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Behavioural therapies, these days have niched down to specific fields in order to focus on different disorders and treat them effectively.
With many different kinds available, it can be hard to decide the one that is best for you. Some therapies look into our past and examine our fears while others focus on behavioral changes.
Dialectical Behavioral Therapy (DBT) is one that encourages behavioral changes. Here’s what DBT is and how it works.
What is dialectical behavioral therapy?
Dialectical behavioral therapy, or DBT, is modified from cognitive behavioral therapy (CBT) and often used to help people who feel intense emotions.
Originally adapted to treat borderline personality disorder, DBT can also help people who have issues with emotion regulation, and those who are struggling with self destructive behaviors such as substance use and eating disorders.
DBT aims to help people:
- Understand and accept difficult feelings.
- Learn how to manage these feelings.
- Make positive changes in their lives.
The word ‘dialectical’ here refers to the ability to understand how two opposing things can be true. For example, accepting yourself while working to change your behavior might feel like two ends of a pole. However, DBT teaches that it is possible to do both of these things at the same time.
What is dialectical behavioral therapy used for?
Dialectical behavioral therapy can be used to treat:
- Borderline personality disorder
- Suicide attempts
- Eating disorders
- Substance abuse
- Offending behaviors
DBT is more likely to work for individuals who are:
- Ready to make positive changes in themselves.
- Ready to work hard and complete homework assignments given by the therapist.
- Ready to focus on their present and future.
- Able to attend and participate in group sessions.
How does DBT work?
DBT is based on the perspective of dialectics, in which opposites are balanced. DBT therapists work with patients to promote balance and accept seemingly opposite perspectives at any one time. Patients are taught how to avoid the all-or-nothing style of thinking.
Components of dialectical behavioral therapy
There are four main components, or modules, in DBT:
Mindfulness is one of the vital skills that patients will learn in DBT. Individuals practice being present in the moment and feel life for what it is now, rather than trying to live years ahead.
Mindfulness will help a person accept, understand and tolerate overwhelming emotions in their daily lives. Patients learn to accept all situations no matter how intense the emotions may be.
Being a mindful person allows individuals to slow down and focus on the positives no matter how stressful a situation is. Because mindfulness is considered as the foundation, patients are usually not taught the other skill sets until they have grasped the concept of being mindful.
Once patients have learned the mindfulness skill, interpersonal effectiveness follows closely. Patients learn how to communicate effectively, including how to disagree and to say no to a request of situations.
They learn now to ask for what they need or want while maintaining self respect. This skill encompasses personal relationships, interactions with other people and how to navigate challenges that can result in a stressful environment.
In distress tolerance, patients learn acceptance and change. Techniques taught in distress tolerance include:
- Thinking about the pros and cons in a particular situation
- Distracting oneself
- Improving stressful situations
One of the vital elements in distress tolerances is the concept of radical acceptance. Radical acceptance enables an individual to accept that there will be both positive and negative situations in life.
Problems should be viewed without being judgemental and outcomes accepted irrespective of the problem. Mindfulness plays an essential role in radical acceptance.
Emotion regulation involves learning how to control your emotions. While this can be a difficult skill for intense people, it is a skill that will greatly help those who struggle regularly with emotions such as:
Emotion regulation enables individuals to manage their feelings and thus, decrease their vulnerability to painful emotions brought about by situations they are unable to control.
What to expect in DBT therapy?
Most DBT treatments will consist of individual therapy sessions as well as a DBT skills group. You will have one on one time with a trained therapist who will be able to help you stay motivated and apply the DBT skills learnt in everyday life.
The therapist will also address issues or obstacles that are hindering you from improving.
In DBT therapy, participants are encouraged to share about their experiences and support each other. Group sessions usually last about two hours each week for about 6 months or so, depending on the needs of the participants.
DBT therapy sessions can be flexible, in that some people only complete the individual session while others, only the group sessions.
Dialectical behavioral therapy vs cognitive behavioral therapy (DBT vs CBT)
Both DBT and CBT are behavioral therapies that help people by changing unhealthy thoughts and behaviors. However, in DBT, people are also accepted for who they are.
Besides this, you can also expect to participate more in group work with DBT. DBT therapists expect and encourage all group members to work hard, and stay motivated to affect positive changes in their lives.
DBT can be very effective for individuals who face intense emotions. If you’re thinking of participating in DBT, check with your mental health practitioner for recommendations. If you’re a DBT therapist, A Space Between offers conducive therapy rooms that are suitable for both individual and group therapies.
The article is a part of our comprehensive series on “Behavioural therapy”