DBT, known as Dialectical Behavior Therapy is an extension of cognitive-behavioral therapy. It aims to treat people with Borderline Personality Disorder(BPD), excessive stress, and other mental conditions.
It can also help people who have problems with regulating emotions, substance use disorders, eating disorders, and (PTSD) post-traumatic stress disorder.
Developed by Dr. Marsha Linehan in the 1980s, it was an addition to cognitive-behavioral therapy. It incorporates a process of Dialectics, which is philosophical in nature. The concept of Dialectics is that everything is composed of opposite forces and change will occur when there is ‘dialogue’ between those forces.
In academic words, dialectics is a thesis, synthesis, and antithesis based on 3 assumptions:
- All the things are connected
- Change is constant and is inevitable.
- We can integrate opposites and form a better approximation of the truth.
In the process, the therapist and the patient work together to solve the contradiction that happens between self-acceptance and change. There is another technique called validation. Use validation along with accepting change and patients will be at ease to cooperate and suffer less. The therapist shall validate the patient that his actions are making sense relating to their personal experience.
A standard DBT has 4 parts:
- Individual therapies
- Training for group skills
- For crisis situation, phone coaching is done
- A consultation group is made for health care providers. It helps them to remain motivated and have discussions.
How DBT works?
Over time DBT has become an evidence-based approach. It is used in 3 settings.
- Group settings – In this setting, patients complete homework and do roleplay of ways to interact with other people to learn behavioral skills.
- Individual therapy – The patients are treated by a trained therapist. Patients learn to adapt their new learned behavior skills to personal life changes.
- Phone coaching – The patients can call their therapist for guidance to cope with any critical situations they are dealing with.
Consultation teams also meet with the therapists to discuss the progress, difficulties, and demands of their patients.
Every setting has its own goals to achieve, but there are common characteristics of DBT in each set:
- Change and acceptance – patients learn to accept the changes around them, get better with the interaction processes.
- Behavioral – Patients learn to analyze their problems themselves and find the solution for it.
- Cognition – Learn to focus on changing behaviors, thoughts, actions that are not helpful.
- Collaboration – Learn team spirit and communication.
- Skillset – learning new skills to improve capabilities.
- Support – Learn to recognize strengths and positive attributes and how to use them.
There are four DBT strategies but one of the most important strategies is mindfulness.
Patients are helped to develop mindful skills. It helps them to live in the moment. It also helps them to understand themselves, their mind, their inner-self. Along with the mind, they learn to use their senses to understand what’s happening around them and not judge it.
They eventually slow down and increase focus by using coping skills. It helps you stay away from negative thoughts and impulsive behaviors.
Other strategies are distressing tolerance, interpersonal effectiveness, and emotional regulations and they all come with several exercises like running down the stairs, walking, focusing on the breath, etc. each step involves validation that helps them improve their thinking.