DBT availability/cost/duration

[Euler2718]

I've heard a lot about DBT therapy (an hour a week personal counseling, 2 hours group, phone calls to therapist). Concrete things can you answer?

1. Can you find this type of help in a big u.s. city (like L.A. for example),
2. What's the treatment cost (I'm betting insurance won't pay, am I wrong)?
3. How long before my BPD "graduates"?

She's had a lot of therapy and is willing to work on stuff so I have high hopes. She's also high functioning. I know it's gonna sound selfish but the main BPD issue is: she pulls away when scared I don't love her and then we break up. This cuts me up.

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[Local_Boogeyman]

Hi Euler,

In my experience with my dBPDw, who completed a DPT program a few years ago here's what I can offer:

1. "Can you find this type of help in a big u.s. city (like L.A. for example)" - Absolutely. I live in a very large East Coast City (I'm you can guess which one), and there were several DBT programs through various hospitals. They may have been even more options, but I know for sure it's program that is offered through medical institutions.

2. What's the treatment cost (I'm betting insurance won't pay, am I wrong) - For my W, insurance covered everything, 100%. Obviously, this is dependent on your policy and insurance carrier, but I'm pretty sure most companies allow for this kind of treatment.

3. How long before my BPD "graduates"? - My W competed a year long program that met once a week in a group setting as well as weekly DBT specialized therapist visits. During that year, the group would go through the program twice. The point being, the first time DBT strategies and concepts are introduced and get folks acclimated to changing their thinking. The second go around cements it and and shows people how it's all connected. During the program, they were issued homework, which, according to my W, really helped.

I can relate to what you are saying. My W is also high functioning now, and DPT did seem to have a big impact. Yes, there are moments, regressions and backslides, but now there is a large improvement regarding her self awareness during these times. DBT is not a cure all, and once the program is complete it doesn't make BPD a mere memory for her or you, but if she puts in the time and work, and you educate yourself on what she's learning, everyone can walk away with some improvement.

Based on your "main BPD issue, DBT will give her the tools to cope with her fears, show her how to reflection on her feelings, and be able to separate facts from feelings. As I mentioned before, if you go through this process with her, learning about the skills she's learning, you'll be able to gentling help her during some more difficult moments and it will allow yourself to understand and take away some skills yourself to help your relationship.

Best of luck to you and and her. 

[Euler2718]

Great! Now how do I go about broaching the subject without setting off shame and insufficiency alarm bells? Her current therapist told her she wasn't BPD, if course that's just nuts ( cutting, bulimia, dysregulation etc). She knows she's a bit off though and called herself "unstable" and "messy, scared and panicky"

Ill of course emphasize that it's totally not her fault and I love her to death.

[Euler2718]

https://behavioraltech.org/resources/find-a-therapist-app/

I did find this and I think the resources are compliled by an institute established by Marsha linehan, so it located many places in the LA area. 560 or so in the u.s. as a whole

[Notgoneyet]

Euler2718,
  My uBPDw of 36 yrs just started DBT classes after 3wks of mandatory IOP (Intensive Outpatient therapy) for alcoholism. (3x 3hrs/ week) The DBT is also 3x 3hrs/ week - up 12weeks. I have pretty good health insurance and it is suppose to pay for all of it minus a co-pay of course.
Getting her to agree to give it a go is a whole story in itself . 
BPD was never mentioned (as you may have read many x's on these pages) T & I used terms like Highly Sensitive Emotions, Easily Depressed, Easily Angered, Etc. 
I more or less manipulated her into at least trying it (told it would look good to the judge in her up coming court date for failed UA (urinalysis) w THC (marijuana) and since she was already 3weeks sober & wanting some additional help staying that way she decided with a small nudge from me it might be worth a go. 
I found 5-6 DBT programs in the St.Louis metro & went w this one bc its only 15 mins from the house and she has no DL. due to dwi. so its convenient for the DD. 
 Still to early to report progress but so far so good.
Praying for success
Hope this helps a bit & best of luck for you & yours  NGY

[Euler2718]

I hope to hear it went well so I can have hope. Scared of hope though, I'm afraid it's the rug that gets pulled out from under ya. Have a good day.

[flourdust]

I've heard a lot about DBT therapy (an hour a week personal counseling, 2 hours group, phone calls to therapist). Concrete things can you answer?

It's usually multiple hours and/or sessions per week, but the exact structure will vary depending on the provider. It can be helpful to look at several programs to see which one fits your schedule and need best.

1. Can you find this type of help in a big u.s. city (like L.A. for example)

Definitely.

2. What's the treatment cost (I'm betting insurance won't pay, am I wrong)?

Insurance will likely pay if they accept the diagnosis and referral -- this will depend on your plan and provider. I've heard that some insurers won't pay for treatment for a BPD diagnosis, but if there's a diagnosis of anxiety, depression, bipolar, etc. they will cover it. (It's often the case that pwBPD have multiple diagnoses.) In that case, you'll probably pay your copay per session ... .which can add up quickly!

3. How long before my BPD "graduates"?

Depends on the program and your pwBPD's engagement -- this is definitely a question to ask as you explore the options. I think anywhere from 9 months to two years is normal.