What Is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy (DBT) is a skills-based therapy that helps people manage intense emotions, get through distress, and improve their relationships. For eating disorders, DBT builds practical skills in mindfulness, distress tolerance, and emotion regulation that interrupt the cycles that keep disordered eating going.
DBT is part of the Eating Disorders Program at PPG, directed by Dr. Heather Rosen. Sessions are available in person at our Chappaqua and Hartsdale offices and online.
Who DBT Is For
DBT is used with teens and adults whose eating disorder is closely tied to strong emotions and urges, such as urges to restrict, binge, or purge. It is often used for bulimia and binge eating disorder, and it can support treatment for other eating disorders, depending on the person.
DBT can be used alongside Enhanced CBT (CBT-E), Family-Based Treatment, or other eating disorder care. A clinical assessment helps decide how it fits.
What DBT Helps With
Intense Emotions
Skills for understanding emotions and responding to them in ways that do not rely on eating behaviors.
Urges to Restrict, Binge, or Purge
Practice with noticing an urge, getting through it, and choosing a different response.
Getting Through Distress
Skills for tolerating hard moments, including the distress that can come with eating, without making them worse.
Relationships
Skills for asking for what you need, setting limits, and keeping relationships steady, including around meals.
Mindfulness and Awareness
Practice with noticing thoughts, feelings, body sensations, and urges as they happen, without judging them.
Balancing Acceptance and Change
DBT holds both ideas together: accepting where you are now while working toward change.
Four skill areas of DBT
-
1
Mindfulness
Skills for noticing thoughts, feelings, body sensations, and urges as they happen, without judging them or acting on them right away.
-
2
Distress Tolerance
Skills for getting through intense moments, including urges to restrict, binge, or purge, without making them worse.
-
3
Emotion Regulation
Skills for understanding emotions, lowering the intensity of difficult ones, and building more positive experiences.
-
4
Interpersonal Effectiveness
Skills for asking for what you need, setting limits, and keeping relationships steady, including around meals and recovery.
The DBT Approach to Care
DBT is practical and collaborative. Your clinician teaches skills, practices them with you in session, and helps you use them between sessions. The pace is set together, and the skills build on each other over time.
Eating disorders can affect physical health, so ongoing medical monitoring by a physician is part of care. With your consent, your therapist coordinates with your doctor, a dietitian, and any other providers involved.
What to Expect
A Free Consultation
We talk briefly about what you are looking for and match you with a clinician whose training and style fit your needs.
An Assessment
Your clinician gathers history about eating, health, and daily functioning, and discusses whether DBT is a good fit and whether medical monitoring or a higher level of care is needed.
A Treatment Plan
DBT is tailored to the person and fits within the rest of the treatment plan. We coordinate with your existing providers and help you add others, such as a dietitian or physician, if needed.
Care That Connects Across Specialties
DBT is often one part of a broader plan. Our clinicians work across specialties, and with your consent your therapist can coordinate with colleagues across the practice.
- Eating Disorders Program: Evaluation, care coordination, and step-down support.
- Enhanced CBT (CBT-E): Individual therapy for adults with eating disorders.
- Bulimia: Therapy for bulimia nervosa.
- Binge Eating Disorder: Therapy for binge eating disorder.
- Child & Adolescent Therapy: Individual therapy for children and teens.
- Adult Therapy: Individual therapy for adults.
