All about Dialectical Behavior Therapy

What is DBT

DBT is one of the most popular psychotherapies today. It was traditionally developed by Dr Marsha Linehan to treat people with borderline personality disorder (BPD). Today, it is used to treat various other mental health illnesses like depression, stress, anxiety and also substance abuse. It is an evidence-based therapy with many kinds of research showing its efficacy in reducing suicidal behaviour. 

It’s based on the principles of mindfulness, dialectical philosophy and cognitive-behaviourist aspects. It has certain core components and techniques which form an abbreviation which makes them easy to remember. We will learn about some of such techniques further in this blog.

Key components and techniques in DBT

DBT is a very comprehensive form of treatment consisting of various techniques for managing emotions, developing a healthy relationship, focusing on their goals and improving the overall quality of life. 

This therapy is based on the dialectics approach. This approach says that two ideas, feelings or thoughts may seem to be opposite but still exist at the same time. For example, you may feel empathetic and angry at the same time. DBT focuses on teaching people to live healthily with both of these feelings without choosing one over the other. 

. There are four main components in DBT as follows: 

• Mindfulness: Focuses on awareness of the present moment. This is done in a non-judgemental manner. People undergoing this therapy may be taught different mindfulness techniques like relaxation, breathing, meditation or body scan. 

• Distress Tolerance: Teaches skills to deal with a crisis situation. This is especially important for people who exhibit self-harming tendencies. Or for people with addictions, this could be beneficial in cases of relapse. 

• Emotion Regulation: Teaches skills to understand and manage emotions better. In this process, you learn about the different types of emotions, how to identify and label emotions, causes and functions, and healthy expression of the emotion. 

• Interpersonal effectiveness: Helps people make healthy conversations and healthy relationships. They may learn how to communicate effectively without being aggressive or submissive. But still being assertive and maintaining boundaries. This may also help people become better listeners and better problem solvers.

Here is an example of some techniques in DBT. In case of experiencing intense unmanageable emotions, DBT uses the acronym TIPP to explain some simple techniques to manage these emotions and reduce emotional arousal. These are part of distress tolerance techniques.

• Temperature change
• Intense Exercise
• Paced Breathing
• Progressive muscle relaxation

DBT uses the acronym ABC PLEASE for strategies to help manage emotions by engaging in positive action. 

• Accumulating positive emotions
• Building mastery
• Coping ahead
• Physical sensations
• Low arousal activities
• Eating a balanced diet
• Avoiding mood-altering substances
• Sleep 
• Exercise.

Improving interpersonal relationships is a key component of DBT. Some of the techniques that give clear indications of healthy communication go by the acronym DEAR MAN. This technique teaches them to be assertive while being mindful of how the other person feels.

• Describe
• Express
• Assert
• Reinforce
• Mindful
• Appear confident
• Negotiate.

Who is it beneficial for

DBT has been shown to be an effective treatment modality for various disorders. Using its various techniques, it helps people manage extreme emotions, improve their overall quality of life, maintain healthy relationships and able to deal with difficult situations healthily. 

Due to its strong base in Mindfulness, Distress Tolerance, Emotional regulation and Interpersonal effectiveness, it’s highly beneficial for people with BPD or signs of BPD. People with difficulty managing emotions can benefit from DBT more than other therapies. 

DBT is also one of the few therapies that have been shown to reduce suicidal behaviour. This may also include people who have trauma or have been through abuse. People who tend to get into unhealthy or abusive relationships or have difficulty setting boundaries can benefit from Interpersonal effectiveness skills. 

It may also be combined with other therapies for certain groups. DBT has been shown to work well with adolescents. This may be combined with family therapy sessions for better results. 

How’s it different from other approaches

DBT is a highly structured therapy. It can be used with individuals or in groups as a skills training program. Similar to Cognitive Behavioral Therapy, the therapist and the client work together to identify unhelpful beliefs and behaviours. Then they might develop certain strategies or learn new skills to deal with the problematic behaviour. 

Benefits of DBT

• It’s highly structured and skill-based.
• DBT has been shown to be extremely effective in controlling self-harming behaviours. 
• It helps build healthy relationships, set boundaries and learn to communicate healthily. 
• It helps in managing difficult or intense emotions. 
• Increases overall life satisfaction.
• Increases awareness of the present and living in the present.
• It can help improve symptoms of a wide range of mental health disorders. 

