In dialectical behavior therapy (DBT), skills for managing intense emotions and negotiating social relationships are taught to the client through a structured psychotherapy program. Since its development to curb chronic suicidal impulses, it has been used for borderline personality disorder, emotion dysregulation, and many other psychiatric conditions. A six-month to a year-long program consists of group instruction and individual therapy sessions, both conducted every week.
Essentially, dialectical behavior therapy acknowledges that life is complex and health is an ongoing process hammered out through a continuous dialogue with oneself and others. Balance is continually sought, and powerful negative emotions are investigated to discover their truth.
The DBT approach recognizes that change is necessary within the context of acceptance of situations and that feelings are constantly changing, often paradoxical, without getting caught up in them. In therapy teaching, therapists help patients accept the messy nature of thought. Science and practice interact in DBT.
Dialectical Behavior Therapy: What Makes It Special?
Dialectical therapy involves bringing together two opposites in therapy — acceptance and change — for better results than alone.
This approach emphasizes accepting the patients’ experiences as a way for therapists to reassure them — while simultaneously working to change their negative behaviors.
There are four parts to a standard comprehensive DBT:
- Therapy on an individual basis
- Training in group skills
- Between sessions, phone coaching may be needed if a crisis arises
- Provider consultation group to stay motivated and discuss patient care
A patient agrees to do homework to practice new skills. As part of this program, a person must fill out daily “diary cards” to track over 40 emotions, urges, behaviors, and skills, such as lying, self-injury, or self-respect.
Techniques Used in DBT
Here are some of the most commonly used methods:
A significant benefit of DBT is the development of mindfulness skills.4 Mindfulness helps you live in the present or to live in the moment. The goal is to tune in to what’s happening inside (your thoughts, feelings, sensations, and impulses) and what’s happening around you (what you see, hear, smell, and touch) nonjudgmentally using your senses.
You can use mindfulness skills when experiencing emotional pain to slow down and utilize healthy coping skills. Also, the strategy can help you avoid impulsive behaviors and automatic negative thoughts.
It is essential to develop distress tolerance skills to accept yourself and your current situation. There are several techniques that DBT teaches for handling a crisis, including:
- Enhancing the moment
- A self-soothing process
- Considering the pros and cons of not tolerating distress
By preparing yourself for intense emotions and empowering yourself to cope with them with a more positive outlook, you can cope with them more healthily and productively.
Being interpersonally effective allows you to express your needs and say “no” while maintaining a positive and healthy relationship. As a result, you will be able to listen and communicate more efficiently, deal with challenging people, and respect yourself and others.
When you regulate your emotions, you can navigate powerful feelings more effectively. You will learn skills that will help you identify, name, and change your feelings.
Anger, for example, is an intense negative emotion. Recognizing and coping with it will reduce your emotional vulnerability and enhance your emotional experiences.
In what situations is dialectical behavior therapy (DBT) used?
People with difficulty managing and regulating emotions benefit from dialectical behavior therapy (DBT).
A wide range of mental health conditions can be treated and managed with DBT, including:
- Borderline personality disorder (BPD).
- Behavior that is suicidal.
- Post-traumatic stress disorder (PTSD).
- Substance use disorder.
- Eating disorders
To understand why DBT is effective for treating these conditions, it’s essential to know that each is associated with unhealthy or problematic attempts to control intense negative emotions. DBT aims to help people find healthier ways to cope rather than relying on effort that causes problems.
Where can I find a DBT therapist?
Therapy can be provided by a psychiatrist (a medical doctor who can prescribe medication), a psychiatric nurse, a psychologist, a social worker, or a family therapist.
It can also be challenging to find the right therapist for DBT therapy. Don’t lose hope. Get a referral for a dialectical behavior therapist from someone you trust, such as your primary care provider or a friend.
Local and state psychological associations can also help you find therapists online.
If you’re looking for a therapist, make sure they’re licensed and state-certified and treat your concerns (such as eating disorders, borderline personality disorder, self-harm, etc.).
The majority of therapists’ websites list the conditions and problems they treat. Before choosing, call or email the therapist’s office with your questions.
Consider asking a potential DBT therapist the following questions:
- In what capacity have you been trained in DBT?
- Is your DBT comprehensive, or are you modifying it? What are the reasons for not implementing comprehensive DBT?
- Are you a member of a DBT consultation team?
- Regarding phone calls and emails during the week, what is your policy?
- How much time will you initially ask me to commit to the entire therapy process?
Dialectical Behavior Therapy (DBT) is a powerful and effective treatment for many mental health issues. It takes commitment and dedication, but the results are worth it. With the right therapist and a willingness to put in the work, DBT can help you make lasting changes in your life.