What is Dialectical Behavior Therapy?

The word “dialectical” means holding two seemingly contradictory views in mind at once, something like a Zen koan. The two opposing ideas DBT founder Marsha Linehan embraced were our complete wholeness in the present moment on one hand — something she calls “radical acceptance” — and our simultaneous desire to evolve and transform on the other. The therapist challenges the patient to balance complete acceptance with a drive for change. Holding that tension is central to DBT.

Conditions Treated

Borderline personality disorder
Substance abuse
Post-traumatic stress
Major depression
Bi-polar disorder
Self-harming behaviors

“The curious paradox is that when I accept myself just as I am, then I change.”

— Carl Rogers

Changing Highly Reinforced Behaviors

The goal of DBT is to help people live a life worth living. For intensely emotionally dysregulated individuals, that could have the literal meaning of grappling with suicidal ideation, self-harming behaviors or addiction.

For those who are emotionally stable, but still desiring more joy, groundedness and wholeness in life, DBT principals and Scott’s unique blend of expertise, spirituality and honesty can lead the way to a more fulfilled life.

DBT individual therapy, skills groups and phone coaching lead to real-world proficiency in being mindful, managing emotional regulation, dealing with emotional distress, building interpersonal effectiveness in relationships, changing highly reinforced behaviors and general problem solving.

The Four DBT Modules

Core mindfulness

Distress tolerance

Emotional regulation

Relationship skills

Core Mindfulness

One of the foundational underpinnings of DBT is cognitive behavioral therapy, which focuses on noticing your thoughts and arguing your way to a new way of thinking. DBT takes that one step further: Using mindfulness, the patient learns to just be with the thoughts, and observe them without judgment.

More and more evidence is building to show how mindfulness and meditation techniques work to calm overreactive emotional centers of the brain, and strengthen executive processing — bringing calm, balance and more reasoned decision making.

“Mindfulness is an integral and central part of DBT, clinically.”

— Scott Spradlin

The History of DBT

In the late 1980s therapist Marsha Linehan developed dialectical behavior therapy as a treatment for borderline personality disorder, and it became the first method with double blind studies showing its effectiveness compared to other modes of treatments. Literature showed higher rates of retention, reduced suicidality and significantly reduced or eliminated hospital admissions.

DBT has since been extensively studied, and is recognized as an evidence-based treatment for complicated conditions, including addiction, ADHD, major depression, anxiety, bipolar disorder and self-harming behaviors. 

Four Components of Comprehensive DBT 

The four essential components of DBT are known as the gold standard or “comprehensive DBT.” Sometimes therapists will offer one or two of the components, which is described as “DBT informed.” Scott practices comprehensive DBT and is the only therapist in Wichita to undergo Intensive Training in Seattle, Washington with founder Marsha Linehan.

The Four Essential Components of DBT

Individual DBT

Group skills training

Therapist meets regularly with DBT consultation team

24-hour phone coaching

If a patient commits to the four essential components of DBT and practices the skills in their daily life, they can see rapid process. DBT has been shown to be as effective, or even more so, than taking anxiety medication.

DBT in Community

When you work with a DBT therapist you become part of a group of other patients also being educated through DBT skills workshops. At the same time your therapist is actively participating in their own consultation team. DBT is so much more than a single patient and therapist relationship: It’s an entire community holding the same goals of acceptance, growth, mindfulness and building a life worth living.

“We want to do what the science says works. If we don’t follow the DBT standards, you’re not going to get the best results.”

— Scott Spradlin

“Scott is a wonderful clinician who has dedicated his work and life to helping others. He embodies what he teaches and is a wiz at DBT. I’d highly recommend him!” 

— Jenny Helms