DBT for Substance use disorders

While DBT was traditionally made for BPD, it has also been shown to be effective in treating substance abuse disorders. It may be combined with other approaches like motivational interviewing, 12 step model, or relapse prevention. It has been shown to reduce the chances of substance use and improve treatment retention.

Researchers have also created models to make DBT more suitable for people with Substance use disorders (SUDs). These include strategies to promote abstinence or reduce the impact and intensity of relapses. This treatment has also been shown to be effective with many co-occurring disorders. 

This might be used while the person is going through rehab or in the relapse prevention phase. DBT can be delivered individually or in groups, in-person or even via online sessions. It directly deals with managing a crisis with minimum damage. This helps people deal with cravings and relapse. 

It also reduces behaviours that might interfere with overall recovery. For example, self-harming behaviour, missing sessions or coming late. DBT for SUDs has certain goals that are specific to substance abuse. These may include reducing cravings for abuse and increasing healthy, helpful behaviours like forming healthy relationships. 

DBT has several randomised controlled trials and meta-analyses proving its effectiveness in treating various types of mental health problems. It helps people manage difficult emotions that they experience through recovery and throughout their lives. DBT techniques are easy to apply and are lifelong skills. It helps people mend their relationships and develop healthy communication and boundaries. Ultimately, DBT helps people be in the present and feel more hopeful and fulfilled in their overall lives. If you or someone you know is looking for mental health or substance use treatment you can browse our list of treatment centers here.

Sources:

Chapman, A. L. (n.d.). Dialectical Behavior Therapy: Current Indications and Unique Elements. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/ 

Dimeff, L. A., & Linehan, M. M. (2008). Dialectical Behavior Therapy for Substance Abusers. Addiction Science & Clinical Practice, 4(2), 39–47. https://doi.org/10.1151/ascp084239 

Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of clinical psychology, 62(4), 459-480. https://doi.org/10.1002/jclp.20243 

What is DBT

DBT is one of the most popular psychotherapies today. It was traditionally developed by Dr Marsha Linehan to treat people with borderline personality disorder (BPD). Today, it is used to treat various other mental health illnesses like depression, stress, anxiety and also substance abuse. It is an evidence-based therapy with many kinds of research showing its efficacy in reducing suicidal behaviour. 

It’s based on the principles of mindfulness, dialectical philosophy and cognitive-behaviourist aspects. It has certain core components and techniques which form an abbreviation which makes them easy to remember. We will learn about some of such techniques further in this blog.

Key components and techniques in DBT

DBT is a very comprehensive form of treatment consisting of various techniques for managing emotions, developing a healthy relationship, focusing on their goals and improving the overall quality of life. 

This therapy is based on the dialectics approach. This approach says that two ideas, feelings or thoughts may seem to be opposite but still exist at the same time. For example, you may feel empathetic and angry at the same time. DBT focuses on teaching people to live healthily with both of these feelings without choosing one over the other. 

. There are four main components in DBT as follows: 

• Mindfulness: Focuses on awareness of the present moment. This is done in a non-judgemental manner. People undergoing this therapy may be taught different mindfulness techniques like relaxation, breathing, meditation or body scan. 
• Distress Tolerance: Teaches skills to deal with a crisis situation. This is especially important for people who exhibit self-harming tendencies. Or for people with addictions, this could be beneficial in cases of relapse. 
• Emotion Regulation: Teaches skills to understand and manage emotions better. In this process, you learn about the different types of emotions, how to identify and label emotions, causes and functions, and healthy expression of the emotion. 
• Interpersonal effectiveness: Helps people make healthy conversations and healthy relationships. They may learn how to communicate effectively without being aggressive or submissive. But still being assertive and maintaining boundaries. This may also help people become better listeners and better problem solvers.

Here is an example of some techniques in DBT. In case of experiencing intense unmanageable emotions, DBT uses the acronym TIPP to explain some simple techniques to manage these emotions and reduce emotional arousal. These are part of distress tolerance techniques.

