DBT
What is DBT and How is DBT Different From Other Therapies?
Thoughts, feelings, and behaviors are interconnected and influence each other. What we think affects how we act and feel. How we feel affects what we think and do. What we do affects how we think and feel. When you want to think, feel, and do differently, you and your therapist can start at any point on the triangle.
For example, in behavior therapy, the idea is to change behavior by changing behavior to think, feel, and do differently (e.g., a bride-to-be who wants to lose weight prior to her wedding may put a picture of her wedding dress on the refrigerator to reinforce healthy eating).
In cognitive therapy, the idea is to change behavior by changing thoughts to think, feel, and do differently (e.g., a bride-to-be who wants to lose weight prior to her wedding may identify and challenge negative beliefs about herself that contribute to overeating).
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In Dialectical Behavior Therapy (DBT), the idea is to change behavior by changing emotions to think, feel, and do differently (e.g., a bride-to-be who wants to lose weight prior to her wedding may improve her coping skills to manage stress instead of engaging in emotional eating). Although DBT also includes behavioral and cognitive strategies, the primary focus is on the idea that if we can better manage our emotions, our thinking and behavior will follow.
DBT is a cognitive-behavioral therapy that includes mindfulness and acceptance strategies to assist clients in resolving dialectics, or opposing opposites, so they may find balance rather than living their lives in extremes. For example, someone may be overly trusting and believe “I can’t tolerate being alone”. Someone else may push others away and believe “I am better off alone”. Some people may go back and forth between these two extremes. The goal of therapy is to find balance (e.g., “I can trust some people sometimes”) and reduce suffering.
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Who does DBT help?
DBT is designed for people who struggle with one or more of the following:
- Intense emotions
- Feelings of shame or emptiness
- Impulsive or risky behaviors
- Unstable or frequent loss of relationships
- Suicidal thoughts or suicide attempts
- Self-injury
- PTSD
DBT is based on the biosocial theory. Specifically, when someone, who is born with a biological predisposition to be emotionally sensitive, grows up in an invalidating environment (e.g., in a household where emotions are not discussed or tolerated), he or she will be more likely to struggle with managing their emotions, behaviors, and relationships.
What Does DBT Include?
DBT consists of 4 primary components:
- DBT Skills Group- to learn the DBT skills
- DBT Individual Sessions- to learn how to apply the DBT skills to your life
- DBT Skills Coaching- to troubleshoot using your DBT skills in your daily life
- DBT Consultation Team- to provide support to your therapist to ensure you receive the highest level of care
Is DBT Effective?
DBT has been extensively researched and there is abundant evidence supporting its effectiveness. The first study, published in 1991 by Dr. Marsha Linehan and her colleagues, found that DBT is effective in treating chronically suicidal and self-injuring women with borderline personality disorder. Since then, research indicates DBT is effective for a wide range of mental health conditions including anxiety, depression, substance use disorders, and personality disorders.
DBT Skills Groups Include Four Modules:
- Core Mindfulness Skills- learn to focus your attention to cope with difficult situations and find more joy in the moments that are joyful
- Distress Tolerance- learn crisis survival skills to get through difficult situations without making them worse
- Emotion Regulation- learn to understand and reduce your overall vulnerability to stress using additional skills
- Interpersonal Effectiveness- learn assertiveness and other skills to get your needs met and improve your relationships
