Dialectical Behavioral Therapy
What is Dialectical Behavioral Therapy?
Dialectical Behavioral Therapy (DBT) is psychotherapy that used to address and treat borderline personality disorder(BPD). It is a modified or developed form of Cognitive Behavioral Therapy (CBT). It aims to help people improve their cognitive and emotional regulation. In this process, people learn about behavioral skills. Different coping skills help to avoid undesired reactions in a sequence of events, thoughts, feelings, and destructive behaviors. DBT is also proved impressive in improving relationships.
Popular psychology researcher Dr. Marsha M. Linehan has developed this approach. Based on her experience and research, she realizes Cognitive Behavioral Therapy (CBT) is not much effective for borderline personality disorder and chronically suicidal individuals. She along with some colleagues developed an advanced form of CBT. It is based on the philosophy of dialectics. Practitioners are using DBT to help people suffering from post-traumatic stress disorders (PTSD), depression, mood disorder, binge-eating, traumatic brain injuries, disorder, and substance abuse.
DBT is known as the first therapy effective in treating BPD. It has moderate effects on borderline personality disorder individuals. DBT uses different cognitive behavioral techniques collectively to address issues. Core behavioral skills modules in DBT are emotional regulation, distress tolerance, mindfulness, and interpersonal effectiveness. Every individual can face different problems. Some may have multiple, only a DBT therapist can decide which DBT goal fits an individual’s requirement.
Patient View of DBT:
In different psychological therapies, the patient can be treated differently, but the DBT treatment program allows the patient to have a view of the therapist as an ally in the treatment of psychological issues. The DBT therapists are willing to address and validate patient feelings and mental health. At the same time educating the patient that some behaviors and feelings can be maladaptive. DBT helps patients in acquiring new behavioral skills and changing their behavior which can lead to improved relationships and mental health.
How DBT components or sessions are planned?
The components are divided in different ways. They are as follows.
Individual: In this way, the patient and DBT therapist discuss the problems that come in a specific period of time. The issues can be recorded in different ways such as diary, cards, or digital notes. As per the issue, a target treatment program hierarchy is followed. The behaviors that are harmful to self like suicidal behaviors, destructive behaviors, or life-threatening behaviors are taken as the first priority. Then there are behaviors that are not directly harmful to themselves or non-destructive behaviors but intervene in the course of treatment. The third is the focus on the quality of life. In this individual therapy both the patient and DBT therapist discuss a skill group improving skill use and mental health.
Group: In this process, a group meets weekly for two hours. The whole emphasis remains on learning different skill uses. behavioral skills are divided into different modules such as mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Different scenarios are discussed where these behavioral skills modules can be implemented.
Phone Coaching: To keep the interaction alive and treat patient’s daily life issues, the phone coaching is designed. The patient often forgets to use different behavioral skills they have learned to cope with the issues of mental health. It’s important to interact with your therapist and get a reminder of your goal.
In the above mentioned components, the individual component is taken necessary to avoid destructive behavior or life-threatening behavior. Any component cannot be used by itself.
What are the Behavioral Skills modules?
We are discussing components, but it’s important to know what are the main behavioral skill modules that DBT emphasis on. These are Mindfulness, Distress Tolerance, Emotion regulation and interpersonal effectiveness. Let’s have an overview of all.
Mindfulness: It is the base for other behavioral skills taught in DBT. Mindfulness helps in accepting and tolerating powerful emotions that usually occurs while challenging the habits or into the upsetting scenario. It is taught in DBT how to pay attention, about experiencing senses, emotions, living in the moment. People are encouraged to apply senses (taste, smell, sight, touch, and sound) to be more aware of the environment they are living in. Acceptance and change behavior is taught.
Distress Tolerance: In distress tolerance, the whole focus remains on dealing with circumstances like traumatic events, death of a loved one, serious illness, or unexpected attacks. The primary goal of distress tolerance is to calmly recognize and address distress and negative situations. In DBT, issues are discussed instead of hiding or becoming overwhelmed. It is taught to make wise decisions and actions instead of destructive emotional reactions. Attention is diverted to other events or actions instead of remaining in distress situations. An environment is created to think about something else.
Emotion regulation: People with destructive behaviors or suicidal behavior are usually emotionally intense. They are usually anxious, intensely frustrated, depressed, and angry. In emotion regulation, patients learn how to understand or recognize emotion and name it. It helps to improve relationships. Different approaches like problem solving, fact-checking, and opposite-reactions are used to change unwanted emotions. The patient learns different coping mechanisms to handle difficult extreme conditions in a crisis situation.
Interpersonal effectiveness: This module is designed to help the patients coping with interpersonal conflict. A person may describe behavioral sequences while interacting with others. But is not able to analyze their own situation. Its focus remains on scenarios where the goal is to change something or to resist changes. The skill goal is to fulfill patient requirements without hurting or damaging self-respect or relationship.