Mental Health: Hope and Recovery · Mind Body Spirit.fm

Navigating Dialectical Behavior Therapy (DBT) with an Expert Therapist

·58 min·3 clips

DBT starts by naming suicidal behaviors, therapy-interfering behaviors, and “commit[ting] to staying alive.”

1. Mental Health: Hope and Recovery Episode 62 focuses on navigating Dialectical Behavior Therapy, or DBT, with an expert therapist. 2. Hosts Helen Sneed and Valerie Milburn introduce Penny Kruger, LCSW, as a 30-year clinical social worker, DBT trainer, and founder of Austin’s first adult DBT intensive outpatient program in 2006. 3. The episode asks what DBT is for, who it helps, and why clinicians use it when other treatments have stalled. 4. Penny says her path into therapy began at LSU in Baton Rouge, where a neuropsychologist teaching abnormal psychology “hooked” her. 5. She describes early work after graduation at a psychiatric hospital in New Orleans with Masters & Johnson programming for sexual trauma, sexual compulsivity, and an eating-disorder program. 6. That setting also introduced her to patients diagnosed with borderline personality disorder and to charted judgments that were not always discussed directly with patients. 7. Penny says those early observations shaped her later commitment to transparent treatment and direct communication. 8. She first encountered DBT while working in a hospital environment where patients could stay six months or a year and still return with suicidality and self-injury. 9. Her first adult DBT implementation in Austin began after she asked supportive administration for training to help patients who were dropping out or becoming dysregulated in group care. 10. She describes a year of team preparation, intensive training, and homework before the Austin group went to DBT intensive training. 11. Penny says she later collected data on rehospitalization, length of stay, and reported self-injury to show that DBT was helping. 12. She notes that those measures went down, which gave her objective evidence that the program was working. 13. Penny says early skepticism centered on DBT being too structured and too workbook-like compared with deeper process work. 14. Her response is that when a client is burning out, dropping out, or in immediate pain, the first order of business is to address “the things that are on fire.” 15. She emphasizes that DBT is a “both and” treatment rather than an either-or choice between skills and insight. 16. Penny says demand for DBT has grown as it became more accepted for clients who were not progressing in traditional treatments. 17. She explains that many programs now use DBT as an adjunct, including with trauma work, EMDR stabilization, OCD treatment, and eating-disorder care. 18. Penny says DBT is unusually transparent because she tells patients directly what she is doing and what she plans to discuss. 19. She describes the treatment as useful for people with intense emotional dysregulation, impulsive behaviors, avoidance, and interpersonal conflict. 20. Listeners who want practical, clinician-level explanations of DBT and recovery skills will get the most from this episode, while people seeking a light or purely theoretical discussion may skip it.

As heard by us

A plain-spoken look at DBT as a structured treatment for intense emotions and target behaviors.

This episode explains DBT as a structured treatment for people dealing with intense emotions, target behaviors, or avoidance that is getting in the way of daily life.

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Why you'd press play

When emotions feel hard to manage and behaviors start costing you quality of life, DBT gets explained without the jargon.

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