Stages of DBT Treatment

DBT targets various symptoms in stages. Of course, clients may not all come into treatment at stage one, which is why your therapist will meet with you for an assessment in order to recommend the most effective course of treatment for you.


Stage 1

Goals of stage one are to obtain behavioral control. For clients experiencing life-threatening symptoms such as suicidal thinking, suicidal behavior and self harm, these behaviors are addressed first as they are priority in the hierarchy of symptoms. The second target of stage one treatment is to decrease any behaviors that interfere with therapy working. The third target is behaviors that interfere severely with one’s quality of life. In DBT, behaviors that interfere with making life feel as if it’s worth living, such as substance abuse, depression, anxiety, avoidance, eating disordered symptoms, problems in relationships, impulsivity, financial stressors, employment problems, etc.  The fourth target of stage one is to increase skills that help with tolerating emotional pain and distress, staying in the present moment, making and keeping healthy relationships and understanding their emotions while knowing how to regulate them.

Stage 2

The main goal of stage two work is to experience emotions and decrease avoidance. This mainly speaks to shutting down that may happen as a result of past trauma or invalidation. Healing from past trauma is the goal in stage two, and at DBT of South Jersey, various techniques from other modalities may be used, such as prolonged exposure, EMDR, compassion focused therapy and sensorimotor therapy.

Stages 3 & 4

Solving ordinary life problems and addressing feelings of incompleteness. Stages three and four address normal levels of unhappiness that may stem from everyday life. Ultimately, therapists strive to help their clients develop a sense of meaning and connection within the world they live in. Through creating meaning in spiritual growth or making other changes in their lives, clients work towards finding ways to meet their own needs and find a sense of completeness. Again, various modalities can be utilized here such as Gestalt therapy, CFT, mindfulness based therapies, among others.

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