Dialectical Behavior Therapy (DBT) in Providence
What is Dialectical Behavior Therapy?
Dialectical Behavior Therapy (DBT) is a science-backed approach in the treatment of depression, binge-eating, bulimia, trauma, and post-traumatic stress disorder (PTSD), addiction, and substance abuse. DBT meets the “gold standard” of care in the eyes of the American Psychological Association.
Dialectical Behavior Therapy originated from Cognitive-Behavioral Therapy (CBT) with one major caveat: DBT focuses on validation, or accepting intense emotions, emotional vulnerability, and behavioral change. The four main DBT skills are core mindfulness skills, distress tolerance skills, interpersonal effectiveness, and emotional regulation. DBT was originally utilized to treat individuals with borderline personality disorder (BPD) at high risk of suicide. BPD is characterized by symptoms ranging from impulsive behaviors, drug use, and suicidal ideation to suicidal behaviors, including suicidal self-injury and nonsuicidal self-injury.
Over time, DBT has been adapted for different mental health settings. DBT aims to help individuals with mental health conditions, impulsivity, stress, and feelings of sadness by encouraging emotional regulation skills and mindfulness. DBT can also help those who struggle with emotional dysregulation or self-destructive behaviors, including eating disorders and substance use disorders. In some cases, DBT is also used to treat PTSD. Through a collaborative approach, therapists help clients accept problematic thoughts, emotions, and behaviors.
With dialectical behavior therapy, clients can work with their therapist to create a recovery plan. Similar to CBT, DBT skills training helps individuals develop skills, such as healthy coping mechanisms and mind-body practices, giving them the strength and power to challenge overwhelming emotions, thoughts, and behaviors. DBT is available in used in three clinical settings:
Group therapy sessions, where individuals learn problem-solving and behavioral skills through homework assignments, role-playing activities, and group skills training.
Individual therapy with a trained therapist, where individuals learn new skills through a personalized treatment plan.
Phone coaching, where individuals call their DBT therapist between therapy sessions for guidance on coping with difficult situations.
One-on-one therapy, group sessions, and DBT phone coaching and may be used in combination with medication treatment or other forms of therapy.
Meet Your DBT Therapist in Providence
Jennifer McMillan, M.S., LMHC
Jennifer McMillan provides DBT-informed individual therapy in Providence and throughout Rhode Island, helping clients who struggle with intense emotions, self harm, emotional dysregulation, and relationship problems.
Jennifer works with clients experiencing a range of mental health conditions including anxiety, OCD, PTSD, life transitions and relationship concerns. What makes Jennifer's DBT therapy effective is her ability to balance acceptance and change—helping you validate where you are while developing new skills for moving forward. DBT teaches concrete behavioral skills you can use in day to day life, from managing immediate crisis moments to strengthening relationships. Jennifer understands that client motivation varies and meets you where you are, using DBT techniques adapted to your specific treatment goals and circumstances.
Is Dialectical Behavior Therapy Effective?
Studies have confirmed the efficacy of DBT in treating a wide range of psychiatric diagnoses, including depression, bipolar disorder, BPD, substance use disorder, and PTSD, in adolescents and adults. In a systematic review by Panos et al., researchers confirmed the validity of DBT therapy sessions in reducing suicide attempts, impulsive behaviors, and symptoms of depression in adult patients with BPD in a clinical setting.
Over the course of treatment, DBT helps decrease the frequency and severity of psychological symptoms, utilizes positive reinforcement to promote behavioral change, and translates the problem-solving and behavioral skills learned during therapy sessions to the client's everyday life. While each practitioner has their own structure and goals, standard DBT generally involves the following goals:
Acceptance — You'll learn new coping skills to accept and tolerate tough situations, emotions, and thoughts.
Behavioral change — You'll learn problem-solving skills to analyze problems and replace destructive and self-injurious behaviors with healthier alternatives.
Cognitive change — You'll learn how to identify and change problematic thoughts, behaviors, and actions.
Collaboration — You'll learn how to communicate effectively and work collaboratively with a team, whether it's your individual therapist or group members.
Support — You'll learn how to recognize your individual strengths and use them effectively.
Despite our recognition that DBT is a highly effective treatment, we would be remiss if we did not mention that Dialectical Behavior Therapy is not the only scientifically proven approach to treatment. The American Psychological Association has also given its stamp of approval to other approaches to mental health treatment used by the Baltimore Therapy Group's therapist consultation team, including Cognitive Behavioral Therapy, Emotion-Focused Therapy, Interpersonal Process Therapy, and Psychodynamic Psychotherapy.
