Dialectical Behavior Therapy (DBT)
For children and adult emotion dysregulation, BPD, self-harm, depression, and addiction
Introduction
Dialectical Behavior Therapy (DBT) is a comprehensive and evidence-based therapeutic approach that was initially developed by Dr. Marsha M. Linehan in the late 1980s. DBT was initially designed to treat individuals struggling with Borderline Personality Disorder (BPD), but it has since been adapted for various other mental health conditions, making it applicable to a broader range of individuals.
Underlying Theory
The foundation of DBT lies in its synthesis of cognitive-behavioral therapy techniques with principles of dialectics. Dialectics is the philosophical concept that emphasizes the integration of opposites to form a synthesis, and in the context of DBT, it refers to finding a balance between acceptance and change. This therapeutic approach is particularly effective for individuals experiencing emotional dysregulation, self-destructive behaviors, and difficulties in interpersonal relationships.
What happens in an DBT session?
DBT is structured around four primary skill modules, which are mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These modules are designed to teach individuals essential skills for managing their emotions, improving interpersonal relationships, and navigating challenging situations. Mindfulness, a core component of DBT, encourages individuals to cultivate awareness of the present moment without judgment, fostering a non-reactive and accepting mindset.
How does it help?
Therapists implementing DBT typically use a combination of individual therapy sessions, group skills training, phone coaching, and consultation teams. Individual therapy focuses on helping clients apply DBT skills to their unique situations, while group skills training provides a supportive environment for learning and practicing the skills. Phone coaching allows individuals to receive real-time guidance during challenging moments, and consultation teams provide support and supervision for therapists delivering DBT.
What can DBT treat?
While DBT was originally developed for adults with BPD, its effectiveness has been demonstrated in treating various mental health disorders. DBT has been successfully applied to conditions such as depression, anxiety disorders, eating disorders, substance use disorders, and attention-deficit/hyperactivity disorder (ADHD), among others. In recent years, adaptations of DBT have also been developed specifically for children and adolescents, emphasizing age-appropriate language and examples.
In the case of children and adolescents, the principles of DBT are often adapted to suit their developmental needs. The skills training may be modified to be more engaging for younger individuals, and the therapeutic process may involve collaboration with parents or caregivers.
Q&A:
Why would it benefit me?
DBT can be beneficial for individuals struggling with emotional dysregulation, interpersonal difficulties, and self-destructive behaviors. It equips individuals with practical skills to cope with intense emotions, navigate challenging situations, and build healthier relationships. The emphasis on acceptance and change makes DBT a versatile approach suitable for a variety of mental health conditions.
How many sessions should I expect to see differences?
The duration of DBT can vary depending on individual needs and the severity of the presenting issues. Positive changes often take time, and progress is typically measured over several months. Consistency and active participation in both individual and group sessions contribute to the effectiveness of DBT.
Can I get it from telehealth?
Yes, DBT can be delivered through telehealth platforms. Many therapists and mental health professionals have adapted their practices to provide remote services, allowing individuals to access DBT from the comfort of their homes. Telehealth sessions can be as effective as in-person sessions, providing a convenient option for those who may face barriers to in-person care.
Our DBT Therapists
References:
Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.
Linehan, M. M. (2014). DBT skills training manual (2nd ed.). Guilford Press.
Linehan, M. M., & Wilks, C. R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69(2), 97-110.
Rathus, J. H., & Miller, A. L. (2014). Dialectical behavior therapy adapted for suicidal adolescents. Suicide and Life-Threatening Behavior, 44(1), 13-27.
Swales, M. A., Heard, H. L., & Williams, J. M. G. (2000). Linehan's dialectical behavior therapy for borderline personality disorder: A tale of two adaptations. Behavioural and Cognitive Psychotherapy, 28(02), 221-229.
Neacsiu, A. D., Rizvi, S. L., & Linehan, M. M. (2010). Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48(9), 832-839.