Comments on
DBT Assumptions

dbt assumptionsEvery therapy operates with a certain set of basic assumptions.  These are sets of hypothesis’, facts or statements that are taken for granted.  They are not always articulated, but they are acted upon as rules and guidelines for treatment.

16 thoughts on “DBT Assumptions

  • November 16, 2010 at 7:34 pm

    From my understanding it is the therapist who fails in DBT, not the therapy and you do have the choice of changing therapists.

    Yes people can fail in DBT and they do. People drop out of DBT all the time and these people are not added to the statistics that boast overwhelming success.

    Chances are it is a very successful type of therapy and certainly sounds very well-rounded but, like everything else in life, it is not infallible.

    Beware of any therapy that says people or the therapy cannot fail.

    • November 17, 2010 at 7:56 am

      Thank you for your comment. I wanted to clarify my understanding of the intention behind the assumption “people cannot fail in DBT.” I believe the intention is to emphasize that it is not the person that has failed, but the treatment or the treatment provider. Too often the people who are receiving help are blamed when treatment doesn’t work for them. This basis of this assumption is that we should not blame people if a treatment is not working for them (people cannot fail in DBT), but should look to find something that does work for them (DBT can fail people).

  • November 16, 2010 at 10:04 pm

    Thank you for this clarity!
    It means more to me than you can imagine!!!


  • November 17, 2010 at 10:59 am

    In developing brain-based coping skills for kids, our motto is using a “no fault” approach — something quite akin to DBT. When kids learn “there’s nothing wrong with me when I get upset or stressed”, they are amazed to learn that their brain controls how they feel, think and act. As an emotional health educator directly working with over 700 pre-teens, it’s obvious that “No child should suffer from the misbelief that they DESERVE the pain they feel inside!” We’ve had nearly 90,000 pre-teens, teens plus many more of their parents, counselors and teachers visit our Coping Skills for Kids free and open access “virtual classroom” in less than 3 years. We need more emotional health education (promoting self-management strategies) so kids and the adults who care from them use a “no fault” approach at home and in schools. As I often say to adult audiences, “Blaming others for how we feel only keeps us from developing healthy coping skills.”

  • November 17, 2010 at 11:24 am

    How is it that the therapist can fail in DBT, but the client can’t?

    It makes sense as a sort of motivational slogan, but it’s difficult to see how it could be descriptive of reality.

    Unless the client is the person in a burning building, and the therapist is the firefighter. But if that’s the case, how does that fit with the client empowerment paradigm?

  • November 17, 2010 at 1:18 pm

    Clients can fail when the other assumptions are not met, such as all clients try. You can’t change without trying to change and using what you are learning. Correctly implementing DBT means that you are unlikely to fail rather than all people will not fail.

  • November 19, 2010 at 12:26 pm

    In DBT, the assumption is that it is the therapist who is responsible for failures – the therapist didn’t do what that client needed in order to succeed.

    I wish that more therapists took that responsibility seriously, although I know how hard that is and what a burden it can be to the therapist. As a therapist myself, I am weary of putting everything I have into trying to help people who reject everything I do. Which emphasizes the importance of therapists needing support. I wish that all modalities and settings would recognize that one too.

    I draw from DBT to the extent that I can, both personally and professionally, but have not had the opportunity to get either live training in DBT or DBT therapy for myself. I do all that I can. I have failed out of therapy 8 times, but I completed my master’s degree with nearly a 4.0. That counts against me in therapy too. But I no longer have insurance, so no help for me.

  • March 10, 2011 at 9:53 pm

    I know my daughter’s therapist failed her miserably. Now they recommend a restrictive “boarding school.”

    DBT is a great therapy – – I recognize that. But, the attitude that the “therapist do not fail the client” is ridiculous. How many other
    DBT-ers out there were recommended to be placed in a restrictive boarding school?

    Also, does anyone have any good DBT therapist in the NYC areas?

  • February 10, 2012 at 11:12 pm

    This comment may come a little late, but the very best DBT therapist I know of in the NYC area is Sarah Wilkinson LCSW-R. She works in Roosevelt Hospital in their Center for Intensive Treatment of Personality Disorders. 212-532-7857. She also has a private practice. She is extremely skilled and unlike any therapist I have ever had before. I owe her my life-for real.

    • May 30, 2013 at 11:10 pm

      Dear DBTGIRL,

      I feel the same way about Ms. Wilksion.
      I am also very grateful for her

  • April 17, 2013 at 12:24 am

    I am a graduate of provincially (state) funded DBT program. I kept in contact with some of the members of my therapy group. 3 Months after discharge one of us has taken her life and 3 of the rest of us are contemplating the same. We have so little hope left.

  • May 26, 2013 at 3:02 pm

    I have been in dbt therapy for bpd for 2 plus years. Participated without fail in all group and individual sessions. Not once was compassion and/or support (that that derives from compassion) offered or provided to myself or others in the program. The program is ran like a militant brainwashing, better put may be you learn words and phrases that must be used by all patients and when they are to be used. At first I went along, then I made a mistake by asking to be moved forward to the trauma resolution stage. That is when I was told to apply again next year if I want to follow the “program”. The icing on the cake? They laid off my therapist the same week due to budget cuts.
    Needless to say, I am starting another behavioral health next month and carry with me dissappointment and fear.

    • August 19, 2013 at 4:02 am

      In my opinion DBT is a load of hyped-up bull s**t. I would go further and argue it can be dangerous. Governments around the world are funding DBT programs because of the glowing statistics of people improving. The problem is the statistics aren’t showing people living a life of better quality, but simply of less resource usage (particularly hospital). DBT has 4 parts but only part 1 is funded by health services as this targets resource usage and all they are interested in is saving money. As nancy has said, DBT programs are run like military boot camps with little compassion and all they want to teach is mindfulness – basically telling you to stop thinking how fu**ed up your life is and all the crap you have been through without giving any real solutions. Get a job – great well give me a job. Whose going to employ me after being on social security for 13 years? Also like Scott said, DBT is being spouted as the last chance saloon – if you don’t get better you may as well give up and stop using resources. Thats also what they want. No other mental disorder is treated with such hatred as personality disorder.

  • December 23, 2018 at 12:46 pm

    Why is euthanasia not an option for people with Borderline? I’ve carried, and I mean, carried…like a huge weight that prevents any real freedom of movement, for over a decade. I’ve done DBT – a lot of it, in an IOP setting. I’m more isolated, hopeless, and damaged than I’ve ever been in my life. I’ve been blamed by so many treatment providers – including DBT therapists – for not responding to treatment. Enough is enough. I’m 52 years old and I have nothing. Make euthanasia an option for people in my situation.

    • February 21, 2019 at 11:30 am

      Okay, thank you. That comment was written when I was going through a very dark time. Things are still dark sometimes but I see some light also. I will try to remember not to give up.


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