Dialectical Behavior Therapy (DBT) is a type of psychotherapy that was originally developed by psychologist Dr. Marsha M. Linehan to treat individuals with Borderline Personality Disorder (BPD). However, it has since been adapted to address various other mental health conditions characterized by emotional dysregulation, impulsive behaviors, and difficulty with interpersonal relationships. DBT combines elements of cognitive-behavioral therapy (CBT) with principles of acceptance and mindfulness.
The main goal of DBT is to help individuals build skills to manage intense emotions, improve interpersonal relationships, and develop strategies for coping with distressing situations. It is based on the dialectical philosophy that emphasizes the integration of seemingly contradictory concepts, such as acceptance and change.
DBT treatment options generally include the following components:
Individual therapy: The client meets with a DBT therapist on a one-on-one basis for weekly sessions. During these sessions, the therapist helps the client explore and address specific issues, behaviors, and emotional struggles.
Group skills training: DBT includes group therapy sessions where clients learn specific coping skills to manage emotions, tolerate distress, improve interpersonal effectiveness, and cultivate mindfulness. The group setting provides a supportive environment for practicing and reinforcing these skills.
Phone coaching: Clients are typically encouraged to contact their therapist outside of scheduled sessions for brief phone coaching when they are facing a crisis or struggling to apply the skills they've learned.
Consultation team: DBT therapists often participate in a consultation team with other DBT clinicians. They meet regularly to receive supervision and support in providing effective treatment to clients. This team-based approach helps the therapist stay grounded and provides guidance in managing complex cases.
DBT incorporates four sets of therapeutic skills:
a. Mindfulness skills: Focus on developing awareness of the present moment without judgment. Mindfulness practices help individuals become more grounded and better able to manage their emotions.
b. Distress tolerance skills: Teach clients how to cope with distressing and overwhelming situations without making impulsive or harmful decisions. These skills help prevent engaging in destructive behaviors during moments of intense emotions.
c. Emotion regulation skills: Help individuals identify and understand their emotions and learn how to modulate and cope with them effectively. These skills aim to reduce emotional vulnerability and improve emotional regulation.
d. Interpersonal effectiveness skills: Focus on developing healthy and assertive communication, setting boundaries, and building positive relationships with others.
DBT is considered an evidence-based treatment with demonstrated effectiveness in treating various conditions, including Borderline Personality Disorder, self-harm behaviors, suicidal ideation, substance use disorders, eating disorders, and other mood disorders characterized by emotional dysregulation.
It is essential to work with a licensed and trained DBT therapist or program for the most effective implementation of this therapeutic approach.