Dialectical Behavior Therapy

According to the research, DBT is hugely effective when it comprises of both individual therapy and regular skills-based group therapy sessions.

What is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a well-researched therapy based on the cognitive-behavioral approach. It has been developed by Marsha M. Linehan at the University of Washington back in the late 70s. The creation of this therapy approach aimed to help clients deal with suicidal thoughts, often seen with individuals diagnosed with borderline personality disorder. Ten years later, DBT became a more widely applied approach, and now it is used to help individuals with various struggles and diagnoses. For example, this therapy type is used to help clients with eating disorders, substance abuse, etc.

The Four Modules

Dialectical behavior therapy is a combination of western and eastern practices. Here are the four main areas, also known as modules, that this therapy approach focuses on:

1. Distress tolerance;
2. Interpersonal effectiveness;
3. Mindfulness;
4. Emotion regulation.

Distress Tolerance

Distress tolerance focuses on skills that assist with accepting and tolerating difficult emotions and feelings. This module helps patients to make healthy choices and to handle the emotions instead of acting out.

Interpersonal Effectiveness

Interpersonal effectiveness is quite similar to those skills that are taught in assertiveness classes. In DBT, this area deals with teaching about asking other people if they need something and saying “no.” By doing this, the individual will learn to set boundaries.

Mindfulness

Mindfulness DBT skills encourage the individual to learn to be present in the current moment, both physically and emotionally. The client will learn to recognize their thoughts, feelings, and sensations. This skill is considered to be the primary one in DBT.

Emotion Regulation

Emotion regulation emphasizes DBT skills that aid in dealing with complicated emotions and regulating their intensity. This module’s main aim is to assist individuals with being less vulnerable to such emotions, increasing their understanding of those emotions, and realizing how they affect them.

Altogether, the goal of DBT is to help people deal with their emotions. This approach is designed to give individuals a more positive avenue of managing challenging situations by changing behavior patterns. Such situations include gambling, self-harm tendencies, etc.

First of all, the specialist applying this approach will identify the triggers that are the reason for those behaviors. Then the therapist will help the individual to recognize the events and thought that those triggers create. After this step, the specialist will encourage the patient to find healthier ways to channel them instead of repeating those wrong behaviors repeatedly. The overall idea behind dialectical behavior therapy is that almost every person has flaws that we continuously try to fix, but lack of the skills needed to succeed in this or can easily get influenced by other people’s good or bad reinforcement, which has the power to interrupt normal behavior and actions.

DBT and Psychotherapy

Dialectical behavior therapy can be applied to solve a variety of struggles and problems and different mental health settings. DBT comprises out of five components:

• Generalization – therapists who apply DBT engage the patients in various techniques that help them develop skills needed for them to be used in different areas of life – home, school, work, etc.
• Structuring the environment – when a client is under multiple types of treatment, with DBT being one of them, the therapist will likely have to combine the programs in one to reinforce the skills taught in dialectical behavior therapy.
• Capability enhancement – this stage aims the development of tools and coping skills to occur. During this DBT stage, the clients learn the skills that they need the most – distress tolerance, interpersonal effectiveness, mindfulness, and emotion regulation.
• Capability and motivational enhancement of the therapist – since DBT specialists often deal with patients diagnosed with severe mental illness, they also need to supervise their clients and help prevent burnouts.
• Motivational enhancement – the dialectical behavior therapist helps the client notice unhealthy and unhelpful behaviors and habits that may negatively influence their life. For this reason, the specialist offers the patient to use tracking records and self-monitoring. They assist the individual in realizing the patterns of such behaviors.

DBT & Individual/Group Therapy

Research shows that DBT is much more effective when combined with individual and weekly group therapy based on skills, which is why it is recommended for DBT to consist of both therapy types.

The individual therapy sessions involve a qualified specialist/counselor and only one patient. Usually, every session is different, but one similar feature is that they are always based on the previous session outcome. The sessions’ primary goals are to identify the client’s struggles, help to reflect upon things, and gain knowledge of new skills. Also, the client learns the skills and tools and ways to apply them to different areas needed to lead an everyday life.

Dialectical behavior group therapy sessions are carried out by a therapist who is a qualified expert, but in this case, not with one client, but in a group of peers that share similar mental health issues. Not only are the patients being taught the DBT skills, but they also are learning to use them. This therapy type is also a great way to get support since the ones in groups have similar struggles.

Thanks to the four modules of dialectical behavior therapy, the individuals get to increase the sense of peace in their lives and strengthen and learn to maintain their relationships. This therapy approach also helps those in need better understand themselves, their feeling, and emotions.

Through regular DBT practice, individuals can realize that they can react to real-world environmental, interpersonal, and other stimuli more healthily.

But it should be noted that only when both individual and group types of therapy are in a combination, the patients will be able to get the most out of DBT. Only with the help of a trained and highly-qualified therapist clients will improve their lives.