• Temperature change
• Intense Exercise
• Paced Breathing
• Progressive muscle relaxation

DBT uses the acronym ABC PLEASE for strategies to help manage emotions by engaging in positive action. 

• Accumulating positive emotions
• Building mastery
• Coping ahead
• Physical sensations
• Low arousal activities
• Eating a balanced diet
• Avoiding mood-altering substances
• Sleep 
• Exercise.

Improving interpersonal relationships is a key component of DBT. Some of the techniques that give clear indications of healthy communication go by the acronym DEAR MAN. This technique teaches them to be assertive while being mindful of how the other person feels.

• Describe
• Express
• Assert
• Reinforce
• Mindful
• Appear confident
• Negotiate.

Who is it beneficial for

DBT has been shown to be an effective treatment modality for various disorders. Using its various techniques, it helps people manage extreme emotions, improve their overall quality of life, maintain healthy relationships and able to deal with difficult situations healthily. 

Due to its strong base in Mindfulness, Distress Tolerance, Emotional regulation and Interpersonal effectiveness, it’s highly beneficial for people with BPD or signs of BPD. People with difficulty managing emotions can benefit from DBT more than other therapies. 

DBT is also one of the few therapies that have been shown to reduce suicidal behaviour. This may also include people who have trauma or have been through abuse. People who tend to get into unhealthy or abusive relationships or have difficulty setting boundaries can benefit from Interpersonal effectiveness skills. 

It may also be combined with other therapies for certain groups. DBT has been shown to work well with adolescents. This may be combined with family therapy sessions for better results. 

How’s it different from other approaches

DBT is a highly structured therapy. It can be used with individuals or in groups as a skills training program. Similar to Cognitive Behavioral Therapy, the therapist and the client work together to identify unhelpful beliefs and behaviours. Then they might develop certain strategies or learn new skills to deal with the problematic behaviour. 

Benefits of DBT

• It’s highly structured and skill-based.
• DBT has been shown to be extremely effective in controlling self-harming behaviours. 
• It helps build healthy relationships, set boundaries and learn to communicate healthily. 
• It helps in managing difficult or intense emotions. 
• Increases overall life satisfaction.
• Increases awareness of the present and living in the present.
• It can help improve symptoms of a wide range of mental health disorders. 

DBT for Substance use disorders

While DBT was traditionally made for BPD, it has also been shown to be effective in treating substance abuse disorders. It may be combined with other approaches like motivational interviewing, 12 step model, or relapse prevention. It has been shown to reduce the chances of substance use and improve treatment retention.

Researchers have also created models to make DBT more suitable for people with Substance use disorders (SUDs). These include strategies to promote abstinence or reduce the impact and intensity of relapses. This treatment has also been shown to be effective with many co-occurring disorders. 

This might be used while the person is going through rehab or in the relapse prevention phase. DBT can be delivered individually or in groups, in-person or even via online sessions. It directly deals with managing a crisis with minimum damage. This helps people deal with cravings and relapse. 

It also reduces behaviours that might interfere with overall recovery. For example, self-harming behaviour, missing sessions or coming late. DBT for SUDs has certain goals that are specific to substance abuse. These may include reducing cravings for abuse and increasing healthy, helpful behaviours like forming healthy relationships. 

DBT has several randomised controlled trials and meta-analyses proving its effectiveness in treating various types of mental health problems. It helps people manage difficult emotions that they experience through recovery and throughout their lives. DBT techniques are easy to apply and are lifelong skills. It helps people mend their relationships and develop healthy communication and boundaries. Ultimately, DBT helps people be in the present and feel more hopeful and fulfilled in their overall lives. If you or someone you know is looking for mental health or substance use treatment you can browse our list of treatment centers here.

Sources:

Chapman, A. L. (n.d.). Dialectical Behavior Therapy: Current Indications and Unique Elements. PubMed Central (PMC). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/ 

Dimeff, L. A., & Linehan, M. M. (2008). Dialectical Behavior Therapy for Substance Abusers. Addiction Science & Clinical Practice, 4(2), 39–47. https://doi.org/10.1151/ascp084239 

Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M. (2006). Mechanisms of change in dialectical behavior therapy: Theoretical and empirical observations. Journal of clinical psychology, 62(4), 459-480. https://doi.org/10.1002/jclp.20243