DBT Therapy

Dialectical means two opposites can both be true. In DBT, the opposites are acceptance and change, which together can bring about positive outcomes. Patients learn to accept their experiences and manifest the internal balance needed for healthy change.

Psychologist and researcher Marsha Linehan developed DBT in the late 1980s as a modified form of cognitive behavioral therapy (CBT). She originally designed DBT to treat patients with borderline personality disorder (BPD) and persistent thoughts of suicide.

Today, DBT is widely used to treat BPD and suicidal thoughts and is also considered an effective therapy for eating disorders, substance use disorders, depression, and other mood disorders.

CBT helps patients recognize how their negative thought patterns are linked to destructive emotions, behaviors, and physical well-being, and how to respond more positively.

DBT is similar to CBT but focuses more on the development of life skills needed to change unhealthy behaviors and to find inner peace. DBT puts more emphasis on balancing emotions and strengthening interpersonal relationships.

Typically DBT utilizes individual therapy and group skills training. Individual therapy helps patients identify challenges in their own lives and develop the motivation to change their responses. Group skills training focuses on development and practice of necessary skills. Phone coaching is available to help patients if a crisis situation arises between sessions.

Patients are often assigned homework, which may include keeping a daily record of their emotions, behaviors, and urges, as well as the practical application of other skills.

According to Linehan, DBT skills training encompasses:

• Mindfulness – the practice of being fully aware and present in the moment.

• Distress Tolerance – how to tolerate pain in difficult situations, rather than attempt to change it.

• Interpersonal Effectiveness – how to ask for what you want and how to say no, while maintaining self-respect and relationships with others.

• Emotion Regulation – how to change emotions that you want to change.

DBT employs a variety of clinical techniques to build these life skills, designed to strengthen self-acceptance, personal balance, boundaries, and healthy relationships. Examples of skill-building techniques associated with DBT include:

• Wise Mind – working to find a balance between emotion and logic.

• Radical Acceptance – learning to accept oneself and the current situation, without question, resistance, or judgment.

• Dear Man – strengthening interpersonal communication skills to help patients meet their own needs while developing healthier relationships with others.

• GIVE – another technique for maintaining healthy relationships by improving communication skills.

• Mindfulness and Meditation Exercises – helping patients become more aware of and more accepting of their own emotions, to be attentive to the present moment, and how to remain calm in the face of distressing situations.

Research has shown DBT to be a valuable component of a comprehensive treatment plan for addiction and mental disorders. The journal, Addiction Science and Clinical Practice cites several randomized clinical trials finding DBT decreased substance abuse in patients with borderline personality disorder, as well as in those with other severe co-occurring disorders.

DBT has been found to increase motivation, decrease maladaptive behaviors like using addictive substances, emotional numbing, and social withdrawal, better manage triggers to maladaptive behaviors, strengthen coping strategies, better manage stress, increase self-esteem and confidence, and avoid relapse.

A 2018 science update published on the National Institute of Mental Health website reports that DBT, which has already been proven effective in reducing suicidal behavior in adults, is also effective in reducing, “suicide attempts and suicidal behavior in adolescents.”

Studies also support the effectiveness of DBT for those with eating disorders. DBT helps patients develop coping strategies for managing triggers to their eating disorder, reduce stress, reinforce positive self-talk and instill healthy eating behaviors.

The Linehan Institute provides a comprehensive list of studies measuring the effectiveness of DBT for a variety of conditions.

At StoneRidge Centers, we take a unique, evidence-based approach to recovery from mental health and addiction challenges. By providing a comprehensive range of treatment programs, from inpatient care to outpatient support, we can meet our patients wherever they find themselves on their recovery journey. Contact us today for more information.