Author: Stephanie Camins – MA, LPC
Facts to know about Dialectical Behavioral Therapy (DBT)
- Created in the early 1990’s as another version of Cognitive Behavioral Therapy
- Originally created for women to treat symptoms of Borderline Personality Disorder
- Can also treat depression and anxiety in adults
- Useful to treat adults with depression who also suffer from co-morbid personality disorders
- DBT has proven to have a lower dropout rate than regular psychotherapy
- Patients treated with DBT have shown signs of reduced depression, anxiety, irritability, anger, and impulsivity, along with a reduction in suicidal actions or ideations and self-harm behaviors (Solar, et al., 2009)
- Overall life satisfaction can improve if DBT is effectively utilized
Why is DBT so Effective?
Many people with mood disorders or personality disorders can’t regulate their arousal levels. Their nervous systems become over aroused easily and it is very difficult for them to calm down once they are activated. They experience extreme swings in their emotional states. DBT uses 4 areas of skill building to regulate thoughts, feelings and actions.
DBT has the same components of cognitive behavioral therapy which help clients identify and correct negative beliefs and assumptions about self and others. Clients work closely with the therapist to solve relationship problems, complete homework, role play better interaction solutions and practice self-soothing techniques. Through this therapy process, individuals learn to identify their strengths and build on them.
Why 4 is a Special Number for DBT
DBT is split up into 4 different types of services: For the more intense needs all four services are recommended in conjunction. Some facilities offer the full DBT program. For skill building in relationships and mood symptoms, weekly therapy sessions and occasional phone consults are more cost effective and convenient.
- 1 hour of weekly of individual therapy
- 2.5 hours of weekly group skills therapy
- Telephone consultations as needed for additional support outside therapy sessions
- Therapy consultations for the therapist in order for them to be the best support possible for their clients
The skill building therapy follows 4 modules:
- Core mindfulness skills teaches awareness, presence, focus and acceptance
- Interpersonal effectiveness – teaches interaction skills with the people around you and in your personal relationships. These include, assertiveness, problem solving, personal boundaries and conflict resolutions.
- Emotion regulation techniques – involves properly identifying emotional states. If you find yourself over activated, these techniques teach you to lower your arousal. It is important to identify obstacles you may be experiencing in shifting your emotional states. These skills help to increase focus on positive events and decrease focus on negative events.
- Distress tolerance skills – help to lower impulsive behaviors by increasing the ability to tolerate emotional upheavals. Four strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons and acceptance skills. (Stepp, Epler, & Seungmin, 2008, p.4)
Solar, J., et al. (2009) Dialectical behavior therapy skills training compared to stand group therapy in borderline personality disorder: A 3-month randomized controlled clinical trial. Behaviour Research and Therapy, (47), 353-358.
Stepp, S.D., Epler, A., Seungmin, J., &Trull, T.J. (2008) The effect of dialectical behavior therapy skills use on personality disorder features. Journal of Personality Disorders, 22 (6), 549-563.