Dialectical Behavior Therapy (DBT)
DBT mixes therapy with mindfulness, promoting acceptance while changing harmful behaviors.
Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy (CBT) developed by Dr. Marsha Linehan in the late 1980s. Originally designed to treat borderline personality disorder (BPD), DBT has since been adapted for other mental health disorders, especially those characterized by severe emotion dysregulation.
DBT teaches people how to manage their emotions, improve their relationships, and handle difficult situations without getting overwhelmed. It combines techniques from cognitive behavioral therapy with concepts of mindfulness and acceptance.
Think of it like having a toolbox of skills to deal with intense feelings and challenging situations in a balanced way.

DBT combines traditional cognitive-behavioral techniques with mindfulness and acceptance strategies. The therapy aims to balance the need for acceptance with the recognition that some behaviors, thoughts, or emotions are maladaptive and require change.

Key Concepts of DBT

  1. Dialectics: The term "dialectical" refers to the process of synthesizing opposites. In DBT, this often means finding a balance between acceptance and change. For instance, a therapist might work with a patient to accept their feelings as they are, while also emphasizing the need for change.
  2. Mindfulness: Inspired by Buddhist meditative practices, mindfulness in DBT involves being fully present and living in the moment. This skill helps individuals become more aware of their thoughts and feelings without judgment.
  3. Emotion Regulation: DBT helps individuals recognize and cope with intense and unstable emotions. It provides strategies to reduce vulnerability to emotion dysregulation.
  4. Distress Tolerance: This focuses on managing and surviving crises and accepting life as it is, even when situations are difficult or painful.
  5. Interpersonal Effectiveness: This involves skills to ask for what one needs, set boundaries, and cope with interpersonal conflict.

Structure of DBT

DBT typically consists of individual therapy, group skills training, and phone coaching. Therapists also participate in a consultation team to support their work.
  1. Individual Therapy: Weekly sessions where the therapist and patient discuss issues that come up in daily life and apply DBT skills to these issues.
  2. Group Skills Training: Typically done in a group setting, participants learn and practice DBT skills alongside others. Groups are led by a trained therapist.
  3. Phone Coaching: Allows patients to call their therapist during crises to receive in-the-moment coaching on how to handle situations using their DBT skills.
  4. Therapist Consultation Team: Therapists consult with a team of their peers to ensure they are providing effective and compassionate care and to receive support themselves.