Dialectical Behavioral Therapy (DBT)

Over the past decade or so, dialectical behavioral therapy (DBT) has grown from a little-known and poorly studied treatment modality to one of the most popular and effective mental health treatments in the world. Many rehab facilities offer DBT, and some of the most effective psychotherapeutic approaches incorporate elements of this potentially life-saving treatment.

What is Dialectical Behavioral Therapy?

Dialectical behavioral therapy was original developed by Marsha Linehan to help people cope with borderline personality disorder (BPD). Borderline personality disorder is a challenging mental illness that interferes with its sufferers' ability to regulate their emotions, cope with distress, tolerate abandonment, and avoid manipulating others. Prior to DBT, many people with BPD spent a lifetime pursuing treatments that didn't work, so DBT was a serious game changer.

In recent years, therapists have begun using DBT to treat other conditions, including depression, anxiety, and some personality disorders. Research suggests that this treatment can be highly effective, especially with people who have difficulties with impulse control and managing strong emotions.

How Does DBT Work?

So how does DBT work? One of its many strengths is that it is extremely formulaic, making it relatively easy to track progress and ensure DBT is done correctly. The therapist endeavors to offer therapy in a validating, judgment-free context so that the patient feels free to express herself. From there, DBT is broken into four distinct components:

Individual therapy, which occurs at least once per week. Through individual counseling, therapists work to target self-injury. From there, the team targets behaviors that interfere with therapy, such as lying or skipping sessions. And then finally, therapy focuses on improving quality of life using specific exercises to promote distress tolerance, encourage self-soothing, and teach healthy emotional and social skills.
Group therapy, which usually occurs once or twice a week. During group therapy, which usually lasts several hours, group members discuss and work to cultivate four key skills: mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance.
Therapist consultation - Because working with people in DBT is exhausting and challenging work, most DBT therapists meet with other DBT therapists to discuss their work and solicit feedback at least once per week.
As-needed coaching. This coaching usually occurs over the phone, but in the context of rehab may take place in person. Brief coaching sessions help patients implement skills specific to common challenges. For example, a woman struggling with a breakup may seek phone coaching when she's tempted to harm herself in an attempt to regain the attention of her former lover.

DBT is similar to other mindfulness-based treatments in that it focuses on noticing and neutrally analyzing emotions, then re-framing them. For instance, a man who feels suicidal because of a breakup would be encouraged to notice these feelings, explore why he might be experiencing them, and then consider better ways to cope with his distress.

Is Dialectical Behavioral Therapy Right for Me?

Dialectical behavioral therapy has been carefully studied, and thousands of patients have seen incredible results with this approach - even when other treatments have failed. Like all treatments, though, DBT is not for everyone. DBT works best for people who struggle with emotion management and social skills. This means that it's not your diagnosis that matters, but the way the diagnosis matters in your life. One person with depression may primarily struggle with sadness, making her a poor candidate for DBT. But a person whose depression causes him to lash out at others, desperately seek emotional support, or lie might be well-suited to DBT.

If you're not sure whether DBT Is right for you, talk to your therapist and consider blending DBT with other treatment options. Even if DBT doesn't work for you, though, the good news is that it's completely safe so will not set your recovery back.

Choosing a Dialectical Behavioral Therapist

If you pursue DBT in rehab, be sure to request a therapist who has specifically trained in DBT. As DBT increases in popularity, so too will the number of therapists who use DBT without ever formally training in this methodology. If you're seeking a therapist on your own, though, be sure to ask plenty of questions, since good therapists will be happy to answer your questions. Some questions to get you started include:

What specific training do you have in DBT?
How long have you practiced? How long have you offered DBT?
Do you use purely DBT, or do you blend DBT with other methods?
Am I a good candidate for DBT?
If DBT doesn't work, what will we try next?
How can I track my progress?
How often will I need to come to therapy?
Do you develop a personalized treatment plan for each patient, and what can I expect from treatment?
Are you licensed to practice? In what state?
Have you ever been disciplined by an oversight board?

Remember, therapy is designed to help you get results as quickly as possible, so stick with it and you may be surprised by the improvements you experience. If you don't see improvements, though, don't be afraid to pursue a different approach or try a new therapist. Northpoint Recovery provides quality drug treatment in Idaho. Call us for a free addiction assessment today.

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