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Dialectical Behavior Therapy

DBT (dialectical behavior therapy) is a modified form of CBT (cognitive behavioral therapy).

Dr. Marsha Linehan developed DBT in the 1980s to treat patients with BPD (borderline personality disorder). Today, dialectical behavior therapy can be effective for the treatment of various mental health conditions, including depression, bipolar disorder, and PTSD (post-traumatic stress disorder).

By engaging with dialectical behavior therapy sessions, you should learn how to deal with challenging emotions more confidently and to decrease conflict in your interpersonal relationships.

Table of Contents

By engaging with dialectical behavior therapy sessions, you should learn how to deal with challenging emotions more confidently and to decrease conflict in your interpersonal relationships.

Article at a Glance:

What is Dialectical Behavior Therapy?

Dialectical behavioral therapy, like CBT, is a form of psychotherapy or talk therapy. 

The primary goals of CBT are as follows: 

  • Teaching you to live mindfully (in the moment)
  • Developing healthier coping strategies
  • Regulating difficult emotions
  • Improving your interpersonal relationships 

Dialectical behavior therapy is a specialized form of cognitive behavioral therapy. Here’s how they differ: 

  • Cognitive behavioral therapy: CBT is a psychotherapeutic treatment. The core goal of therapy is to help clients to understand the interrelated nature of thoughts and emotions more deeply. A time-limited therapy, a cognitive behavioral therapist leads a client, helping them to identify triggers for poor behaviors, and imparting healthy coping strategies.
  • Dialectical behavior therapy: DBT is based on CBT’s foundational principles. Dialectical behavior therapists help clients to restructure thoughts and to better regulate emotions while living mindfully. 

DBT makes the following central assumptions: 

  • Everything is interrelated
  • Change is unavoidable and constant
  • If you integrate opposite, you can arrive at a more precise version of the truth 

Working from those assumptions, DBT helps you to build skills in these key areas: 

  1. Mindfulness
  2. Emotional regulation
  3. Distress tolerance
  4. Interpersonal effectiveness 

These four skills are referred to as modules in the context of DBT. Linehan likened the modules to the active ingredients of dialectical behavior therapy. As you work through the modules, you will become more accepting of your thoughts and your behaviors, altering any destructive thoughts or behaviors to produce more positive outcomes. You will also sharpen your emotional regulation through harnessing productive outlets for tough emotions.

1) Mindfulness

Mindfulness involves being fully present and engaged in what you are doing without being overwhelmed or overreactive. When you practice mindfulness, you can acknowledge thoughts and feelings without attaching any judgment to those thoughts and feelings. 

Through engaging with the mindfulness module of DBT, you’ll learn how to balance emotion with more rational thoughts. By applying radical acceptance – a distress tolerance skill – you’ll learn how to become more tolerant of certain aspects of yourself.

2) Emotional Regulation

Whether you are in the early phase of addiction recovery or grappling with a mental health condition, you may feel as though you cannot escape your emotions. Engaging with dialectical behavior therapy will ensure you can more effectively regulate those emotions. 

A therapist will guide you toward heading off primary emotional reactions, preventing these from escalating into a series of secondary reactions. An example could be arresting thoughts of guilt about relapse before the resultant feelings of worthlessness and shame trigger anxiety, depression, or another relapse. 

This DBT module will help you to be more mindful and less judgmental of your emotions.

3) Distress Tolerance

The skills you will learn in the distress tolerance module of DBT can help you navigate stressors and moments of crisis without resorting to poor behaviors like substance use. 

You will sharpen your coping techniques in these important areas: 

  • Improving the present moment for yourself regardless of external circumstances
  • Distracting yourself and buying the time to deal rationally with the situation instead of being emotionally-driven
  • Evaluating the strengths and weaknesses of various coping strategies
  • Using your senses to soothe and relax yourself

4) Interpersonal Effectiveness

If you are prone to experiencing turbulent emotional ups and downs or dramatic mood shifts, you might find it difficult to deal with others. The more you can illuminate what you want from life, the more readily you can build worthwhile social connections. 

DBT interpersonal effectiveness skills involve a combination of: 

  • Listening skills
  • Social skills
  • Assertiveness training 

By applying the techniques you learn in this module of DBT, you will find you can alter the outcome of situations while safeguarding your values and your recovery. 

What is dialectical behavior therapy used for, then?

What is it Used For?

Borderline personality disorder dialectical behavior therapy can also be applied to treat the symptoms of: 

  • PTSD (post-traumatic stress disorder)
  • ADHD (attention deficit hyperactivity disorder)
  • Bipolar disorder
  • Major depressive disorder
  • Bulimia and other disordered eating
  • Co-occurring disorders (addiction and co-occurring mental health disorder) 

If dialectical behavior therapy is used as part of an integrated treatment program, it can help you to restore emotional and mental balance. How can you achieve this?

Dialectical Behavior Therapy Techniques

DBT practitioners teach the four modules using the following delivery methods: 

  • Individual sessions: A trained psychotherapist will help you to adapt the behavioral skills you acquire through homework assignments
  • Group sessions: In group sessions, you can use role playing to practice interacting with others in a controlled environment.
  • Phone sessions: You can call the therapist between sessions if you need advice on overcoming specific challenges. 

The variation of techniques is one of the primary reasons for DBT’s effectiveness.

What are the Six Main Points of Dialectical Behavior Therapy?

  1. Cognitive: You will learn how to change negative, self-defeating thoughts and beliefs
  2. Behavioral: By analyzing destructive behavior patterns and replacing them with more healthy and effective ones, DBT can help you to make meaningful behavioral changes
  3. Skill sets: Learning new skills through engaging with DBT can enhance your overall capabilities
  4. Change and acceptance: DBT sessions will help you to tolerate and accept your emotions and your life circumstances more effectively. You will also learn how to improve your interactions with others
  5. Support: Your therapist will help you to recognize your strengths and to develop these strengths more fully
  6. Collaboration: DBT will strengthen your communication skills and your ability to work as part of a team

Is Dialectical Behavior Therapy Effective?

Researchers have discovered that DBT is effective regardless of sex, sexual orientation, race, and age. 

This approach is proven effective for helping patients improving coping skills and emotional regulation. 

Studies show that dialectical behavior therapy is effective for treating BPD and minimizing suicide risk in those with BPD. When DBT is applied to reduce suicidality, outcomes are more favorable when the intervention incorporates skills training, according to this study.

While most DBT research focuses on the treatment of borderline personality disorder, some studies show it could be effective for other mental health disorders.

This study indicates that DBT could be useful for the treatment of mood dysregulation disorder in children.

Dialectical Behavior Therapy at California Detox

Here at California Detox, we offer inpatient and outpatient treatment programs for addiction and mental health disorders. 

All of our programs offer you access to evidence-based therapies like DBT. These include: 

  • MAT (medication-assisted treatment)
  • DBT (dialectical behavioral therapy)
  • CBT (cognitive behavioral therapy)
  • Individual counseling
  • Group counseling
  • Family therapy

Our programs are designed to take you from detox to discharge, helping you to unpack the physical and psychological aspects of addiction, while also addressing any underlying mental health issues. 

Get started today by calling the friendly team at 949.567.8790.

FAQs

Generally, DBT sessions will last 40 to 60 minutes but it is entirely dependent on each individual situation.

Sources

What Principle Underlies Cognitive Behavioral Therapy?

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