Dialectical Behavior Therapy (DBT) is widely known for being developed to treat borderline personality disorder. It is now utilized to treat various mental health disorders. DBT is influenced by the philosophical perspective of dialectics: balancing opposites. Dialectical behavioral therapy focuses on high-risk, tough-to-treat individuals. These individuals often have multiple diagnoses. DBT provides individuals with the skills to manage difficult emotions and resolve as well as decrease conflict in relationships. DBT is considered an evidenced based practice (EBP). An EBP is the integration of the best available research with clinical expertise in the context of patient characteristics, preferences, and culture. This allows for DBT therapy to be both effective and accessible. There is no set timeline for DBT.

Dialectical Behavior Therapy (DBT) Defined

Dialectical behavior therapy is a heavily based cognitive behavior therapy. Through dialectical behavior therapy, the therapist assists individuals in discovering a balance between acceptance and change. DBT focuses on four key areas; mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The mindfulness guides individuals in being more self aware and be present in the moment. Distress tolerance which teach individuals how to experience intense feelings without resorting to self-injurious behaviors or substance abuse to manage the feelings. Emotion regulation helps individuals recognize, label and adjust their emotions. Interpersonal effectiveness teaches individuals how to navigate conflict and interact assertively with others. In DBT, individuals learn coping skills like mindfulness practices in order to improve unhealthy behaviors and thoughts. In general, DBT has two main components; individual weekly psychotherapy sessions and weekly group therapy sessions. The weekly individual sessions are where individuals are given the space to discuss any difficulties that arose in the past week. If there are suicidal and/or self-injurious behaviors they are always first priority.

Therapist will assist individuals with applying the DBT skills learned in session in their daily lives and teach individuals how to manage emotional trauma rather than reducing or taking them out of crises. The weekly group sessions are led by a trained DBT therapist, where participants learn and practice skills related to the previously mentioned four key areas. During the group sessions, individuals also have the freedom to share their personal experiences and provide mutual support to other members. Similar to cognitive behavioral therapy, individuals are assigned homework after group sessions. Phone coaching is also a component of dialectical behavior therapy if needed for crises between sessions and a consultation group for health care providers to stay motivated and discuss individual care. Research has shown that DBT decrease the frequency and severity of dangerous behaviors, uses positive reinforcement to motivate change, emphasizes the individual’s strengths and helps translate the things learned in therapy to the person’s everyday life.

What DBT is Used for:

Although dialectical behavior therapy was developed originally to treat borderline personality disorder, research has shown it to be effective treating other disorders and mental health problems that threaten a person’s safety, relationships, work, and emotional well-being such as:

  • Depression
  • Bulimia
  • Binge-eating disorder
  • Bipolar disorder
  • Post traumatic stress disorder
  • Substance abuse as a result of
  • Individuals with suicidal behavior

Choosing a Type of Therapy:

No matter what type of therapy a therapist uses it is crucial to determine what fits an individual’s personality and their presenting symptoms. It is also important to ensure that the therapist utilizing DBT is qualified. Qualification should include their background, education, certification, licensing, and their areas of expertise. Change does not happen over night and is not one sided. An individual must put the work in with their therapist in order to make changes that they are seeking. The psychotherapist’s job is not to “fix” the individual or make unpleasant situations go away. DBT therapy provides individuals with the skills to regulate emotions, tolerate distress and negative emotions, be mindful and present in the given moment, and communicate and interact effectively with others.

Resources

Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements.
Psychiatry (Edgmont (Pa.:Township)), 3(9), 62–68.
National Alliance on Mental Illness. (2019). Retrieved from:
https://www.nami.org/Learn-More/Treatment/Psychotherapy
PsychCentral. (2019). Retrieved from:
https://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/
Psychology Today. (2019). Retrieved from:
https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
WebMD. (2019). Retrieved from:
https://www.webmd.com/mental-health/dialectical-behavioral-therapy#1