Dialectical behavioral therapy (DBT) is specifically designed to help individuals tolerate, regulate, and control their emotions. Its core principles are based on the cognitive behavioral therapy principles and mainly focus on acceptance and problem solving.
DBT model was first developed in the 1990s to treat borderline personality disorder and other suicidal behaviors. However, the model has evolved over the years and is proven to treat a wide range of other mental conditions.
This blog post is dedicated to discussing everything you need to know about dialectical behavioral therapy. What is it? What techniques are used? What does it treat? Read on to learn more.
What is Dialectical Behavioral Therapy (DBT)?
Dialectical behavioral therapy is a slightly modified type of cognitive behavioral therapy (CBT). DBT is designed to help people learn how to cope with difficult emotions by developing healthy ways to cope with stress and improving their relationships with others.
The term “dialectical” refers to a unique combination of two opposing ideas. The first of these two ideas is acceptance of the reality of an individual’s life and behaviors, while the second opposing idea is the change of situations, emotions, and dysfunctional behaviors.
DBT therapy online is stage-based, meaning it involves specific stages. Here is a summary of the four stages and how DTB principles are applied at each stage:
- Stage 1: Stage 1 involves stabilizing the patient and helping them gain control of their behaviors. Therapy involves crisis intervention and keeping the patient safe from self-harm, suicide or addiction.
- Stage 2: During stage 2, a patient will work on their traumatic experiences and emotional pain. At this point, your DBT group therapist will help you identify unhelpful thoughts, beliefs, and behaviors.
- Stage 3: During stage 3, you will be expected to be in a good position to solve issues you may encounter in your everyday life without drifting towards self-harm, suicide, or addiction. This is the right time to join DBT groups near me for support and encouragement. You will also be expected to maintain progress and set achievable goals.
- Stage 4: In the final stage of DBT, you will be working towards advancing your life and achieving spiritual fulfillment. Most DBT strategies at this stage are focused on ensuring you never go back to your old habits and behaviors.
How Does DBT Compare to CBT?
Although DBT is widely regarded as a branch of CBT, there is a lot of overlap between these two forms of therapy. Both involve talk therapy to help patients understand and manage their thoughts and behaviors.
However, DBT usually puts more emphasis on managing interpersonal relationships and emotions. This is because the therapy was originally developed to treat borderline personality disorder, which is marked by dramatic swings in moods and behaviors that can lead to strained social relationships.
DBT also uses a consistent dialectical philosophy while employing mindfulness and acceptance-based interventions to help patients take control of their lives.
What Can Dialectical Behavioral Therapy Treat?
Originally, Dr. Marsha Linehan developed DBT to treat borderline personality disorder. BPD is a mental health disorder involving intense fear of abandonment, difficulty managing interpersonal relationships, emotions, and self-image issues.
BPD has relatively strong associations with self-harm and suicidal behaviors. In fact, research shows that up to 10% of people struggling with BPD die by suicide.
In recent years DBT has undergone some changes pushing mental health professionals to adapt it for treatment of various other issues and conditions, including:
1. DBT for Anxiety
While CBT is widely considered the gold standard for treating anxiety, it doesn’t work with all clients. The model’s emphasis on changing behaviors and thoughts doesn’t do enough to convince patients into accepting where they are right now.
CBT alone can be quite invalidating to people who find concepts such as cognitive distortions wrong. DBT provides something that works – a model that acknowledges and supports the truth upon which patients’ experiences are fully based.
What makes DBT for anxiety unique is its emphasis on dialectical thinking and mindfulness. Rather than treating symptoms, emphasis is put on accepting experiences as they are in the moment. In fact, DBT is one of the few acceptance-based behavioral therapies (ABBTs).
DBT skills for anxiety recognize the fact that emotions are an important part of our lives and are linked to anxiety. People naturally become anxious when there is a threat to their health, life or well-being. Fear linked to anxiety may motivate them to act and protect themselves.
DBT for anxiety takes you through the process of learning emotional and cognitive skills and how to apply the skills to your life. Generally, DBT tackles the difficult and distressing emotions which gives you the ability to regulate harmful emotions.
Comprehensive DBT for anxiety includes individual therapy, group skills training, skills coaching and a therapist’s participation in a consultation team.
