Firefly Counseling  Services, P.C.

4950 NE Belknap Ct. Suite 205

Hillsboro, OR 97124

503-560-5822 (voice)

888-503-2864 (fax)


The practice is located on the corner of Belknap Ct. and Elam Young Pkwy next to Intel Hawthorne Farms.


+1 503-560-5822


+1 888-503-2864


verified by Psychology Today verified by Psychology Today Directory
verified by Psychology Today

Buisness Hours: We are in the office Monday-Friday with appointment times ranging from 8AM-6PM. If you are having a mental health emergency and need immediete assistance please call the Washington County Crisis Line at 503-291-9111 or the Multnomah County Crisis Line at 503-988-4888 or proceed to your nearest emergency room for assistance.



"We don't accomplish anything in this world alone...and whatever happens is the result of the whole tapestry of one's life and all the weavings of individual threads from one to another that creates something."

-Sandra Day O'Connor

Firefly Counseling Services:Care,Education,Integration
Firefly Counseling Services:Care,Education,Integration

Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) 

Overview: What is Dialectical Behavior Therapy or DBT?


Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard psychological treatment for BPD and for those struggling with overwhelming emotions (McKay, 2007; Stouffer, 2012). In addition, research has demonstrated that it is effective in treating a wide range of other disorders such as substance dependence, self-harming behaviors, adjustment to major life changes, relationships, impulsivity depression, post-traumatic stress disorder (PTSD) and eating disorders (Swales & Heard, 2009; Callahan, 2008; Shapiro, 2008).


What Does the Term 'Dialectical' Mean?

The term 'dialectical' means a synthesis or integration of opposites. The primary dialectic within a DBT program is between the seemingly opposite strategies of acceptance and change (Callahan, 2008). All skills and strategies taught within a DBT program are balanced in terms of acceptance (mindfulness and distress tolerance) and change (emotion regulation and interpersonal effectiveness). Firefly Counseling Services, P.C. utilizes the core concepts of balance within the dialectical framework to facilitate change within the client system.

Philosophy and Principles of DBT 


DBT is based on three philosophical positions. Behavioral science and research underpins the biopsychosocial model as well as the DBT behavioral change strategies and protocols (Callahan, 2008). . DBT is an integration of both biological and environmental theories along with developmental and learning perspectives when organizing thought regarding treatment and care (Swales & Heard, 2009). Emotions are viewed as the body responding to the environment; therefore contemplative practices also underpin DBT mindfulness skills and acceptance practices for clients (Bein, 2014). DBT was the first psychotherapy to incorporate mindfulness as a core component of practice. The dialectical synthesis of acceptance and change was what distinguished DBT from other behavioral interventions. Dialectics keeps the entire treatment focused on a synthesis of opposites, primarily on acceptance and change, but also on the whole as well as the parts and maintains an emphasis on flexibility, movement, speed and flow in treatment (Linehan, 1993). 


History and Development of DBT as a Treatment Practice


Marsha M. Linehan attempted to apply standard Cognitive Behavior Therapy (CBT) to the problems of adult women with histories of chronic suicide attempts, suicidal ideation and non-suicidal injury. She was trained as a behaviorist and interested in treating discrete or specific behaviors. Her clients posed significant challenges as many of them required therapy for multiple issues or problems and current treatment models at the time appeared to be falling short in meeting client needs. Linehan at first utilized CBT, but the nature of her problems encouraged her to balance and complement traditional behavior therapy with other therapeutic strategies. She carefully researched her work and began to develop a new theory of practice with treatment manuals to help guide other clinicians interested in applying a different type of behavioral approach with flexibility for clinical problems and thus DBT was formed.


Firefly Counseling Services, P.C. DBT: What to Expect


There are two components to DBT at Firefly Counseling Services, P.C.


1.) DBT Skills Training Group: The DBT skills training group is focused on enhancing client capabilities by teaching behavioral skills. The group runs like an informative class where the group leader teaches the skills and assigns practice to be done outside of the group work during everyday living. Groups meet weekly for 1 hour for the duration of the 16 week curriculum. The group has open enrollment at week one and then again at week 8 to allow for continuity of care. Clients are encouraged to schedule their 16 week group work at the onset of treatment to ensure group work can complement and work in concert with individual or family therapy.

2.) DBT Individual or Family Therapy: The individual or family therapy component of our program is designed to help with client motivation and to help clients apply skills to specific challenges and events within their lives. Individual or family therapy is once a week or biweekly depending upon client need for as long as the client is in therapy and can run concurrently with skills groups. Each session will utilize a variety of therapeutic tools which may include records such as a weekly diary card, chain analysis or other DBT skills based on strategies to bring about change and acceptance specific to targeted client treatment goals. 


What Skills are Taught in DBT?


DBT includes four sets of behavioral skills.


  • Mindfulness: The practice of being fully aware and present in the moment.
  • Emotional Regulation: How to change emotions that you want to change.
  • Interpersonal Effectiveness: How to ask for what you want and say no while maintaining self-respect and relationships with others.
  • Distress Tolerance: How to tolerate pain in difficult situations, not change it.


Firefly Counseling Services, P.C. Treatment Target Prioritization:


Clients who work with their therapist through DBT at Firefly Counseling Services, P.C. typically have multiple areas they wish to work on, however we will use the following hierarchy of treatment targets to help organize the priority of goals.


  1. Life-threatening behaviors: First and foremost, behaviors that could lead to the client's death are targeted including all forms of suicidal and non-suicidal self-injury, suicidal ideation, suicidal communications or other behaviors that have the purpose of causing bodily harm.
  2. Therapy-interfering behaviors: This includes any behavior that interferes with the client receiving effective treatment. These behaviors can be on the part of the client and/or the therapist such as coming late to sessions, cancelling appointments and being non-collaborative in working towards treatment goals.
  3. Quality of life behaviors: This includes any type of behavior that interferes with clients having a reasonable quality of life such as mental health issues, relationship problems or financial or housing crisis.
  4. Skills acquisition: This includes the need for clients to learn new skillful behaviors to replace ineffective behaviors to help them achieve their goals. 

Within any given session the above problems are addressed in the above order. For example, if a client expresses wishes to self-harm or reports recurrent impulsive behaviors the therapist will target these behaviors first in counseling before moving onto other issues of concern.


How Effective is DBT?


Research has shown that DBT is very effective in treating suicidal behavior, non-suicidal self-injury, substance abuse, anger, depression, anxiety and improving social and global functioning (Swales & Heard, 2009; Wilks, Korslund, Harned & Linehan, 2012; Mehlum, Ramberg, Tørmoen, Haga, Diep, Stanley, Miller, Sund & Grøholt, 2016). 


Expected Costs:


Individual or family therapy sessions, parent consultation appointments and group work can usually be billed to a primary insurance company depending upon a client's eligability & benefits. Every insurance company is different; therefore it is important to verify with your specific insurance company if mental health or behavioral health coverage is included within your plan. Clients are responsible for all copays, coinsurance or fees not covered by the insurance plan. Firefly Counseling Services, P.C. does not accept secondary insurance. There is a small materials fee associated with the DBT program to cover books and other materials clients need to succussfully participate. 




Please contact our offices at 503-560-5822 for more information regarding enrollment within our program. Our administrative staff will be happy to assist you with scheduling or to answer specific questions related to the program.





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