Dialectical Behavioral Therapy (DBT)
Depression, anxiety, anger, and feelings of anger are part of the everyday experiences of people. Do you or a family member, friend, or roommate appear to get angry, jealous, or envious, or to be anxious, fearful, or rejected faster, more often, or more deeply than others? This behavior is referred to as emotional dysregulation and is characteristic of many mental health disorders, especially BPD. From the different treatments provided, the most useful treatment for this disease is dialectical therapy, which is also helpful in tackling other problems. Explaining what DBT is and how dialectical behavior therapy steps are used and the patient population likely to benefit from the approach.
What is Dialectical Behavior Therapy?
It is a kind of talk therapy that can help you unlearn the imperative of self-criticism, even mistreatment. At the same time, you will focus on eliminating negative, unhealthy behaviors that are counterproductive in your life. This kind of therapy has, however, been in existence since the 1970s, when it was developed by a prominent American psychologist. If you have trouble dealing with your feelings or keeping bad, undesirable, or self-destructive behaviors in check, then DBT could be for you.
How does Dialectical Behavior Therapy work?
DBT is oriented to emotions and how they fuel non-adaptive behavior schemes. Several aspects of therapy are focused on the patient’s ability to correctly identify, describe, and control the emotions. It also helps in managing interactions that lead to the experience of negative or painful feelings. Patients fill out a diary "card” in the individual psychotherapy sessions, often through an app. Self-monitoring is a form that pertains to mood, behavior, and skills that are personal treatment plan goals. Patients have to write about the emotions they feel daily. They also have to write which among these emotions, including fear, shame, sadness, anger, pain, suicide attempts, and others, is intense. The patient can provide additional information about the identified experiences. Through a checklist of skills, which also works as the memory of their application by patients, patients indicate the rate of their positive behaviors, such as self-comforting and practicing radical acceptance, lowering one’s emotional exposure, and behaving in ways that are opposite to what one may feel. The information written in the diary card tells the therapist how to time the sessions. Life-threatening or self-injurious behavior has absoluteness, not surprisingly. In the context of the patient and subsequent behavioral targets for a session, the therapist assists in the identification of behavioral analysis as to what has led to a certain problem situation the patient was in. This also includes potential beliefs or attitudes that covertly endorse the behavior, as well as looking at the potential outcomes of the patient’s actions. The therapist and the patient identify better strategies of handling emotional and life issues.
What Conditions Does Dialectical Behavioral Therapy Treat?
- Anxiety & Depression: The method you learn in DBT is about recognizing the bad patterns of thinking and then altering them. It also enables you to concentrate on the positive activity that is required to sustain good health.
- Substance Abuse: Some of the ways DBT assists are helping you minimize cravings, avoid situations that would favour substance use, and the elderly come up with positive ways of handling stress.
- Self-Harm: DBT, for example, has strategies for handling the urge to self-harm and ways of avoiding such behaviors.
- Borderline Personality Disorder (BPD): DBT is useful in reducing increased levels of emotions and being more patient in situations with high stress indicators and other related stimuli. It also assists with regards to other concern behaviors such as problematic relating, self-harming behaviors, and impulsiveness.
- Eating Disorders: The most important helpful skills of DBT are for sorting out bulimia, anorexia and binge eating by focusing on the distress tolerance and the management of the emotions.
- Post-Traumatic Stress Disorder (PTSD): DBT has been useful in structuring assimilation of traumatic events and in helping clients with dialectical behavior therapy techniques to minimize the intensity of Post-Traumatic Stress Disorder (PTSD).
- Anger Management: DBT assists you in identifying triggers and also teaches ways on how to decrease emotion without acting in anger.
Integrating DBT into Our Therapeutic Approach
When DBT is used in conjunction with other treatments, the client gets a more comprehensive utilization of therapeutic services, given that all aspects of the mental health disorder are considered. Here, for the rehabilitation of the patient, more dialectical behavior therapy techniques are used.
Cognitive Behavioural Therapy It should also be noted that although DBT is a transmutation of CBT, incorporating classical CBT strategies can consolidate the effects of the cognitive restructuring part of the therapy. CBT is about changing negative cognitions, and this can cooperate well with DBT, which targets skills of managing emotions and being mindful.
Medication Management In the present study, medication may be regarded as a tool that can help many people with mental disorders to alleviate symptoms. This approach guarantees that the patient gets a complete treatment package that impacts the psychological as well as the biological aspects of the disease.
Acceptance and commitment therapy Acceptance and commitment therapy (ACT) bears some resemblance to DBT in as much as ACT also has some roots in Baer’s third wave of CBT, especially mindfulness and acceptance. An integration of DBT with ACT can improve the outcomes by focusing on the patient’s willingness and choice to change behavioral and cognitive patterns, which are also important to their emotional and psychological health.
Interpersonal Therapy Incorporation with the interpersonal therapy effectiveness training of DBT can enable the patients to strengthen their relations with other individuals and therefore enhance the level of social support they receive.
Trauma-focused Therapies For patients with PTSD or trauma history, the integration of DBT with other trauma-informed treatments, including EMDR or trauma-focused CBT, may be especially helpful. These therapies target the effects of the trauma, whereas DBT deals with the effects on emotional wellbeing and distress.
Family Therapy Family therapy can be helpful when used as a supplement to DBT, especially for adolescents and people whose family environment influences their wellbeing. This therapy is responsible for treating families and resolving their issues. These issues include various communication gaps and conflicts within family members.
