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Dialectical Behavior Therapy

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Dialectical Behavior Therapy

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) provides clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas. First, mindfulness focuses on improving an individual's ability to accept and be present in the current moment. Second, distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. Third, emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life. Fourth, interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

When It's Used

DBT was originally developed to treat borderline personality disorder. However, research shows that DBT has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic-stress disorder, and substance abuse. DBT skills are thought to have the capability of helping those who wish to improve their ability to regulate emotions, tolerate distress and negative emotion, be mindful and present in the given moment, and communicate and interact effectively with others.

What to Expect

DBT treatment typically consists of individual therapy sessions and DBT skills groups. Individual therapy sessions consist of one-on-one contact with a trained therapist, ensuring that all therapeutic needs are being addressed. The individual therapist will help the patient stay motivated, apply the DBT skills within daily life, and address obstacles that might arise over the course of treatment.

DBT skills group participants learn and practice skills alongside others. Members of the group are encouraged to share their experiences and provide mutual support. Groups are led by one trained therapist teaching skills and leading exercises. The group members are then assigned homework, such as practicing mindfulness exercises. Each group session lasts approximately two hours, and groups typically meet weekly for six months. Groups can be shorter or longer, depending on the needs of the group members. DBT can be delivered by therapists in many ways. For instance, some people complete the one-on-one therapy sessions without attending the weekly skills group. Others might choose the group without regular one-on-one sessions.

How It Works

DBT is a cognitive-behavioral treatment developed by Marsha Linehan, Ph.D., in the 1980s to treat people with borderline personality disorder. Those diagnosed with BPD often experience extremely intense negative emotions that are difficult to manage. These intense and seemingly uncontrollable negative emotions are often experienced when the individual is interacting with others—friends, romantic partners, family members. People with borderline often experience a great deal of conflict in their relationships.

As its name suggests, DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.

What to Look for in a Dialectical Behavior Therapist

DBT assumes that effective treatment, including group skills training, must pay equal attention to the behavior and experience of providers working with clients as it does to clients’ behavior and experience. Thus, treatment of the providers is an important part of any DBT program, and therapists should practice the skills themselves. They need to know basic behavior therapy techniques and DBT treatment strategies. Look for a mental health professional with specialized training and experience in DBT. The Linehan Board of Certification, a non-profit organization, has developed certification standards for clinicians. In addition, it is important to find a therapist with whom you feel comfortable working.

More on Dialectical Behavior Therapy

The Chaos That Borderline Personality Disorder Can Cause

Borderline personality sufferers try to relieve their inner turmoil.

By Elizabeth Svoboda

What Is DBT?

Transforming destructive behaviors into positive outcomes.

By Greta Gleissner LCSW

Sources

Chapman AL. Dialectical Behavior Therapy: Current Indications and Unique Elements. Psychiatry. Sep 2006;3(9):62-68

Panos PT, Jackson JW, Hasan O, Panos A. Meta-analysis and systematic review assessing the efficacy of Diabletctical Behavior Therapy (DBT). Research on Social Work Practice. 2014;24(2).

Valentine S, BankoffSM, Poulin RM, Reidler EB, Pantalone DW. The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology. Jan 2015;71(1):1-20.

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On 10/9/2018 at 9:48 AM, Lindsay said:

Dialectical Behavior Therapy

What Is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) provides clients with new skills to manage painful emotions and decrease conflict in relationships. DBT specifically focuses on providing therapeutic skills in four key areas. First, mindfulness focuses on improving an individual's ability to accept and be present in the current moment. Second, distress tolerance is geared toward increasing a person’s tolerance of negative emotion, rather than trying to escape from it. Third, emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life. Fourth, interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

When It's Used

DBT was originally developed to treat borderline personality disorder. However, research shows that DBT has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic-stress disorder, and substance abuse. DBT skills are thought to have the capability of helping those who wish to improve their ability to regulate emotions, tolerate distress and negative emotion, be mindful and present in the given moment, and communicate and interact effectively with others.

What to Expect

DBT treatment typically consists of individual therapy sessions and DBT skills groups. Individual therapy sessions consist of one-on-one contact with a trained therapist, ensuring that all therapeutic needs are being addressed. The individual therapist will help the patient stay motivated, apply the DBT skills within daily life, and address obstacles that might arise over the course of treatment.