While therapists in the Providence Therapy Group use a variety of empirically supported treatments including Cognitive Behavioral Therapy, Interpersonal Process Therapy, Psychodynamic Psychotherapy, and Emotion Focused Therapy to help clients overcome the struggles that bring them to therapy, our therapists also use Dialectical Behavior Therapy or “DBT”.
Frequently Asked Questions About DBT in Providence
What is dialectical behavior therapy (DBT) and how does it work?
Dialectical behavior therapy (DBT) is a comprehensive evidence based treatment originally developed by psychologist Marsha Linehan for borderline personality disorder. DBT focuses on balancing acceptance and change through four core skills modules: emotion regulation (managing intense emotions), distress tolerance (surviving immediate crisis without making things worse), interpersonal effectiveness (strengthening relationships while maintaining self respect), and mindfulness (being fully aware in the present moment). Research in journals like the British Journal of Psychiatry and Australian controlled trials shows DBT teaches behavioral skills that effectively reduce self harm, suicidal ideation, and emotional dysregulation.
What mental health conditions does DBT treat besides borderline personality disorder?
While DBT was originally developed for borderline personality disorder, DBT treatment now addresses many mental health conditions including eating disorders, post traumatic stress disorder (PTSD symptoms), personality disorders, substance use concerns, self injury and self harm, suicidal ideation and life threatening behaviors, depression and anxiety, and relationship problems. DBT therapy works well for anyone struggling with intense emotions, emotional dysregulation, or behavioral patterns that interfere with creating a life worth living. Systematic review research shows dialectical behavior therapy DBT helps diverse populations manage mental illness effectively.
How is DBT different from regular cognitive behavioral treatment?
DBT is a type of cognitive behavioral treatment but adds dialectical philosophy (balancing opposites like acceptance and change), structured skills training in four specific modules, telephone coaching for crisis support between sessions, and focus on validation alongside change. While CBT primarily targets negative thoughts and behavior patterns, DBT teaches concrete behavioral skills for regulating emotions, tolerating distress, and improving interpersonal effectiveness. DBT techniques include radical acceptance, mindfulness techniques, and behavioral tech strategies that help you manage intense emotions in day to day life more effectively than standard therapy approaches.
Does DBT help with eating disorders and PTSD symptoms?
Yes. While dialectical behavior therapy was originally developed for borderline personality disorder, research demonstrates DBT treatment effectively addresses eating disorders by teaching emotion regulation skills that reduce emotional eating and purging behaviors, plus distress tolerance techniques for managing urges. For post traumatic stress disorder, DBT helps manage PTSD symptoms including emotional dysregulation, self harm, and relationship problems common after trauma. DBT focuses on building life worth living skills rather than requiring detailed trauma processing, making it suitable for clients not ready for exposure-based trauma therapy.
Can I do DBT if I'm not in crisis or don't have borderline personality disorder?
Absolutely. While DBT addresses life threatening behaviors and was originally developed for borderline personality disorder, DBT therapy benefits anyone struggling with intense emotions, relationship problems, or behavioral patterns they want to change. You don't need a specific personality disorder diagnosis—DBT teaches behavioral skills useful for managing stress, improving interpersonal effectiveness, and building self respect in everyday life. Many clients use DBT skills training to handle difficult emotions, strengthen relationships, and create positive changes without being in immediate crisis. Jennifer can help determine how suitable DBT is for your goals.
What are DBT skills and how do I learn them?
DBT skills fall into four modules: Emotion regulation skills help you understand and manage intense emotions, identify and change negative thoughts, and increase positive emotions. Distress tolerance skills teach radical acceptance, crisis survival strategies, and tolerating difficult situations without making them worse. Interpersonal effectiveness skills help you ask for what you need, set boundaries, and strengthen relationships while maintaining self respect. Mindfulness techniques teach being fully aware in the present moment without judgment. DBT teaches these through skills groups, individual therapy, and practice in day to day life between DBT sessions.
How do I know if DBT is the right therapy for me in Providence?
DBT may be suitable if you experience intense emotions that feel overwhelming, engage in self harm, self injury, or suicidal ideation, struggle with relationship problems or interpersonal skills, have been diagnosed with borderline personality disorder, eating disorders, or personality disorders, find cognitive behavioral treatment alone hasn't been enough, or want to learn concrete behavioral skills for managing day to day life.