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How Dialectical Behavior Therapy (DBT) Works

Dialectical behavior therapy, How Dialectical Behavior Therapy (DBT) Works

Many people don’t realize that not all therapy is the same. Dialectical behavior therapy (DBT) is a form of talk therapy that has been around since the 1970s. DBT is often used to help people who struggle to manage difficult emotions or who engage in harmful or unhealthy behaviors. DBT is one way Highland Hospital Behavioral Health in Charleston, West Virginia, teaches patients new coping strategies and problem-solving skills.

CBT versus DBT

Many people are familiar with cognitive behavioral therapy (CBT), which is focused on identifying thinking flaws and unhealthy behaviors and considers how a person’s past contributed to these. DBT grew out of CBT, so the two share many similarities, but DBT has more of a present or future focus, with emphasis on a client’s current ability to regulate difficult emotions and utilize their interpersonal relationship skills.

Another difference between CBT and DBT is that how a practitioner administers CBT can shift considerably based on the client’s specific needs and concerns. DBT does not tend to change as much based on the client’s condition.

What is Dialectical?

The word dialectical means that two different ideas can be true at the same time. For example, someone can be doing their best to manage their mental health and also be capable of learning additional coping skills so that they can do better in the future. Recognizing that two seemingly opposed ideas can both be true is referred to as the middle path, and it can sometimes make it easier for people to make important changes in their lives. It can help people to learn to think, not just in black-and-white terms, but also in varying shades of gray.

Conditions DBT Can Treat

DBT has been shown to be effective with adolescents, adults, and seniors. Anyone can utilize the skills taught in DBT, but the people who find DBT most helpful are those who experience large emotions more quickly, frequently, and intensely than others. Many mental health conditions fall into this category. DBT can be offered in individual or group sessions and is used to treat a variety of mental health concerns, some of which include:

Is DBT Right for Me?

If you aren’t sure if you could benefit from DBT, it may help to ask yourself if some of what you would like to address includes:

  • Difficulty with intense emotions or maintaining relationships
  • Self-sabotaging behaviors
  • Feeling like you mess everything up
  • Addiction-like behaviors
  • A constant sense of shame

DBT Skills

The skills that are taught in DBT are generally broken down into four areas:

  • Mindfulness – Helps people to stay focused on what is happening in the current moment without judging it. Also helps with attention and focus. 
  • Distress tolerance – Helps people cope with distress and pain. By recognizing that no one can completely avoid stress and pain, it becomes possible to tolerate discomfort.
  • Interpersonal effectiveness – Helps people know how to interact with others in social situations, deal with conflict, and build and maintain relationships.
  • Emotional regulation – Helps people to better understand and control their emotions.

These skills can be taught in individual or group therapy sessions and are often assigned as homework to encourage people to develop and practice their skills between sessions and identify areas they want to work on at the next session. 

Duration of DBT and Its Outcomes

The amount of time it takes a person to complete an entire DBT program depends on that person’s treatment goals and how well they respond to therapy. A year is commonly recommended. Often, the four DBT skills are broken into modules that each take multiple weeks to complete.

Some of the positive results that have been documented from DBT include:

  • Less frequent and less severe suicidal thoughts
  • Shorter hospitalizations
  • Decreased anger
  • Increased ability to form and maintain relationships
  • Decreased self-harm behaviors

At Highland Hospital Behavioral Health, we utilize DBT as one of many tools to support our patients along their mental health and/or substance use recovery journey. Our services are available to children, adolescents and adults.

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