2. DBT for Mood Disorders
DBT for mood disorders targets emotional dysregulation, usually characterized by high sensitivity to emotional stimuli, emotional intensity and relatively slow return to baseline emotional state.
DBT for mood disorders consists of four core skills training: distress tolerance, mindfulness, interpersonal effectiveness, and emotional regulation.
Mindfulness teaches patients to be more aware of their emotions, thoughts, feelings, and behaviors, resulting in an increased degree of self-control and the ability to manage distressing emotions and thoughts.
Distress tolerance skills teach patients alternative ways of coping with suicidal or self-harm thoughts. They also teach how to avoid drug/alcohol abuse, gambling, and over-spending.
Emotion regulation skills help patients learn how to effectively manage their feelings and emotions by validating their own emotions to avoid emotional escalation. The skills are particularly important when one is faced with episodes of hypomania or depression.
Lastly, interpersonal effectiveness skills help patients to improve their interpersonal relationships. One of the many consequences of bipolar is that it always results in damaged social relationships due to anger and irritability experienced in maniac or depressive episodes.
However, these skills will help the patient repair those relationships and act in ways that will minimize or eliminate the risk of damaging the relationships again.
3. DBT for Substance Abuse
With substance abuse treatment programs, DBT is important because it promotes acceptance and change. The therapy is realistic about abstinence and motivates patients to stay engaged and complete their treatment. This makes it an excellent choice for dual diagnosis treatment programs.
DBT for substance abuse is designed to encourage complete abstinence by breaking down long-term sobriety into relatively smaller and achievable goals.
The therapist may suggest that the patient set up a small goal of remaining sober for an hour, a day, or a week. Once e/she has successfully attained the smaller goal, they can set a newer and slightly bigger goal, which helps move them closer to long-term abstinence.
The primary objective of DBT for substance abuse is to help the patient develop a “clear mind.” With a clear mind, the patient remains focused on their long-term recovery goals while also being aware of potential threats to their target.
This can help the patient avoid relapse triggers or cope with them should they arise unexpectedly.
4. DBT for Personality Disorders
DBT was mainly created to help treat borderline personality disorder. This condition is usually marked by difficulties with interpersonal relationships, emotional regulation, thoughts of suicide, self-harm, low self-esteem, and other symptoms.
When Dr. Linehan created DBT, she hoped to provide long-lasting relief to affected individuals, a condition she experienced herself. Since BPD patients experience black-and-white thinking, one of the core foundations of DBT is dialectics.
Dialectics can be defined as a process of holding two but seemingly opposing ideas concurrently while considering both to be truths.
The other aspect of DBT is mindfulness which helps people living with DBT learn to make more intentional and conscious decisions to reduce the risk of inflicting self-harm.
One mindset taught during the sessions is the “wise mind,” which encourages dialectical thinking in normalcy and crisis. It also helps patients attend to their emotions and reason to make sober and balanced decisions.
5. DBT for Psychosis
CBT for psychosis was developed with the primary aim of helping people struggling with psychosis deal with their thoughts more effectively so that they don’t affect their behavioral and emotional world negatively.
However, there is a missing link that DBT addresses. While CBT is great, it doesn’t provide concrete skills and intervention mechanisms for emotionally dysregulated people. People struggling with psychosis often get caught in a vicious cycle of strong emotions that only worsen their symptoms.Through emotional regulation, patients learn how to break the emotional cycle and start to make better decisions than just focusing on medications.
With mindfulness, psychosis patients learn to accept their symptoms rather than challenge them. You don’t have to like them, but you have to notice that they exist, and there is nothing you can do about it. This is a great step towards overcoming emotional distress that affects your decision-making capability.
Dialectical behavioral therapy (DBT) was originally designed to treat BPD, but it has evolved to become a critical component for treating other mental issues such as mood disorders, substance abuse, psychosis, and even eating disorders.
It is a highly structured assistance-based therapy that involves individual therapy, group sessions, and phone consultations. Patients learn how to regulate and accept their emotions and set realistic goals to improve their quality of life.
However, DBT may not work for everyone. So, if you feel like the therapy isn’t working for you, feel free to try other forms of therapy. Your doctor or therapist can advise you on other options to try.