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Dialectical Behavioral Therapy

Dialectical Behavioral TherapyDialectical Behavioral Therapy (DBT) is a type of therapy that focuses on the connections between one’s thoughts, feelings, and behavior. Specifically, DBT explores how one’s social interactions are affected by their psychological illness and its symptoms. This therapy was originally designed to help treat people with Borderline Personality Disorder. Individuals with Borderline Personality Disorder tend to experience extreme fluctuations in mood, which affects their social interactions. They also tend to experience more intense reactions to emotional stimulation and these reactions are sustained for a longer-than-average period of time. In other words, people with Borderline Personality Disorder tend to stay in this heightened state longer than others. Therefore, the goal of DBT is to teach coping mechanisms and skills to manage their fluctuations in mood, as well as to help identify triggers in order to reduce the level of intensity of their emotional reactions.

Three Parts to Dialectical Behavioral Therapy

A person who is participating in a DBT program will likely have individual therapy as well as group therapy. However, one significant aspect of this treatment method is participation in a 16-week skills group. The typical three facets of a DBT program are described below:

Individual Therapy – During these sessions, a person works one on one time with a trained DBT clinician.
Group Therapy – During these sessions, those suffering from various mental illnesses gather together for a shared therapeutic experience. A trained clinician is facilitating the experience.
Skills Group – This is the time for an individual to learn the necessary life skills that make DBT so effective. The Skills Group typically meets for 90 minutes once per week, while individual therapy or group therapy can take place once to twice per week, focusing on sharpening skills and integrating them into daily life.

Research on Dialectical Behavioral Therapy

Research on the treatment effectiveness of Dialectical Behavioral Therapy revealed that those participating in DBT were half as likely to make a suicide attempt and required fewer hospitalizations. They were also less likely to drop out of treatment. Because of this research and consistent studies showing the effectiveness of this method, DBT is known as an evidence-based treatment method.

Strategies of Dialectical Behavioral Therapy

Dialectical Behavioral Therapy has evolved to be included in treatment plans for many other psychological illnesses, including severe depression, suicidal thinking, Bipolar Disorder, self-harm, and other illnesses that result in extreme mood fluctuations.  The therapy progresses from most urgent issues (such as ensuring a person’s physical safety when he or she might be experiencing suicidal thoughts) to less urgent issues.

Some of the strategies of DBT have been used in other therapy approaches because of its effectiveness. These include the Support Strategy, Structuring the Environment, teaching skills to help regulate emotions, the Dialectical philosophy, and Mindfulness.

The Support Strategy – This is a focus on working with individuals to help restore a positive self-image, and help them build on their strengths, rather than focusing on their weaknesses.
Structuring the Environment – This involves providing individuals with a safe, non-judgmental place in which to experience treatment, as well as teaching them ways in to alter their own environments, such as refusing to spend time with harmful people. This is also a time for participants to evaluate the ways and times which they respond strongly to emotional stimulation and life circumstances, and how to better manage their reactions.
The Dialectical Philosophy – This is an underlying philosophy which guides the therapeutic work. It refers to the balance that DBT therapists strive for – helping participants know that they are well-accepted, while encouraging them to make positive changes, in order to move forward and grow.
Mindfulness – This is a skill of concentration taught to participants. Mindfulness invites a person to be fully present and notice oneself and one’s environment, without judgment.  Over time, by individuals can learn to be fully engaged in the situation they’re currently in, without reacting. Mindfulness also helps them develop self-awareness which can also help them better manage their reactions.

If you or someone you know is suffering from a severe psychological illness, Dialectical Behavioral Therapy might be able to help.