What Is Dialectical Behavior Therapy (DBT)?
Dialectical behavioral therapy (DBT) is an approach within clinical psychology that aims to treat personality disorders and other mental health conditions. DBT was developed out of cognitive behavioral therapy, or CBT. CBT helps people become aware of and work to adjust flawed thought patterns that cause unhelpful or distressing emotions and/or behaviors. Dialectical Behavior Therapy also does this, and tacks on additional dialectical components and skills training. Depending on the symptoms or challenges you’re experiencing, DBT might be an effective therapeutic option to consider seeking out.
Key Components Of DBT
Dialectical behavior therapy, DBT,was originally conceptualized by psychologist Marsha Linehan. She saw that CBT was effective for identifying negative thought patterns and changing them, but noticed that it lacked a component to help people learn how to handle situations when their emotions were heightened or intense.
Dialectical therapy focuses on helping people learn to manage emotional distress and intense emotions. It’s intended to equip an individual with a toolbox of behavioral skills to help them cope with pain and intense negative emotions. DBT skills training focuses on the following areas:
Mindfulness skills, or being aware of and calmly accepting one’s feelings in the present moment
Distress tolerance, or recognizing 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 relationships
Who Can Benefit From DBT
Research has found that comprehensive DBT can be a clinically effective treatment for a variety of mental health conditions. It’s most commonly recommended for those with borderline personality disorder (BPD). This mental illness is characterized by an intense fear of abandonment, impulsive and/or risky behaviors, wide mood swings, angry outbursts, rapid changes in self-identity, and suicidal threats or behavior. DBT can help with these symptoms by assisting individuals in learning to improve distress tolerance skills, emotion, control, and adopt healthy coping skills.
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.
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, and post-traumatic stress disorder. That said, virtually anyone can benefit from learning some dialectical behavior skills since everyone experiences difficult emotions and self-destructive behaviors from time to time. Whether it’s used as the primary clinical treatment for a certain, specific condition depends on the individual and the professional opinion of their provider.
DBT treatment may or may not be used in conjunction with medication for certain mental health issues. It can take the form of individual sessions, group sessions, or a combination of both. Contacting a licensed mental health professional is typically the best way to know whether DBT might be right for your particular situation.
What To Expect From A DBT Session
Depending on your unique situation, a therapist may recommend just one on one sessions of DBT, or one on one sessions in addition to group therapy sessions. Individual therapy with a DBT therapist are 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 the future. 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 an individual cultivate a nonjudgmental awareness of their emotions as they arise so they can more calmly and effectively cope. Note that whatever session structure your provider decides is best, it’s usually important to stick with it for the duration they recommend for skills training—often a period of six months or more. This is because DBT is like a training method for rewiring how you relate to your own emotions, which can take time to be effective.
Seeking Out DBT
If you feel that DBT 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 someone 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 licensed provider 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 delivery of DBT programmes is feasible and may be more accessible, acceptable and as safe and effective as face-to-face delivery”. Meeting with a qualified provider can help you find out what might be best for you.
Frequently Asked Questions (FAQs)
What are the six main points of dialectical behavior therapy?
The six main points of Dialectical Behavior Therapy 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.
In the case of 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 them. The job of DBT therapists is to help their patients balance these dialectical dilemmas.
When is DBT not appropriate?
DBT therapy 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 the most effective or only options 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 therapy 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 the 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 therapist, 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 therapist for it to work most effectively.
What are the change skills of DBT?
The four primary DBT skills are:
What's the difference between CBT and DBT?
What are the 4 components of DBT?
What is DBT therapy best used for?
What is an example of dialectical thinking?
Is DBT a trauma?
Is DBT a trauma therapy?
Can I do DBT on my own?
What is the first skill taught in DBT?
What are the 5 skills of DBT?
What skills are DBT examples?
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