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The complete guide to dialectical behaviour therapy

People who use dialectical behaviour therapy find it easier to control and accept their emotions. It is based on cognitive behavioural concepts and emphasises acceptance and problem solutions.

In the 1990s, dialectical behavioural treatment (DBT) was developed to treat borderline personality disorder (BPD) and suicidal tendencies. It is being used by mental health specialists to address a variety of complex diseases and problems.

This page examines DBT, including how it functions and the conditions it can address.

Dialectical behaviour therapy
Dialectical behaviour therapy

Definition

DBT is a flexible kind of psychotherapy that incorporates components of behaviour therapy, cognitive behaviour therapy (CBT), and mindfulness, according to the American Psychological Association (APA).

Combining two diametrically opposed viewpoints is referred to as “dialectical.”

Accepting the truth of a person’s life and behaviour is the first of these concepts.

The second competing viewpoint is that dysfunctional behaviours and settings should be changed.

Stage-based therapy, such as DBT, requires going through particular stages. These stages, according to specialists, are as follows:

Stage 1

During this phase, persons are stabilised and assisted in regaining control over their actions. Crisis intervention and keeping patients away from self-harm, suicide, or addiction problems are key components of stage 1 therapy.

Stage 2

People will work on their emotional suffering and traumatic experiences in stage 2. Therapists assist their patients in recognising problematic attitudes, actions, and beliefs.

Stage 3

In stage three, problems that the person associates with their daily lives are resolved. The purpose of therapy is to maintain development and establish reasonable objectives. Helping people accept responsibility for their actions and discover joy in life is the goal.

Stage 4

In the latter phase, people strive to improve their lives and find spiritual contentment.

CBT versus DBT

A modified version of CBT is DBT. Both treatments help patients comprehend and control their thoughts and behaviours.

CBT seeks to alter unfavourable cognitive patterns in order to improve mood and behaviour. According to research, CBT is a successful treatment for a variety of conditions, including anxiety, substance abuse, eating disorders, and depression.

While DBT and CBT have many similarities, DBT places more of an emphasis on interpersonal connections and emotion management. This is due to the fact that DBT was first created by therapists to address BPD.

Other variations include utilising interventions based on acceptance and mindfulness, as well as a coherent dialectical philosophy.

What abilities does DBT foster?

The four major life skills that DBT aims to improve are as follows:

Tolerance for stress

This ability entails being able to experience strong feelings like anger or grief without reacting rashly or turning to unhealthy coping mechanisms like substance addiction or self-harm.

Emotion control

Emotional control is a crucial aspect of DBT. People will learn to acknowledge and embrace their feelings without passing judgement on them. They will discover how to control their bad feelings.

For instance, people can learn to prevent emotions like grief from turning into agony, depression, guilt, and shame.

Additionally, they can learn how to amplify positive emotions like love and joy.

Mindfulness

The practise of mindfulness entails developing heightened present-moment awareness while maintaining an accepting, unreactive, and open mindset.

A person’s knowledge of their body, their capacity to control their emotions, and their view of themselves can all benefit through living in the moment.

DBT teaches people mindfulness practises so they can experience the present moment more fully.

Relationship effectiveness

People who can control their emotions are better able to handle conflict and speak more assertively. The ability to engage with others is thus improved by these abilities.

People can gain social skills including assertiveness, listening, and other interpersonal ones through DBT.

DBT procedures

DBT employs particular methods to accomplish its therapeutic objectives. These consist of:

Individual counselling

Individual therapy often involves people working on emotional control, traumatic events, and other issues that come up.

The therapist may give homework assignments, address problems as they arise, and assist clients in using their newly acquired abilities outside of therapy.

The person often fills out a diary card, also known as a self-monitoring form, once each week to keep track of their numerous treatment objectives. This card aids in scheduling sessions and guiding treatment.

Training group for skills

A weekly skills group session is a common part of DBT. Members of the group frequently talk about new abilities, practical work, and homework assignments.

Each group typically consists of 4 to 10 people according to earlier study.

Consultations over the phone

Between sessions, DBT therapists are frequently reachable via phone to address emergencies.

Consulting team for therapists

It might be difficult for therapists to treat patients with BPD and other difficult disorders. In order to provide support, instruction, and feedback, the therapy team normally meets once per week. As a result, the therapists are kept competent and motivated.

What health issues might DBT help with?

DBT was created by Dr. Marsha Linehan to treat BPD, a mental illness characterised by a severe fear of abandonment, problems with one’s self-image, difficulty controlling emotions, and relational difficulties.

Self-harm and suicidal behaviour are also linked to BPD. According to certain research, up to 10% of those with BPD will commit suicide.

Some estimates place the lifetime prevalence of BPD at 5.9% Trusted Source. It can reach 20% in inpatient mental health facilities.

The effectiveness of DBT in the treatment of BPD is backed by numerous studies and organisations.

Since its creation, DBT has been modified by mental health experts to treat a variety of additional disorders and problems, such as:

Eating problems

Mood disorders like bipolar depression and disorder

Trauma-related stress disorder (PTSD)

Misuse of drugs

Advantages of DBT

DBT advantages include:

A decrease in self-destructive and suicidal conduct

Increased emotional control and tolerance

A decrease in stress, trauma, anxiety, and depression signs and symptoms

Acquiring the ability to develop practical goals to enhance quality of life

Reducing unhealthy attitudes and behaviours that have an impact on relationships and quality of life

The development of self-confidence and respect

Dangers of DBT

DBT may not be effective for everyone even though it can have numerous advantages. DBT has been criticised and may have several drawbacks, which include:

There is a large time commitment required for the therapy in terms of attendance and assignments.

Not everyone is able to complete homework on a regular basis. Some individuals lack the logical and academic style of DBT because they are more spiritual in nature.

Most of the research on DBT involves small sample sizes, and not all studies include post-treatment follow-ups as well. This makes it very tough to know who the therapy will work for and how long the effects may last.

Alternative therapies

There are many other forms of psychotherapy available. Options consist of:

CBT, which involves changing negative ideas and fundamental beliefs to favourably impact emotions and actions.

Therapy sessions with family members or romantic partners are referred to as family and couple therapy and are intended to address problems in communication and relationships.

Humanistic therapies, which promote a more positive self-image and increased self-awareness in patients.

Interpersonal psychotherapy (IPT) is a brief kind of psychotherapy that focuses on resolving interpersonal conflicts to support mental health issue healing.

Psychodynamic therapy, which emphasises unconscious processes, helps people become more self-aware and recognise how issues from their past affect how they behave in the present.

Summary

For BPD and other difficult-to-treat conditions like substance abuse and eating disorders, DBT therapy seems to work well.

It is an organised course of treatment that includes phone consultations, group activities, and individual counselling. People will learn how to control, accept, and make goals to enhance their quality of life.

But not everyone may benefit from DBT. A person should think about attempting one of the many other types of treatment if they don’t think DBT is helping them. On their options, they can get advice from a doctor or mental health specialist.

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