Dialectical Behavior Therapy
Dialectical behavioral therapy (DBT) is an approach within clinical psychology that aims to treat personality disorders and other mental health conditions. Dialectical behavioral therapy was developed out of the practice of cognitive behavioral therapy, or CBT. CBT helps people become aware of and work to adjust flawed thought patterns that cause unhelpful or distressing emotion and/or behavior. Dialectical Behavior Therapy also does this, and tacks on additional dialectical components and skills training. Depending on the symptoms or the challenges you’re experiencing in your life, dialectical behavioral therapy might be an effective therapeutic option to consider seeking out.
The key components of dialectical behavioral therapy: Interpersonal effectiveness, skills training, emotion control, and more
Dialectical behavior therapy (DBT) was originally conceptualized by the psychologist Marsha Linehan. She saw that behavior therapy was effective for identifying negative thought patterns and changing them, but noticed that it lacked the component to help people learn how to handle situations when their emotions were heightened or intense.
Linehan wanted to develop a form of mental health treatment that could help people cope when they were experiencing more extreme emotional pain instead of turning to their unhealthy mechanisms, which is how DBT was born.
Dialectical behavioral therapy focuses on helping people learn to manage their emotional distress and intense emotions. It’s intended to equip the individual with a toolbox of behavioral skills to help them cope with pain and learn emotion control to manage emotions and other mental health problems. Dialectical behavior therapy skills training focuses on the following areas:
Mindfulness skills, or being aware of and calmly accepting one’s feelings in the present moment to achieve emotion control
Distress tolerance, or recognizing the painful emotions and managing them effectively and healthily with emotional control skills
Interpersonal effectiveness, which involves learning how to better communicate with others and navigate their relationships
What can DBT treat: DBT for borderline personality disorder and more
Research has found that comprehensive DBT can be a clinically effective treatment for a variety of mental health problems and conditions. DBT therapy is most commonly recommended for those with borderline personality disorder (BPD). This personality disorder is characterized by an intense fear of abandonment, impulsive and/or risky behaviors, wide mood swings, angry outbursts, rapid changes in self-identity, self harm, and suicidal threats or behavior. Dialectical behavioral therapy can help with these symptoms by assisting individuals in learning to improve their distress tolerance skills, emotion, control, and adopt healthy coping skills through therapeutic intervention.
If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.
Dialectical behavioral therapy ongoing research
In addition, ongoing research is in progress to determine whether DBT may also be a clinically effective treatment for disorders and mental health conditions like depression, anxiety, eating disorders including binge eating disorder, drug and alcohol dependence, and post-traumatic stress disorder. That said, theoretical and empirical observations suggest that virtually anyone can benefit from learning some dialectical behavior skills since everyone experiences difficult emotions and self-destructive behaviors from time to time that they may want to change with the help of therapy. Whether it’s used as the primary clinical treatment for a certain, specific condition depends on the individual and the professional opinion of their therapy provider.
DBT treatment may be used in conjunction with the use of medication for certain mental health issues or as a stand-alone treatment. It can take the form of individual therapy sessions, group sessions, or the combination of both. Contacting a licensed mental health professional is typically the best way to know how suitable DBT might be for treating your particular situation.
What to expect from a DBT session
Depending on the situation, a therapist may recommend solely one-on-one, individual DBT therapy sessions, or one-on-one sessions in addition to group therapy sessions. Individual therapy with a DBT therapist is generally intended to offer you a safe, nonjudgmental space where you can take a look at past emotional reactions, identify where they may have come from, and learn better coping techniques for them in the future. Specific treatment targets are dependent upon each individual’s unique situation; some may focus on radical acceptance, while others may focus on interpersonal skills modules. In general, DBT sessions focus on teaching patients to better understand their emotions and reactions and better cope with hardships.
Group CBT sessions may also be designed to teach healthier coping mechanisms and offer the opportunity to practice them in a communal setting.
Learning and implementing mindfulness techniques will likely be an important part of either format since they can help individuals cultivate a nonjudgmental awareness of their emotions as they arise so they can more calmly and effectively. Note that whatever session structure your treatment team decides is best, it’s usually important to stick with it for the duration your DBT consultation team recommends for skills training—often the period of six months or more. This is because DBT focuses on implementing a training method for rewiring how you relate to your own emotions, which can take time to be effective. You may receive homework assignments to bolster your therapy sessions.
Seeking out DBT
If you feel that dialectical behavioral therapy could be helpful for you, connecting with a qualified mental health provider to discuss your situation more specifically is usually a good first step. You can search for "DBT therapy near me" to locate a therapist in your area or to see available DBT therapists if you prefer to meet with a therapist in person. Or, if you prefer the convenience of attending therapy sessions from the comfort of your own home, you might consider an online therapy platform like BetterHelp. The therapist you get matched with can evaluate you and let you know if online, individual DBT sessions might be right for you, or if some other type or format of therapy may be better for your situation. One study suggests that online therapy may be more convenient and as safe and effective as in-person therapeutic treatment. Meeting with a qualified provider can help you find out what the best for you might be.
Takeaway
DBT training can be helpful for people in certain situations. DBT techniques can help individuals implement new emotion control strategies, and improve interpersonal skills and mindfulness skills. Speaking with a licensed online counselor can help you conclude whether dialectical behavior therapy, cognitive behavioral treatment, comprehensive validation therapy, or some other therapeutic intervention might be most effective for you.
Frequently asked questions (FAQs)
What are the six main points of dialectical behavior therapy?
Six main points of DBT are:
Acceptance and Change – accepting your circumstances to make positive changes
Behavioral – learning coping skills to refrain from self-destructive behaviors
Cognitive – focusing on changing negative thinking patterns and learning self-respect
Skills Training – learning new skills or hobbies
Collaboration – learning how to navigate relationships and work productively with others
Support – recognizing your strengths and using your new skills to help others
What does dialectical mean in dialectical behavioral therapy?
The word “dialectical” refers to “dialectic,” meaning two opposing things coming together to form something new. An example might be an optical illusion in which one viewer sees two people looking at each other and another viewer sees a cup; these two opposing things are in fact both true.
With dialectical behavior therapy, these opposing things are known as dialectical dilemmas. For example, a patient with Borderline Personality Disorder may fluctuate between different emotions, or between under and over-controlling those feelings. DBT counselors help patients balance these dialectical dilemmas.
When is DBT not appropriate?
DBT can be especially useful in helping individuals tolerate distress, increase self-esteem, learn about acceptance and change, practice emotional control skills, and form healthy ways to challenge negative thoughts. However, DBT and other types of behavioral therapy are not always most effective for someone looking for a healthier quality of life. For example, someone with a trauma disorder such as PTSD may do better with a trauma-focused validation-based treatment that does not focus on labeling behaviors as negative.
DBT is often productive for those with mental health conditions like personality disorders, social anxiety, suicidal behaviors, substance use disorder, eating disorders like bulimia nervosa, and social concerns. If there is a direct suicide risk, always intervene right away by going to your nearest emergency room or calling 911.
Can I do DBT on my own?
Yes, you can do DBT in a group setting or within individual psychotherapy. You can even do DBT online or through phone coaching with a trained counselor, behavioral tech, or healthcare provider who has knowledge of DBT. Learning about tolerating distress and emotion control on your own can also be beneficial. Some people may need DBT to be administered through a mental health provider for it to work most effectively.
What are the change skills of DBT?
The four primary DBT skills are:
Mindfulness
Distress tolerance
Emotional control
Interpersonal effectiveness
What is DBT best used for?
Can I do DBT on my own?
What skills are DBT examples?
Is DBT a trauma?
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