Art and Expressive Therapies It can be combined with other forms of treatment, such as art therapy and other types of creative therapies, so that the patient can communicate in other ways other than in words. These therapies can improve on the aspect of mindfulness and emotional regulation since patients are encouraged to be artistic in their ways as they reflect on themselves.
Strategies used in dialectical behavior therapy
There are different strategies used in dialectical behavior therapy, and these are given as follows:
Core Mindfulness
Whereas mindfulness is designed to take practice in order to be aware and give attention to the things happening at the current time. Some DBT skills to practice mindfulness include:
- Look at these thoughts, feelings, and bodily experiences as passing observations without comment.
- Stretching exercises can take you into another world apart from your own stressful place.
- Practicing kindness and self-compassion during the practice of mindful meditation.
Distress Tolerance
Sometimes, when individuals experience these feelings, they may try to manage. They also try to get rid of them or at least the distress associated with them in some way or form that makes them feel so better in the process.
DBT skills to improve distress tolerance include:
- Distraction: Averting one’s mind from negative cognition and affecting Scientology.
- Radical acceptance: This acceptance of change can be well explained in the medical field by the saying, “You can change what you can change and let go of what you cannot change.”
- Self-soothing strategies: Taking a moment to calm and refresh yourself to activities you can do with five organs of sensation
- Safe-place visualization: They are thinking of a safe place with no violence, such as a beach or a mountainous region.
- Spirituality: One should empower themselves through that feeling of spirituality of their own self.
Interpersonal Effectiveness
Interpersonal effectiveness is all about making those relationships working within an individual or between the existence of two or more people better.
Some DBT interpersonal effectiveness skills include:
- Empathic concern for determining other's concrete cognitions and affective-emotive experiences
- Substituting assertive behavior for what can be described as passive aggressive behavior
- Asking for what you want in simple terms and at the same time guarding your relationships
- It is about active listening rather than passive listening.
Emotion Regulations
Some people have feelings that are out of their control, as they may have some past trauma or if they feel threatened or abandoned. This is known as emotional dysregulation. Some DBT emotion regulation skills include:
- Recognizing your emotions.
- Acknowledging how thinking patterns and behavioral patterns affect emotions.
- Recognizing self-destructive behaviors.
- Increasing positive emotions.
Stages of DBT
There are four stages of dialectical behavior therapy normally, and each of them has certain skills and objectives.
Stage 1: Foundational DBT Skills This stage is concerned with the acquisition of skills required in handling anger, working on relationships, and overcoming impulsiveness. These skills include mindfulness, full acceptance, distress tolerance, emotion regulation, and other interpersonal effectiveness. The work done in stage 1 is to enable a systematic foundation for further development work in the latter stages.
Stage 2: Addressing the Issue This stage aims at treating various matters, such as trauma, which may have led to emotional dysregulation. From the stage 1 skills, more complex and intense situations are addressed with new skills focused on trauma and other related problems.
Stage 3: Greater Sense of Self-Respect The primary aim of this stage is to establish the improvement of self-respect and self-esteem as well as enhance the aspect of self-identity. In this stage, understanding of self-awareness, self-acceptance, and self-validation, which are acquired from the previous stages, is improved through practical application of the skills.
Stage 4: Meaning & Purpose Here you have to stay focused on finding the true meaning of life and spirituality. The knowledge gained from the previous stages is applied to build a better understanding of the mission, fulfill it, and search for ways to make a change in the world.
Goals of DBT
Group skills training, individual psychotherapy, and phone coaching all of them are included in DBT characteristics.
- Acceptance and change: It is often called ‘learning acceptance skills’ for that reason, as you will discover how to accept life situations, moods, and yourself. You also learn skills that enable you to change certain behaviors believed to be negative within you and those you have, as well as the people you interact with.
- Behavioral: It’s used to evaluate problems or over-destructive behavior and develop ways of healthy and constructive behavior.
- Cognitive: You will only work on the negative thought patterns that are maladaptive or non-beneficial.
- Collaboration: You will understand how to share information and collaborate interprofessionally with a therapist, a group therapist, and a psychiatrist.
- Skill sets: This will be an opportunity to acquire new skills to improve the firm’s capacity.
- Support: To this end, you will be motivated to embrace positive aspects and character features and cultivate as well as deploy them.
Benefits of DBT
Under DBT, the patients decide how to harmonize acceptance with change in order to achieve the desired change in the patient under treatment. One of these ways is the validation process, which makes people tend to be more likely to cooperate and rather not to have distress feelings at the prospect of change. Thus, the therapist will not dispute that a particular behavior of an individual is justified as a response to a given situation or problem, and that is not the same thing as saying that the behavior is the right thing to do.
Techniques of DBT
They comprise three modes of dialectical behavior therapy techniques that are employed while imparting these four DBT skills, as explained below. For some, it is believed that this blend of techniques makes DBT one of the most effective treatment genres.
One on One Typically, it takes one hour per week for each patient to have one-on-one sessions with the DBT therapist. Your therapist will also spend this time increasing your competency and helping you to manage certain issues.
Skills Training DBT has a skills training group, and most skill groups convene weekly. For about two to three hours, these sessions last. The common meeting duration is 24 weeks. However, several DBT programs provide skills training in cycles; the programs therefore take one full year. In your skills group, you will discover what every skill is and how it works, and then discuss with other people in your skills group how you would get around that problem. In the employment of DBT, this is one of the major strategies that are being used.
Phone Coaching In addition to your individual therapy sessions, some therapists also conduct telephonic counseling to help you through the other days. This would be good to have on standby if one feels stressed or just wants some assistance at some point. In DBT, your therapist will instruct you over the phone how to solve the current problem using your DBT skills.