Dialectical Behavioral Therapy: What is DBT?
DBT is a type of talk therapy specially adapted for people who experience intense emotional reactions. DBT focuses on helping people accept the reality of their situation, reframe their perception, regulate their reaction, and change their lives.
Every day, we face challenges big and small. Our emotional reactions can often dictate the outcome of these challenges and how they affect us. When we are met with trauma early in life, coping with stress can feel nearly impossible, even as we get older. Oftentimes, those who experience trauma go on to feel things so intensely that they struggle to enjoy their lives, build meaningful relationships, and maintain stability. Many people try to manage unstable feelings with actions like intentional self-harm, with the intension of releasing emotional pain. While these maladaptive coping skills may mask pain, these behaviors are inherently dangerous, and ultimately the pain will return. This is where dialectical behavioral therapy (DBT) can help.
What is DBT?
DBT is an evidence-based treatment that addresses people’s thoughts about themselves, their life, and their emotional pain. Its name is rooted in the treatment process, first starting with the change of behavior, and then the acceptance that our feelings and interpretations may not represent reality. DBT offers concrete ways to address day-to-day struggles, taking dangerous coping mechanisms, and replacing them with healthy ways to process. This means we can change some of the ways we think and feel about the things we have been through. DBT typically includes participation in group therapy, individual therapy, and medication management, and other components discussed below. This is designed to create a caring environment with an integrative care team that serves a population of people that have often felt marginalized. Some DBT groups will even hold a graduation at the end of the treatment, which often marks an important milestone for participants.
DBT is support oriented, meaning it helps a person identify their strengths and builds on them so that the person can feel better about themselves and their life. Much like Cognitive Behavioral Therapy (CBT), DBT is cognitive-based, which means it helps people identify thoughts, beliefs, and assumptions that make life harder. Thoughts like “I have to be perfect at everything” or “my anger makes me a terrible person” can be changed to “I do not have to be perfect at everything to be worthy of love” and “anger is a normal and healthy emotion that everyone experiences”. DBT is collaborative, which means it requires constant attention to relationships between clients and staff. Problems and relationships are worked out together, between the therapist and patient, through techniques like homework assignments, role-playing, practicing skills, and more. The therapist helps the patient to learn, apply, and master the DBT skills.
What is DBT used to treat?
Dialectical Behavior Therapy (DBT) is a structured form of cognitive-behavioral therapy (CBT) that was originally developed to treat individuals with borderline personality disorder (BPD). However, over time, it has been adapted and found effective in treating a range of mental health conditions and emotional dysregulation. DBT can be used to treat the following conditions:
Borderline Personality Disorder (BPD): DBT was initially developed by Dr. Marsha Linehan to specifically address the symptoms and emotional instability associated with BPD. It has been shown to be highly effective in reducing self-destructive behaviors, impulsivity, and emotional dysregulation in individuals with BPD.
Substance Use Disorders: DBT has been adapted to treat individuals with substance use disorders, helping them manage cravings, improve impulse control, and develop healthier coping strategies.
Eating Disorders: Some components of DBT, particularly the focus on emotion regulation and distress tolerance, have been integrated into the treatment of eating disorders like bulimia nervosa and binge-eating disorder.
Post-Traumatic Stress Disorder (PTSD): DBT has been used as part of a comprehensive treatment approach for individuals with PTSD, especially when there is a need to address emotional dysregulation and self-harm behaviors.
Depression: While DBT is not a primary treatment for depression, some elements, such as mindfulness and emotion regulation, can be incorporated into therapy for individuals with depression.
Anxiety Disorders: DBT skills can be useful for individuals with anxiety disorders, helping them manage intense emotions and reduce anxious responses.
Self-Harm and Suicidal Behavior: DBT is particularly effective in helping individuals who engage in self-harming behaviors or have a history of suicidal thoughts and attempts. It provides strategies for coping with distress without resorting to self-destructive actions.
Emotion Dysregulation: DBT can be beneficial for anyone who struggles with intense emotions, difficulty in managing anger, or emotional instability, even if they do not have a specific diagnosis.
While DBT was originally developed for severe and chronic conditions like BPD, its effectiveness in addressing emotional regulation has led to its broader application in the treatment of various mental health challenges. It is often used in conjunction with other therapeutic approaches to provide a comprehensive treatment plan tailored to an individual's specific needs.
What are the components of DBT?
Dialectical Behavior Therapy (DBT) is a comprehensive therapeutic approach that consists of several interconnected components aimed at helping individuals build a life worth living while addressing emotional dysregulation and improving their overall mental health. The key components of DBT include:
Individual Therapy: In individual therapy, the client works one-on-one with a trained therapist. The therapist and client collaborate to set treatment goals and target specific behaviors or issues. Individual therapy sessions often focus on problem-solving, skill-building, and addressing life challenges.
Skills Training Groups: DBT includes weekly group sessions where individuals learn and practice essential skills. These groups typically cover four main areas:
Mindfulness: Mindfulness skills help individuals become more aware of their thoughts, feelings, and sensations in the present moment without judgment. This helps reduce impulsivity and emotional reactivity.
Emotion Regulation: These skills teach individuals how to identify, understand, and manage intense emotions effectively. Techniques include emotion awareness, distress tolerance, and strategies for decreasing emotional vulnerability.
Interpersonal Effectiveness: These skills focus on improving communication, setting boundaries, and navigating relationships more effectively. Individuals learn how to express their needs and wants while maintaining self-respect and respecting others.
Distress Tolerance: Distress tolerance skills are designed to help individuals cope with crises and intense emotions without making impulsive or self-destructive decisions. Techniques include self-soothing, distraction, and radical acceptance.
Consultation Team: DBT therapists participate in consultation teams where they meet with other therapists to receive guidance and support in implementing DBT effectively. These team meetings help ensure that therapists maintain adherence to the treatment model and provide the highest level of care to their clients.
Treatment Structure: DBT emphasizes a structured and balanced approach to therapy. It includes a commitment to maintaining a balance between accepting the client as they are (validation) while also working toward change (problem-solving). This dialectical approach recognizes that change is possible through acceptance.
Assessment and Treatment Planning: DBT starts with a comprehensive assessment to understand the client's strengths, challenges, and treatment needs. Based on this assessment, a tailored treatment plan is developed, including specific goals and strategies for change.
Homework Assignments: Clients often receive homework assignments to practice the skills learned in therapy sessions and skills training groups in their everyday lives. These assignments help reinforce learning and promote skill integration.
Our past traumas can make our present lives more difficult than is necessary. DBT can change dangerous patterns, help develop new thoughts and behaviors, renew relationships, improve quality of life, and instill hope. DBT allows us to step out of our emotions and view them as if we are a third party.
Can DBT be done through Telehealth?
Yes. At Modyfi, we offer virtual mental health care that can be easily accessed by our patients from the comfort of their own homes. We offer DBT, along with many other types of therapy and other services like medication management. If you are in need of mental health care, do not hesitate to reach out. There are healthy ways to cope with our day-to-day struggles and help us to thrive. Life can be positive, beautiful, and enjoyable. Healing and growth are possible. You can do this. Complete the group therapy signup form today to get started with DBT at Modyfi.
