers.  Some helpful questions you can ask them:
  • What are my mental health benefits?
  • What is the coverage amount per therapy session?
  • How many therapy sessions does my plan cover?
  • How much does my insurance pay for an out-of-network provider?
  • Is approval required from my primary care physician?
Does what we talk about in therapy remain confidential?
Confidentiality is one of the most important components between a client and psychotherapist. Successful therapy requires a high degree of trust with highly sensitive subject matter that is usually not discussed anywhere but the therapist's office.   Every therapist should provide a written copy of their confidential disclosure agreement, and you can expect that what you discuss in session will not be shared with anyone.  This is called “Informed Consent”.  Sometimes, however, you may want your therapist to share information or give an update to someone on your healthcare team (your Physician, Naturopath, Attorney), but by law your therapist cannot release this information without obtaining your written permission.
However, state law and professional ethics require therapists to maintain confidentiality except for the following situations:
* Suspected past or present abuse or neglect of children, adults, and elders to the authorities, including Child Protection and law enforcement, based on information provided by the client or collateral sources.
* If the therapist has reason to suspect the client is seriously in danger of harming him/herself or has threated to harm another person.

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