Dialectical Behavior Therapy: Use, Techniques and Benefits

What is Dialectical Behavior therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a specialized form of psychotherapy that aims to assist individuals grappling with emotional regulation challenges. Psychologist Marsha Linehan developed it in the 1970s (1). Rooted in cognitive-behavioral therapy (CBT), Dialectical Behavior therapy (DBT) combines cognitive-behavioral therapy with mindfulness-based techniques to help individuals learn how to manage their emotions, improve their relationships, and achieve their goals.

Dialectical Behavior Therapy Techniques

Dialectical Behavior Therapy (DBT) is a well-established treatment approach that integrates various techniques to equip individuals with valuable skills to manage their emotions, enhance their relationships, and accomplish their personal goals (2). Some of the fundamental techniques used in DBT include:

Mindfulness. DBT emphasizes the practice of mindfulness, which involves being fully present and engaged in the current moment without judgment. Mindfulness exercises can help individuals become more aware of their thoughts and emotions and provide a foundation for other skills learned in therapy.

Emotion Regulation. DBT teaches individuals skills for managing emotions, including identifying and labeling emotions, reducing emotional vulnerability, and increasing positive emotions. Techniques may include emotional exposure, opposite action, and checking the facts.

Distress Tolerance. Distress tolerance skills help individuals cope with intense emotions and distressing situations without resorting to harmful behaviors. Techniques may include radical acceptance, self-soothing, and distraction.

Interpersonal Effectiveness. Interpersonal effectiveness skills help individuals communicate effectively and assertively, set healthy boundaries, and build and maintain healthy relationships. Techniques may include DEAR MAN, GIVE, and FAST (3).

Cognitive Restructuring. Cognitive restructuring techniques help individuals challenge and change negative thoughts and beliefs contributing to emotional distress. Techniques may include identifying and challenging cognitive distortions, examining the evidence, and generating alternative thoughts.

Exposure Therapy. Exposure therapy is a technique used in DBT to help individuals confront and overcome their fears or phobias. This may involve gradually exposing the individual to the feared situation or object and learning to tolerate the accompanying emotions.

How does DBT work?

Dialectical Behavior Therapy (DBT) is a type of psychotherapy originally developed to treat individuals with borderline personality disorder. It has since been adapted to treat other mental health conditions, including depression, anxiety, and substance use disorders.  DBT is based on the idea that individuals who struggle with intense emotions and impulsive behavior often have difficulty regulating their emotions and that this difficulty can be addressed through specific skills and strategies.

During individual therapy sessions, the therapist works with the individual to identify their goals and develop a treatment plan. They may use various techniques, including Cognitive-Behavioral Therapy (CBT) and mindfulness-based interventions, to help the individual learn skills for managing their emotions and improving their relationships. The treatment comprises several components: individual therapy, group skills training, phone coaching, consultation team, mindfulness, and a commitment to treatment.

Group skills

In group skills training sessions, the therapist teaches the individual specific skills related to mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. These skills are practiced in a supportive group setting, and the therapist provides feedback and guidance to help individuals develop and apply their new skills.

Phone Coaching

Phone coaching is available to provide support and guidance between therapy sessions, especially in managing crises or difficult situations. Consultation teams are groups of therapists who meet regularly to support each other and ensure they provide the best possible care to their clients.

Mindfulness

It is a core component of DBT and involves paying attention to the present moment without judgment. Mindfulness exercises can help individuals become more aware of their thoughts and emotions and provide a foundation for other skills learned in therapy.

Commitment to Treatment

Commitment to Treatment is an essential component of DBT. This involves the individual committing to attend therapy sessions, practicing the skills they learn in therapy, and actively working towards their goals.

Overall, DBT provides individuals with the skills and strategies they need to manage their emotions, improve their relationships, and achieve their goals. By learning these skills and working with a supportive therapist and group, individuals can develop a greater sense of control and achieve a better quality of life.

 What Is Dialectical Behavior Therapy Used For?

• DBT has since been adapted for the treatment of a variety of mental health conditions, including (4):

• Borderline Personality Disorder

• Self-Harm

• Suicidal Behavior

• PTSD

• Substance use disorder

• Eating Disorders

• Depression

• Anxiety

Overall, DBT is used to help individuals learn skills to manage their emotions, improve their relationships, and achieve their goals. It is a flexible treatment approach that can be adapted to the needs of each individual, making it a valuable tool for a wide range of mental health conditions.

