What Can Dialectical Behavioral Therapy Do For You?
Updated December 02, 2019
Reviewer Karen Devlin, LPC
What Is DBT?
DBT is a form of mental health treatment that is used for people who have personality disorders or suffer from behaviors that they don't want to have, such as suicidal thoughts. The treatment gives the client many skills to help them cope, such as being mindful, regulating their emotions, and teaches people to live a better life.
In case of you were wondering, dialectical is when opposites are integrated. What one of the opposites DBT will tackle is change and acceptance. A therapist will accept the client for the person they are, but will also tell them that their behavior should change. The theme of opposites is quite prevalent in DBT, as we'll soon be discussing.
DBT is rooted in cognitive behavioral therapy (CBT), and psychology research Marsha Linehan developed it. It was developed in the late 1980s, so it's still quite new compared to some other forms of psychological treatment. People with a borderline personality disorder were DBT's original target demographic, but it's also been shown to treat other disorders, too.
Dr. Linehan was using CBT to treat her clients, and many of the elements of CBT are the same as what you can find in DBT. However, CBT focused too much on changing the client, and this turned off many clients for wanting to continue. The clients felt like their emotional needs were being ignored, and the therapist was ignoring their suffering while being too confident with their treatments. Clients would quit treatment altogether.
Upon realizing this, Lineham noticed that the clients stayed whenever their emotional needs were being fulfilled. These involved strategies to help the clients tolerate their emotions, as well as techniques to help them live a better life. Soon, the clients felt like the therapists could empathize better with them, and they kept doing the treatment. This led to CBT turning into DBT, which focused more on helping the client's emotions before teaching them skills on how to change their lives.
What Can It Treat?
DBT is shown to treat quite a few mental disorders, including:
- Eating disorders
- Suicidal thoughts
- Borderline personality disorder. It's one of the most effective treatments for BPD.
As you can see, it targets mostly the undesirable behaviors or thoughts we have. If you have any of these, talk to a therapist and see if DBT is right for you. It isn't a cure, but it can help you cope and reduce the effects of your disorder.
What Is DBT About?
With any form of therapy, there are many components, principles, and terms that DBT uses. It's a treatment that requires input from the client as well. While goals may vary, the main goal of DBT is to take undesirable behaviors and thoughts and replace them with better ones.
DBT has five components.
Component 1: Capability Enhancement
We all have our capabilities, and DBT is set to make them grow by teaching skills to modify their behavior. When you go to skills training, it's almost like you're in a class. You may be in a group, and you may get "homework" for you to do. The homework consists of practicing what you've learned. If you encounter a situation where you can use that skill, then all the better. The sessions are weekly, and they last for about 2-3 hours. It may take about five months for you to use all your skills. However, some classes aren't as long, so talk to your therapist if you can't handle a typical class.
There are five main skills to learn:
- Emotion Regulation: this teaches you how you can be aware and take control of your emotions whenever an undesirable one pops up.
- Mindfulness: perhaps the most well-known skill. Mindfulness teaches people how to be aware of the present. Most people lack self-awareness, and mindfulness can have many benefits.
- Distress tolerance: When you're faced with a tough problem, distress tolerance can teach you how to survive it.
- Interpersonal effectiveness: It's hard to say no, or ask someone for a favor. Interpersonal effectiveness teaches you to do both and still be respectful.
Component 2: Motivation Enhancement
Individual therapy is used when enhancing motivation. Many of these skills need the drive to use them, but most clients lack that motivation. This is where component 2 comes in.
Component 3: Coaching
DBT therapists will talk to you on the phone and support their clients when they have a tough situation. Sometimes, a client needs a refresher or motivator outside of therapy, and the good thing about DBT is that the therapists are just a phone call away.
Component 4: Case Management
However, there comes a time when the client needs to manage their problems on their own. Case management teaches the client how to handle their problems, and the therapist will consult them only in an emergency.
Component 5: Supporting The Supporters
There is also a consultation team for DBT therapists. Sometimes, a therapist will have a client who is difficult to treat, and the consultation team provides therapy for their therapists by keeping them motivated and teaching them skills the therapist can use. Sometimes, even your therapist needs a therapist. They usually meet every week and practice their skills, such as mindfulness. Then, there is a client review.
This almost adds some extra peace of mind to the client when deciding to take DBT. If the therapists are using their techniques to support themselves, then it must be effective.
The Priorities Of DBT
When a client goes to get therapy, they rarely have one problem. Instead, they'll have multiple problems that require treatment. For a therapist, they can't just choose a random problem and treatment. They have to organize, and DBT therapists have their list of problems to treat.
Obviously, problems that can have a risk of death to the client are their first target. Suicidal thoughts and self-harm are such examples. Giving the client the will to live can help their other treatments go smoothly.
Then, they target behaviors that may stop the treatment from going smoothly. If the client keeps canceling for no good reason, that behavior needs to stop. If the client won't cooperate, then the therapist needs to figure out why.
Then, they look at behaviors that can affect the client's life quality. These problems can range from mental disorders, bad behaviors, or personal problems such as finances or children.
Finally, the therapist will teach valuable life skills to the client that they can use to live a great life.
How Treatment Works
With any therapy, there are stages the client goes through. There are four stages in this case, and there is no time limit. Depending on the client, these stages may be shorter or longer.
Stage 1 - This stage is trying to help the client learn how to control their behaviors. When they come in, they are likely riddled with behaviors they can't keep under control, and this can be problematic when trying to treat the client.
Stage 2 - This involves making the client want to have a great emotional experience. They may have some control over their behaviors, but their emotions are still not under control. This especially applies to patients with PTSD or another behavior that threatens emotions.
Stage 3 - The client, lists goals they may have learned how to have better self-esteem and finds their happiness. This involves emotional regulations, usually.
Stage 4 - This stage involves the client trying to find a deeper meaning to their life. This can be a spiritual meaning or just a way to help them be more connected to the world around them. This will obviously depend on the client's current behavior, and it may be optional.
The fact that the DBT therapists rely on their therapy should be proof that it has to be somewhat effective. Clients who applied DBT to their lives found that they were less suicidal, less likely to self-harm, more reliable with scheduling, less likely to abuse substances, and had an overall better quality of life.
If you're experiencing suicidal thoughts or self-harm, you need to talk to a professional immediately. Otherwise, if you just want to modify an undesirable behavior, learn how to be more mindful of the world around you, and need assistance on reaching your goals, then DBT is quite an effective method for you.
Talk to a counselor today to see if DBT can work. There are many good counselors waiting for you. Just remember that you have to work to make it work. You need to be on time for your appointments, stay in contact with your therapist on a regular basis, and apply the skills to your daily life. DBT is highly effective, but you need to put in participation as well. Therapists can't wave a wand and treat you. Instead, they teach you how to be on the right path to living a better life.