DBT skills group participants learn and practice skills alongside others. Members of the group are encouraged to share their experiences and provide mutual support. Groups are led by one trained therapist teaching skills and leading exercises. The group members are then assigned homework, such as practicing mindfulness exercises. Each group session lasts approximately two hours, and groups typically meet weekly for six months. Groups can be shorter or longer, depending on the needs of the group members. DBT can be delivered by therapists in many ways. For instance, some people complete the one-on-one therapy sessions without attending the weekly skills group. Others might choose the group without regular one-on-one sessions.

How It Works

DBT is a cognitive-behavioral treatment developed by Marsha Linehan, Ph.D., in the 1980s to treat people with borderline personality disorder. Those diagnosed with BPD often experience extremely intense negative emotions that are difficult to manage. These intense and seemingly uncontrollable negative emotions are often experienced when the individual is interacting with others—friends, romantic partners, family members. People with borderline often experience a great deal of conflict in their relationships.

As its name suggests, DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.

What to Look for in a Dialectical Behavior Therapist

DBT assumes that effective treatment, including group skills training, must pay equal attention to the behavior and experience of providers working with clients as it does to clients’ behavior and experience. Thus, treatment of the providers is an important part of any DBT program, and therapists should practice the skills themselves. They need to know basic behavior therapy techniques and DBT treatment strategies. Look for a mental health professional with specialized training and experience in DBT. The Linehan Board of Certification, a non-profit organization, has developed certification standards for clinicians. In addition, it is important to find a therapist with whom you feel comfortable working.

More on Dialectical Behavior Therapy

The Chaos That Borderline Personality Disorder Can Cause

Borderline personality sufferers try to relieve their inner turmoil.

By Elizabeth Svoboda

What Is DBT?

Transforming destructive behaviors into positive outcomes.

By Greta Gleissner LCSW

Sources

Chapman AL. Dialectical Behavior Therapy: Current Indications and Unique Elements. Psychiatry. Sep 2006;3(9):62-68

Panos PT, Jackson JW, Hasan O, Panos A. Meta-analysis and systematic review assessing the efficacy of Diabletctical Behavior Therapy (DBT). Research on Social Work Practice. 2014;24(2).

Valentine S, BankoffSM, Poulin RM, Reidler EB, Pantalone DW. The use of dialectical behavior therapy skills training as stand-alone treatment: A systematic review of the treatment outcome literature. Journal of Clinical Psychology. Jan 2015;71(1):1-20.

I'd say this is a really good form of therapy. I don't have massive experience with it, but what experience I have has been excellent.

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7 hours ago, MargotMontage said:

I'd say this is a really good form of therapy. I don't have massive experience with it, but what experience I have has been excellent.

I agree. I finished the three modules over a year ago and decided to continue to retake them. It has genuinely helped me to manage my emotions, especially when I'm distressed. 

There are a couple of items Lindsay wrote about that I'm particularly eager to expand on and emphasize:

The doctor who developed DBT lives with mental illness. Dr. Linehan's innate understanding of the realities of MI (and her compassion for others suffering from it) permeates the DBT modules. Personally, I thought a "for us by us" therapy sounded kinda cool. It made it seem more acceptable which gave me a reason to be less difficult and cynical than I generally was in counseling.

Learning to accept and show compassion for oneself and finding balance is essential to using DBT techniques successfully. I feel that this theme is missing in Cognitive Behavioral Therapy, CBT seemed to create gaps between how I actually am and the potentially better version of me. 

But it's not flawless. I think it's so important to acknowledge that DBT is heavy on information, requires participation, concentration, effort and it's a big time commitment. That is an awful lot to ask of someone experiencing severe, unmanaged symptoms of mental illness - which is likely impairing their cognition and functionality. To be honest, that's a big reason why I felt I had to repeat the program. 

If you're reluctant or anxious because it's a classroom with a group of strangers, i get it. The upside is you'll meet new people with whom you have a lot in common. It ain't easy to meet other depressed people in real life, we don't have a "Mental Illness Ball and Soirée" or get a parade (not sure we'd show up if we did)!

 

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