What are the Benefits of Dialectical Behavior Therapy?

Dialectical Behavior Therapy (DBT) has been shown to be effective in treating a range of mental health conditions, including Borderline Personality Disorder (BPD), depression, anxiety, post-traumatic stress disorder (PTSD), eating disorders, and substance use disorders. Some of the specific benefits of DBT include:

• Improved emotion regulation: DBT teaches individuals skills for managing emotions, reducing vulnerability, and increasing positive emotions.

• Better interpersonal relationships: DBT focuses on interpersonal effectiveness skills, which help individuals communicate effectively, set healthy boundaries, and build and maintain healthy relationships.

• Increased mindfulness: DBT emphasizes the practice of mindfulness, which can help individuals become more aware of their thoughts and emotions and reduce reactivity.

• Reduced self-harm and suicidal behavior: DBT includes techniques to help individuals cope with intense emotions and distressing situations without resorting to harmful behaviors.

• Improved overall functioning: DBT can help individuals achieve their goals and overall quality of life by providing them with the skills and strategies to manage their emotions and build healthy relationships.

• Lower relapse rates: DBT has been shown to reduce the risk of relapse in individuals with various mental health conditions, including BPD and substance use disorders.

• More cost-effective: DBT has been found to be a cost-effective treatment option for individuals with BPD compared to other treatments.

How to Find the Right Therapist

• Determine your specific needs. Clarify your reasons for seeking therapy and identify the specific issues or challenges you want to address. Consider factors such as the type of therapy you prefer (e.g., DBT), the areas of expertise you seek, and any specific preferences regarding the therapist's race, gender, age, cultural background, or therapeutic approach.

• Seek recommendations. Ask trusted individuals in your social network, such as friends, family members, or healthcare professionals, if they have any therapist recommendations. Personal referrals can provide valuable insights and help you narrow down your search.

• Utilize online directories. Utilize online therapist directories or databases that allow you to search for therapists based on location, preferred therapy type, and specialization. Examples include Phoenix Rising Centers, Psychology Today, GoodTherapy, Inclusive Therapist, Therapy for Black Girls, and TherapyDen. These platforms often provide detailed profiles of therapists, including their qualifications, specialties, and approaches.

• Research therapist credentials. Check the credentials and qualifications of potential therapists. Look for licensed mental health professionals with relevant training and experience in the specific therapy approach you seek (e.g., DBT). You can verify their credentials through professional licensing boards or organizations.

• Consider compatibility. A good therapeutic relationship is built on trust, understanding, and rapport. Review therapist profiles, websites, or online reviews to gauge their approach, style, and personality. Consider whether you feel comfortable and connected with their therapeutic philosophy. Most important, trust your gut when searching for someone. 

• Contact potential therapists. Reach out to a few potential therapists to inquire about their availability, fees, and whether they offer a free initial consultation. During this initial contact, ask questions about their experience working with your specific concerns and the therapeutic approaches they utilize.

• Schedule consultations. Consider scheduling consultations or initial sessions with a few therapists to determine compatibility and if you feel comfortable working with them. This can allow you to discuss your goals, ask further questions, and gauge the therapist's communication style and approach.

Remember that finding the right therapist may involve some trial and error. Feel free to switch therapists if you feel the current one needs to meet your needs or if the therapeutic relationship is not a good fit. Your mental health is a priority; finding the right therapist can significantly impact your therapeutic journey.

Resources:

1. DBT Therapy | Dialectical Behavior Therapy. Good therapy. https://www.goodtherapy.org/learn-about-therapy/types/dialectical-behavioral-therapy

2. Dialectical Behavior Therapy (DBT). Verywellmind. https://www.verywellmind.com/dialectical-behavior-therapy-1067402

3. Microsoft Word - Give Dear Man Fast. Healingconnectionsonline. https://www.healingconnectionsonline.com/wp-content/uploads/2014/12/Dear-Man-Give-Fast.pdf

4. Dialectical Behavior Therapy (DBT): What It Is & Purpose. [online]. Available at: https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt.