Dialectical Behavior Therapy (DBT)
Dialectical behavioral therapy (DBT) is a type of cognitive-behavioral therapy. Cognitive-behavioral therapy tries to identify and change negative thinking patterns and pushes for positive behavioral changes. DBT may be used to treat suicidal and other self-destructive behaviors. It teaches patients skills to cope with, and change, unhealthy behaviors. In addition, researchers are investigating whether DBT may be effective in treating these conditions: mood disorders, binge eating, ADHD, and posttraumatic stress disorder.
Standard comprehensive DBT has four parts:
- Individual therapy
- Group skills training
- Phone coaching, if needed for crises between sessions
- Consultation group for health care providers to stay motivated and discuss patient care
Patients agree to do homework to practice new skills. This includes filling out daily “diary cards” to track more than 40 emotions, urges, behaviors, and skills, such as lying, self-injury, or self-respect.
What to Expect
DBT treatment typically consists of individual therapy sessions and DBT skills groups. Individual therapy sessions consist of one-on-one contact with a trained therapist, ensuring that all therapeutic needs are being addressed. The individual therapist will help the patient stay motivated, apply the DBT skills within daily life, and address obstacles that might arise over the course of treatment.
DBT skills group participants learn and practice skills alongside others. Members of the group are encouraged to share their experiences and provide mutual support. Groups are led by one trained therapist teaching skills and leading exercises. The group members are then assigned homework, such as practicing mindfulness exercises. Each group session lasts approximately two hours, and groups typically meet weekly for six months. Groups can be shorter or longer, depending on the needs of the group members. DBT can be delivered by therapists in many ways. For instance, some people complete the one-on-one therapy sessions without attending the weekly skills group. Others might choose the group without regular one-on-one sessions.
How It Works
DBT is a cognitive-behavioral treatment developed by Marsha Linehan, Ph.D., in the 1980s to treat people with a borderline personality disorder. Those diagnosed with BPD often experience extremely intense negative emotions that are difficult to manage. These intense and seemingly uncontrollable negative emotions are often experienced when the individual is interacting with others—friends, romantic partners, family members. People with borderline often experience a great deal of conflict in their relationships.
As its name suggests, DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.
Although some addicts do recognize the problems their addiction has created and seek treatment and recovery on their own, this is not the case with everyone.
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