+ What's the difference between DBT and Open DBT?
RO-DBT and DBT are different types of treatment but we commonly receive phone calls for DBT when the client’s needs are actually RO-DBT. So, why use one or the other? What’s the same? What’s different?
People who contact us will frequently say they need DBT and say so because they have a friend or even another professional telling them so. DBT, simplified, is a therapy which utilizes behavioral skills to address symptoms of Under-Control, UC, of Emotions. Frequently this manifest as poor self-control of emotions, behaviors, expression of self, and frequent broken relationships due to this under-controlled emotional based behaviors. Both Sameera Malik, LCSW, and Whig Mullins, LCSW, spent years practicing DBT with clients who needed it and for whom it worked. However, there was also a group of clients who partially fit this highly sensitive group, and occasionally self-harm too. This second group of clients had some of the additional characteristics of high sensitivity to threat, insensitivity to reward, inhibited emotional expression, low sensation-seeking behaviors, perfectionism, and aloof or distant relationships. These clients are better described as Over-Controlled. They too occasionally self-harmed and have other behaviors which degrade relationships. Individuals described as having excessive self-control are often highly successful, risk intolerant, and have lower flexibility in thinking and receptivity, particularly where criticism is concerned.
Under Control of Emotions is frequently experienced in these diagnoses:
- Borderline Personality Disorder
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Histrionic Personality Disorder
- Conduct Disorder
- Bipolar Disorder
- Externalizing Disorders Under Controlled behaviors are best treated using Dialectical Behavior Therapy.
Over Control is more frequently experienced in these diagnoses:
- Obsessive Compulsive Personality Disorder
- Paranoid Personality Disorder
- Avoidant Personality Disorder
- Schizoid Personality Disorder
- Anorexia Nervosa
- Chronic Depression
- Autism
- Treatment Resistant Anxiety
- Internalizing Disorders Over Controlled behaviors are best treated using Radically Open-Dialectical Behavior Therapy.
We can assist you to determine if you may need one and if so, which is best for you. We have specific short scientifically proven measures to help us determine the best fit as well as your own needs.
+ What types of concerns do you treat?
- Overcontrol
- Hyperfectionism
- Chronic Depression
- Treatment Resistant (Refractory) Depression
- Treatment Resistant Anxiety
- Obsessive Compulsive Disorder
- Obsessive Compulsive Personality Disorder
- Paranoid Personality Disorder
- Avoidant Personality Disorder
- Schizoid Personality Disorder
- Anorexia Nervosa
- Autism
- Aspergers
- How I'm Feeling
- How I'm Acting
- Relationship Challenges
- Parenting Challenges
- Family Challenges
- Aging Challenges
- Marital Challenges
- Mediation
+ I made an appointment, now what can I expect?
Most of our clients make initial contact with us at the peak of crisis for them - when “it” becomes intolerable. That intensity may actually carry you through the initial contact and making of the appointment. We would think and hope that this provides some relief in the short term. However, along with the relief, there is often anxiety about what will happen in the first session. Here is a breakdown of what to expect:
- Schedule a consultation
- You will receive a basic intake form via email that you are invited to complete and return through our online system prior to your appointment. (Our office is paperless. Any paper documents that are received are scanned and then shredded).
- At the consultation, a therapist will greet you and ask you to fill out certain assessments based on the information in your intake form. Each assessment will be explained to you as well as what to do after you complete them. This process typically takes between 10-20 minutes. These assessments will help us begin figuring out whether we are the right “fit” for you and able to provide the services you need.
- Your therapist will return to collect you and your paperwork and take you to his or her office for the completion of the intake. The total time for an intake meeting is 60-90 minutes. Plan on 90 minutes.
- Once in session, we will go over our role as mandated reporters and what that means for confidentiality. The therapist will quickly review your paperwork and also in what may feel like excruciating detail, the info you sent in the intake via email. This is because we have an ethical duty to ensure that we understand your situation to the best of our ability and that we are providing services in a timely manner based on your needs. If suicidality is a part of your history, then expect us to discuss this with you. We will also be looking for potential diagnoses and/or to understand why you have been diagnosed with what you have.
By this point, you may be feeling frustrated that you have not been able to get to the “it” that brought you in even though you’ve been in the office for quite awhile at this point and the therapist keeps asking questions. Please know we will absolutely get to “it”.
To help us get to “it” faster, please come prepared to provide us with contact info for other service providers from internists to pediatricians to psychiatrists and/or other therapists. We take a team approach to your healing and will contact other providers as we feel necessary, but not without your consent unless it is a matter of safety.
We truly believe that therapy is not a lifetime commitment; it is about healing and living your life on your terms without us as soon as possible. To that end, we will ask you your goals for therapy and how we will know you have achieved them. What would that look like? It is ok if you cannot answer that right away – just know we will ask.
We hope this helps manage some of the “unknowns” of our first meeting. Please feel free to contact us with any questions or concerns. We look forward to seeing you soon!
+ Do you accept insurance?
At Core, we believe in empowering clients to manage the degree of confidentiality they are most comfortable securing. To that end, we made the decision to be an out-of-network provider. This allows you to decide how best to manage charges. Insurance companies may request access to certain information about you and your treatment. By providing you with a bill containing the minimal required information, we feel you are then in charge of making decisions about how you wish to proceed. Please know that we cannot guarantee you reimbursement by your insurance company should you choose to seek out of network reimbursement.
+ What are your rates?
We offer a free initial twenty minute phone assessment. If we feel we can be of service to you then our rate is $180.00/hour for individual sessions, $200/hour for couples sessions, and $75/class session, regardless of class time or number attending.
+ What types of payment methods do you accept?
We expect and appreciate payment in full at time of service and accept cash, checks and credit cards (MasterCard, Visa, Debit).