1993: The first DBT treatment manual was published by Dr. Marsha Linehan
2000: Dr. Yong Cho started his first DBT skills training group for Korean immigrants at the Zucker Hillside Hospital/Long Island Jewish Medical Center in New York
2003: The first DBT Program started in Seoul, Korea
Dr. Cho provided educational seminars and lectures on DBT to professionals and graduate students in the field of mental health
2007: Dr. Cho translated Dr. Linehan’s first DBT treatment manual into Korean
2007: The DBT Center of Korea was established in Seoul with the help of Dr. Linehan and the team of Evidence Based Treatment Center of Seattle
2008: Dr. Linehan visited Seoul and provided the first DBT workshop in Korea
2008: DBT Standard Treatment Program was formalized and implemented for the Korean speaking population
2017: DBT Skills Manual for Adolescents and DBT Skills Training Handouts and Worksheets, Second Edition were published
2018: DBT Skills Training Manual, Second Edition was published
Dialectical Behavioral Therapy (DBT) is a psychotherapy treatment that was developed by Dr. Marsha Linehan at the University of Washington to treat borderline personality disorder (BPD) and chronic suicidal behaviors. It is an effective treatment for people who have difficulties with regulating emotions, interpersonal issues, anger control, chronic self-destructive behaviors, and other related difficulties.
Through Randomized Clinical Trials, the effectiveness of DBT treatment has been compared to Treatment-As-Usual (TAU) for treating BPD and related symptoms. Cochrane Database of Systematic Reviews, an institution based in England, selected DBT as the only treatment that has been proven to be effective in treating BPD symptoms.
DBT Standard Treatment Program consists of DBT individual therapy, DBT skills training group, skill coaching, and DBT team consultation. Scientific evidence shows that DBT has a lower relapse rate compared to other treatments because it helps the clients to learn and apply DBT behavioral skills successfully into their daily lives and to strengthen the skills to become their behavioral repertories that comprise the essential part of human personality.
Numerous studies show that DBT has significantly lowered anger outbursts, feelings of hopelessness, suicidal thoughts and behaviors in people with BPD and suicidal crisis compared to other treatment modalities.
Though DBT was initially developed for clients with BPD, its module-based system has made it applicable to treat other related symptoms. Recent studies have shown that DBT is effective for treating depression, PTSD, eating disorders, emotional and behavioral problems in adolescents, ADHD, impulsivity, as well as aggressive behaviors.
According to the 2007 study of Allec Miller, author of DBT Skills Manual for Adolescence, DBT is a very effective and inclusive treatment that can be applied to treat adolescents who are experiencing emotional and behavioral dysregulation regardless of their diagnosis.
Dr. Yong Cho who established DBT KOREA in Seoul has started his first DBT skills training group for Korean immigrants at the Zucker Hillside in New York since 1998. Dr. Cho and his DBT team at the DBT Center of Korea have been providing the DBT Standard Treatment Program in both Korean and English since 2003. Additionally, they have invited Dr. Linehan to the first DBT workshop in Korea, during which Dr. Linehan and Dr. Cho promised that the DBT Center of Korea will provide the best DBT treatment in Korea with no modifications of the standard program.
As promised, the DBT Center of Korea has been providing DBT Standard Treatment Program to adults as well as adolescents and their families who experience difficulties in emotion regulation, self-destructive behaviors, and impulsive behaviors; the efficacy of the treatment program has been proven by the clients who have successfully completed the DBT program.
DBT Treatment Areas & Symptoms
Dialectical Behavior Therapy (DBT) is a behavior treatment program that helps clients change their problem behavior by learning and applying alternative behavioral skills.
DBT is for clients who are experiencing difficulties regulating emotions and managing impulsive and self-injurious behaviors of which behaviors often hurt people around them. Through DBT behavior skills, they are able to change their ways of responses to others and to themselves.
Clients who were exposed to invalidating environment during their childhood often experience emotional dysregulation issues. Emotion dysregulation decreased the self-efficacy of their problem-solving skills, constantly creating conflicts with others and worsened their capacity of regulating emotions. Without proper treatment, the vicious cycle of invalidation aggravates the symptoms of Borderline Personality Disorder
DBT Standard Program for Adults/Young Adults is for clients who experience extreme emotional dysregulation, have trouble managing interpersonal conflicts, and display self-destructive and impulsive behaviors that lead to negative consequences triggered by unstable emotional state.
DBT Standard Program for Adults, Young Adults, Adolescent & Family
DBT primarily focuses on reducing emotional distress by improving skills to regulate emotions and tolerate distress with the empirical framework of Cognitive Behavior Therapy and Mindfulness skills training. Since 2003, the Center for International Psychological Services at the Tree Group has been providing DBT services to people who are suffering from various disorders that include borderline personality disorder, post-traumatic stress disorder, eating disorders, chronic suicidal behaviors and emotion dysregulation related symptoms such as dissociation, depression, interpersonal difficulties, etc.
