What is Dialectical Behavioral Therapy or DBT
Dialectical Behavior Therapy or DBT is an evidence-based form of psychotherapy, more commonly referred to as ‘talk therapy.’ Dialectical behavior therapy is a modified version of cognitive-behavioral therapy (CBT) to help people learn to be more present in the moment, learn coping skills to better manage their emotions and reduce the intensity of their emotions, and learn effective communication skills to cultivate healthy relationships. Dialectical behavior therapy was created by Marsha Linnehan for individuals struggling with Borderline Personality Disorder (BPD). However, DBT has been proven to be effective for multiple mental health diagnoses such as anxiety, depression, obsessive-compulsive disorder (OCD), post traumatic stress disorder (PTSD), substance abuse, and more. DBT treatment involves three different therapeutic techniques, individual therapy, group therapy to learn DBT skills, and twenty-four- seven phone coaching for crisis intervention. These therapeutic techniques place an emphasis on the four different DBT modules of, mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
DBT Therapeutic Techniques
Individual Therapy: Once weekly 45 minute individual sessions allow you to discuss personal
challenges and how to implement the DBT coping skills in your life to manage them effectively. During the sessions, you and the therapist may review a diary card that you filled out during the week to explore your moods, track your negative behaviors, and identify your triggers.
Group Skills Therapy: Once weekly 90 minutes skills group therapy that is structured. Each
week you’ll learn a new skill and be assigned homework to practice that skill during the week
and review in the following group therapy session.
Phone Coaching: Patients can contact their therapist twenty-four-seven when experiencing
overwhelming and intense emotions that are difficult to cope with. Phone coaching is structured and focused on using the DBT coping skills with the therapist to manage your emotions and your current situation.
The Four DBT Modules
Mindfulness: The goal of mindfulness is to help you learn to live in the moment, rather than
living in the past or the future. It’s about being present and aware of your thoughts, feelings, and impulses; as well as being aware and present with what is going on in your external
environment such as what you’re seeing, hearing, smelling, touching, and tasting. Mindfulness skills include wise mind, the WHAT to do to be mindful which includes observing, describing, and participating, and the HOW to be mindful which includes one-mindfulness, non- judgemental, and effectiveness.
Emotion Regulation: The goal of emotion regulation is to learn coping skills that will allow you to manage your emotions by learning how to identify, name the emotion, and change the emotion. By learning how to name and change your emotions you reduce the intensity of the emotion and vulnerability to it. Learning to manage your emotions will enable you to react more appropriately to the emotion. Emotion regulation skills include describing the emotions, check-the-facts, opposite-to-emotion actions, problem-solving, the PLEASE skill (Physical iLlness, Eat three balanced meals, Avoid mind and mood-altering substances, get balanced Sleep, and Exercise daily), and the ABCs of DBT (Accumulating positive experiences, Building mastery, and Coping ahead).
Distress Tolerance: The goal of distress tolerance is to cease or reduce intense overwhelming
emotions to prevent engaging in negative behaviors such as anger outbursts, self-harming
behaviors, and more. These skills help empower you to handle intense and overwhelming
emotions. Distress tolerance skills include STOP (Stop, Take a step back, Observe, Proceed
mindfully), TIPP (Tip the Temperature, Intense exercise, Paced breathing, Paired muscle
relaxation), pros and cons, distract, self-soothe skills, IMPROVE the moment (Imagery, find
Meaning, Prayer, Relaxation, One thing at a moment, Vacation, Encouragement), radical
acceptance, willingness, half-smiling, and willing hands.
Interpersonal Effectiveness: The goal of interpersonal effectiveness is learning and utilizing
communication skills that promote and develop healthy relationships with friends, family,
colleagues, and partners. This module focuses on learning to be assertive with your needs while also learning to listen and respect others' needs and compromise. Interpersonal effectiveness skills include DEARMAN (Describe, Express, Assert, Reinforce, be Mindful, Appear confident, and Negotiate), FAST (Fair, Apologies, Stick to your values, be Truthful), GIVE (Be Gentle, remain Interested, Validate, have an Easy manner), and attend to your relationships.
DBT requires a twice-a-week commitment and completion of weekly homework
assignments in order to receive the most effective treatment. One cycle of DBT takes roughly six months, and it is often encouraged to complete two cycles of DBT as you learn the skills in the first cycle and master the skills in the second cycle. If you’re unsure if DBT treatment is for you, it is recommended to speak with a professional who can educate you on how and why DBT can be helpful in improving your mental health and reaching your goals.