Dialectical Behavior Therapy

Psychotherapy is a powerful counseling tool which can help teens and adults with all manner of life issues, minor relational struggles, behavioral troubles, and mental illnesses.

Cognitive behavioral therapy (or CBT) is one such tool, with a focus on changing ideas and thought patterns to positively affect behaviors.

While CBT is an effective therapeutic approach, psychiatric professionals have recently turned to a modified form of this therapy called Dialectical Behavior Therapy (or DBT). This treatment approach emphasizes individual psychotherapy, group skills training, and life strategies to create a life plan for teens and adults. Initially designed as a treatment for bipolar disorder, this approach has become widely lauded for its efficiency in treating a wide range of issues.

Components of DBT

DBT is more intensive than most forms of psychotherapy. As such, most therapists recommend adhering to a strict schedule of weekly, in-person sessions where they can discuss problem-solving behavior for the past week. These sessions address issues in a person’s life on a hierarchy, placing self-harm behavior first, followed by interfering behaviors, quality of life issues, and finally improvement of skills. Phone communication with the therapist is also strongly encouraged throughout the week and between sessions. Weekly group sessions are the second element of DBT, where a person will learn aspects of the four modules of dialectical behavior therapy. These modules are:

  • Mindfulness – The practice of being entirely present in one’s current situation. This involves concepts like observation, description, and participation and the values of efficiency and open-mindedness.
  • Interpersonal Effectiveness – Creating a healthy means of interacting with other people, including setting boundaries, developing self-respect, and communicating effectively. The primary focus of this module is in situations where the goal is to create change, i.e., making requests or resisting unwanted changes from outside influences.
  • Distress Tolerance – Learning to tolerate pain or distress without needing to change it. This module includes strategies like a distraction, self-soothing, improving the moment, and pro-con lists.
  • Emotion Regulation – Discovering the means by which one can change their own emotions. People in DBT often need to learn how to accurately identify their own feelings, after which they can create strategies to adjust their perceptions and replace them with more positive ones.

Stages of Treatment

DBT is typically broken down into four distinct stages. Every client is encouraged to progress through these stages at their own pace with no definite timeline, setting and achieving goals and milestones as they move forward.

The first stage is usually the stage which brings a person into treatment in the first place. As such, this is where their behavior is going to be at its worst and their emotional distress at its highest. The goal during this stage is simply to get the client from feeling entirely out-of-control and hopeless to achieving some kind of behavioral control.

Stage two is a more controlled version than the first stage. Here, the client probably feels like their behaviors are getting under control but are continuing to suffer. The goal with this stage is to move from silent suffering to emotional calm and awareness. For those suffering from trauma, this is where that is going to be addressed.

In the third stage, clients begin to move past their initial reason for attending therapy. They will start to define life goals, develop self-respect, and really find some happiness in their lives.

The final stage is an optional stage for people who find it necessary. Stage four includes the search for a deeper meaning, typically through spirituality. While many people are able to find happiness in the third stage, some people need to go further, seeking spiritual fulfillment and a greater sense of universal connection.

What Sets DBT Apart From Other Treatments?

Although DBT is a modification of CBT, it is a much more comprehensive and thorough approach to behavioral therapy. DBT shares many techniques with CBT, but the newer approach emphasizes the development of a “life worth living” which wasn’t quite found in traditional CBT. During CBT treatment, a lot of patients felt that their pain was being underestimated or brushed off and they were expected to change rapidly in ways they found themselves unable to do. That’s why DBT created a balance between “change” and “acceptance” strategies. After all, the word “dialectic” means “to weight and integrate contradictory facts.” In this way, many clients who would ordinarily be prescribed a CBT treatment may find greater success with DBT.

DBT is a relatively new therapy, but it has been extensively researched and tested, and it is considered an evidence-based treatment. It’s been clinically shown to be effective in treating suicidal behavior, self-injury, substance abuse, anger, and depression.

Dialectical Behavior Therapy is a fascinating and highly effective treatment for people suffering from all kinds of behavioral and mental disorders. By creating a balanced version of CBT and even daring to approach spiritual concepts within a therapeutic setting, DBT is one of the most unique and comprehensive forms of treatment available. While it requires a certain level of dedication, it is an exciting option for people to build new hope.