The DBT Standard Program is the scientifically proven treatment that follows Dr. Linehan’s original clinical protocols.
It has the very clear treatment structure with a weekly individual psychotherapy session and a skills training group session; the structure however could be varied depending on the urgent needs and/or complexity of the clients’ symptoms.
During the DBT skills training group, clients learn to acquire mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress tolerance skills. They learn to apply these skills to their everyday lives in their DBT individual psychotherapy session, which is aimed to alter their unhelpful, negative behaviors into healthy, positive behaviors.
For DBT to be effective and treat severe and complex symptoms, clients must participate voluntarily with full commitment as the skills must be learned and practiced for an extended period of time. The typical duration of DBT Standard Program is 12 months of one weekly individual psychotherapy session and one skills training group session.
In the beginning of DBT individual psychotherapy sessions, clients will be given basic orientation and rational of DBT, an introduction to behavioral analysis and how to fill out a DBT diary card. The clients will identify their own treatment goals and should make a full commitment to participate in the treatment.
Standard DBT and Primary Target Goals
– Pre-treatment: DBT orientation and agreement of treatment plan
1) Pre-treatment evaluation
2) Orientation and agreement of treatment plan
– DBT Stage 1: acquire basic skills and reduce impulsive behaviors
1) Reduce life-threatening behaviors
2) Reduce treatment-interfering behaviors
3) Improve quality of life
4) Improve behavioral skills
– DBT Stage 2: reducing trauma-related stress and symptomatic issues
1) Reduce trauma-related symptoms
2) Reduce residual mental disorders with moderate severity not treated in Stage 1
3) Reduce intensity and duration of emotional dysregulation
– DBT Stage 3: facilitate self-respect and help clients achieve their own personal goals
1) Solve problems in living
2) Achieve personal goals
– DBT Stage 4: increase self-confidence, happiness, and find meaning in life
1) Solve problems of human incompleteness
2) Find freedom and happiness
2003 ‘DBT Skill Training Manual for Borderline Personality Disorder’ by Dr. Linehan was translated into Korean and published
Dr. Cho started DBT for Korean immigrants in New York since 2000. He translated each worksheet in ‘DBT Skills Training Workbook’ written by Dr. Marsha Linehan and conducted DBT skills training group sessions for clients.
DBT Skills Training Group
Since the first publication of the DBT treatment manual in 1993, studies have investigated the effectiveness of DBT for treating various symptoms and disorders.
Initial studies mainly focused on applying DBT skills to adults with borderline personality disorder, self-destructive behaviors, and suicidal crisis. However, recent studies have shown that DBT is also effective for treating eating disorders, impulsive behaviors, post-traumatic stress disorder, depression, addiction, and other emotional or behavioral difficulties.
DBT is an effective and inclusive treatment that could support children, adolescents, and adults with emotional difficulties.
DBT is composed of scientifically proven behavioral skills. The main goal of the DBT skills training group is for the clinicians to help their clients apply these behavioral skills to their everyday lives. The participants of the group learn the DBT skills in each class, practice the skills outside of the group, and record how he/she practiced the skills using separate worksheets.
During the DBT skills training group, clients learn to acquire the skills in the following four modules within a six-month period: mindfulness skills, interpersonal effectiveness skills, emotion regulation skills, and distress tolerance skills. In the standard DBT program, the clients learn each module twice over 12 months. The Walking the Middle Path module is an individual module in DBT for Adolescents, whereas it is included in the Interpersonal Effectiveness module in DBT for Adults.
– The goal of the mindfulness module is to reduce emotional suffering, increase happiness, and increase control over our behaviors. The core mindfulness skills are to observe, describe, and participate (WHAT skills) as well as doing this non-judgmentally, one-mindfully, and effectively (HOW skill).
– The interpersonal effectiveness module involves skills to make new relationships, strengthen current relationships, and solve interpersonal conflicts. Participants learn skills like DEAR MAN (Describe, Express, Assert, Reinforce, Mindful, Appear Confident, and Negotiate) which they can apply when asking for what they want while maintaining self-respect and respect for the other person.
– The Walking the Middle Path module teaches participants how to validate one’s own perspective and another person’s perspective at the same time and to think and act dialectically.
– The skills in the emotion regulation module can be applied to reduce emotional suffering and intensity as well as to change emotional reaction. Understanding our emotions, opposite action, and other emotion regulation skills are included in this module.
– The distress tolerance module consists of skills for crisis survival and for accepting reality, which would help participants to reduce the behavior triggering the crisis. This module also includes skills to help addiction problems through dialectical abstinence.
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“Where does our suffering come from?”
“What is the Karma that professionals trying to alleviate the pain of others’
Among those who are involved in DBT therapy or dedicated to the field of mental health, there are individuals who