Dialectical behavior therapy, commonly known as DBT, is a specific type of cognitive behavioral model in psychotherapy. It’s a highly effective form of therapy that helps to treat many mental health disorders such as depression, borderline personality disorder, and others.

What is DBT?

Psychologist Marsha M. Linehan first developed dialectical behavioral therapy in the late 1980s. It was originally developed to help better treat borderline personality disorder. It has since been successful in treating many other types of disorders.

DBT is a type of cognitive-behavioral therapy that emphasizes the psychosocial aspects of treatment. The core theory behind DBT is that some people are more likely to react intensely or out-of-the-ordinary towards certain emotional situations. These emotional situations primarily exist in family, romantic, or friend relationships. The theory suggests that some individuals’ arousal levels increase more quickly and intensely than an average person’s. DBT teaches these people with intense arousal levels how to cope with these emotional surges.

What are the characteristics of DBT?

There are three main characteristics of DBT that set it apart from other forms of therapy.

• Support-Oriented: DBT helps a person identify what their personal strengths are and builds them up so that their self-esteem and self-image improves.
• Cognitive-Based: During DBT, patients get help identifying thoughts and beliefs that make their life harder, such as “I have to be perfect”. It helps give them new ways of thinking about life to make it easier.
• Collaborative: DBT fosters a relationship between the therapist and the patient. In DBT people work out their relationship problems with the therapist and vice versa. Patients work on homework assignments, role-playing tasks, and practice coping skills. All of this is done through close collaboration between the patient and therapist.

What does a DBT session look like?

DBT has two components, individual and group sessions. How many of each type of session is determined on an individual basis but both types of sessions are usually recommended for the best outcomes.

• Individual Psychotherapy Sessions: Individual therapy sessions usually happen weekly. During the 1-on-1 sessions, problem-solving behavior is emphasized. Patients work on issues like suicidal behavior, quality of life problems, dealing with trauma, and improving self-esteem. Therapists work to teach and reinforce adaptive behaviors in the patient. They help patients manage emotional trauma rather than working to remove them from emotionally charged situations.
• Group Psychotherapy Sessions: Group therapy sessions last about 2 and a half hours and happen weekly. A trained DBT therapist leads the sessions. During group DBT, people learn one of the four modules. They get a chance to discuss and practice skills they learned during individual DBT sessions.

What are the four modules of DBT?

1. Mindfulness

An essential part of the skills taught during DBT is learning to be mindful. People learn to ask two questions. The first is, “What do I do to practice core mindfulness skills?” DBT teaches them the answer is to observe, describe, and participate. The second question is, “How do I practice core mindfulness skills?” to which the answer is non-judgmentally, open-mindfully, and effectively. Mindfulness is taught so that patients learn to take the judgmental “good” or “bad” labels out of emotions.

2. Interpersonal Effectiveness

DBT teaches people interpersonal response patterns. Effective strategies for asking what one needs, saying no, and coping with interpersonal conflict are taught. This module focuses on teaching patients how to handle situations where they want something changed, or want to resist change. This helps maximize the chances that a person’s goal will be met, and in the process that relationships aren’t damaged.

3. Distress Tolerance

Many approaches to mental health treatment focus on changing distressing situations. For instance, DBT focuses on learning to accept emotional pain or distress. Distress is a natural part of life, so knowing how to handle it is a valuable skill. During sessions, people learn how to accept situations in a nonjudgmental or approving way. Furthermore, DBT teaches the important distinction between accepting reality and approving of reality. 

4. Emotion Regulation

Emotional regulation is something that people with certain mental health disorders don’t have. DBT, as a cognitive behavioral model, focuses on skills to help people with these disorders regulate their emotions so that they aren’t constantly experiencing intense emotions. They learn skills such as:

• Labeling and identifying emotions
• Identifying obstacles to changing emotions
• Increasing positive emotional events
• Increasing mindfulness to current emotions
• Taking the opposite action
• Applying distress tolerance techniques

What disorders benefit from DBT?

While DBT was originally a treatment for borderline personality disorder, it has since been used for many other mental disorders. In some instances, it is modifiable to better fit the treatment needs for the disorder, like with eating disorders. DBT is an effective treatment for the following disorders:

• Anxiety Disorder
• Bipolar Disorder
• Substance Addiction
• Depression Disorders
• Eating Disorders
• Borderline Personality Disorder
• Post Traumatic Stress Disorder (PTSD)

Conclusion

Overall, there is an emphasis on regulating emotions and finding healthy coping mechanisms. So, DBT is increasingly popular for the treatment of many types of mental health disorders. It’s a highly effective cognitive behavioral model that can help many different people.

So, if you or someone you love has been diagnosed with any of the disorder above and are interested in learning more or signing up for DBT sessions, please contact us. Certainly, we look forward to hearing from you.