Dialectical Behavioral Therapy (DBT)

Dialectical behavioral therapy (DBT) falls under the broad umbrella of cognitive behavioral treatment interventions. It was first developed to help people with chronic tendencies toward self-injury or suicide, but it has been since been successfully applied to depression, anxiety disorders, and eating disorders.

Basic Principles of DBT

DBT is based on a number of different assumptions about how disorders develop and how best to treat them. First, from cognitive behavioral therapy, DBT borrows the notion that our thoughts, actions, and emotions are all closely linked. Emphasizing practical changes that can produce positive results is prioritized over exploring causation and history.

DBT also stresses the importance of validation of an individual’s previous experience and actions. By recognizing that an individual’s response to life situations is understandable, therapy assists in putting individuals in a better frame of mind for accepting the need for change.

DBT also utilizes principles of dialectics, the notion that two opposing ideas can simultaneously be true, and that accepting them both allows us to better understand the truth. For example, an individual might be taught that they should both love and value themselves as they are, but also recognize that change is necessary.

Powerful Strategies for Adaptation

DBT emphasizes that individuals need to learn coping strategies that can extend the benefit of treatment from the limited number of treatment sessions into a lifetime of better skills for dealing with life’s adversity. The most common skill areas addressed include:

  • Mindfulness: Learning to be present in the moment and being aware of one’s response to events, while not necessarily engaging those responses and using them as the basis for action or further thoughts and emotions. Defusing automatic responses and thoughts gives an individual more control over their lives.
  • Distress tolerance: To some extent, difficult situations are inevitable in life, and are not without their value. Individuals are taught how to cope with difficult situations when necessary and even choose to enter difficult situations when there is good reason to do so based on their personal values.
  • Emotional regulation: Inability to control emotion is a signature feature of mood, anxiety, and other disorders. DBT teaches individuals how to understand the reasons for their emotions and experience these emotions without being overwhelmed. This also includes taking maintenance steps such as eating properly and getting enough sleep to ensure one has the strength to deal with emotions.
  • Interpersonal effectiveness: Our relations with other people can have a powerful positive or negative impact on our mood. Learning to manage these relations helps us validate our own feelings, express them, and resolve conflicts to maintain more complete and fulfilling relationships.

Often, DBT utilizes a combined approach to delivering instruction and feedback, including personal sessions, group sessions, and even interactions by phone and online. Homework between sessions helps individuals understand and apply lessons learned during treatment.