Dialectical Behavioral Therapy
DBT has four components that help clients to create, maintain and implement healthier coping skills while staying motivated for treatment.
There are many different types of therapy available for mental health treatment. Dialectical behavioral therapy is a type of therapy that sounds similar to cognitive behavioral therapy, but it is very different in its therapeutic approach. Learning more about dialectical behavioral therapy and how it works can help you decide if it may be the right treatment type for you.
What Is DBT (Dialectical Behavioral Therapy)?
Dialectical behavioral therapy (DBT) is a type of cognitive behavioral therapy (CBT) that focuses on reframing thoughts and emotions. Through this reframing, a person can learn to accept their current situation and begin working toward change.
Dialectical is defined as bringing two opposites together; in the case of DBT, these opposites are acceptance and change. Therapists accept their clients where they are at but also encourage them to change in the areas where they want and need to grow.DBT is commonly used to treat borderline personality disorder, as it can help someone who experiences extreme emotions and reactiveness to regulate their responses more effectively. DBT has also been used to treat:
- Substance dependence
- Eating disorders
DBT vs. CBT (Cognitive Behavioral Therapy)
DBT and CBT are both types of psychotherapy that deal with regulating thoughts, feelings and behaviors. Both are talk therapies that have a large focus on the therapist-client relationship. Many times, CBT and DBT will have homework assignments for clients as well.
DBT and CBT differ in that DBT is a type of CBT. CBT has a foundation of helping clients to recognize ways of thinking and behaving that are problematic to their life. DBT does this as well, but it also focuses on regulating extreme emotions and improving interpersonal relationships.
How Does DBT Work?
DBT is unique from other types of psychotherapy in that it uses two opposing rules as the basis of treatment. This form of treatment uses a talk therapy approach that is coupled with behavioral therapy. The goal of DBT is to help patients manage their negative emotions in order to improve relationships and overall communication.
DBT involves learning various skills that are split into four different groups. These skills are meant to help someone better regulate their emotions and improve their behavior and reactions.
Four Components of DBT
There are four different components of DBT, including skills training groups, individual treatment, DBT phone coaching and consultation teams. Through these components, DBT works to:
- Enhance behavioral capabilities
- Increase motivation for change
- Integrate new behaviors into everyday life
- Make therapy beneficial to both the client and therapist
- Enable therapists to motivate clients for change
DBT individual therapy provides a one-on-one approach that allows the client and therapist to work on individual goals and motivation for treatment. Individual therapy typically occurs once a week for 60 minutes and happens alongside a DBT skills group.
DBT skills training focuses on improving a client’s capabilities through teaching behavioral skills. Skills training is held in a group setting where a group leader teaches the skills and assigns homework so that clients can practice using these skills in everyday life. Group length varies, but they typically meet weekly for a set number of weeks to master each different skill.
DBT Mindfulness Skills
Mindfulness is the practice of being in the moment and fully present in what is occurring. From a DBT perspective, mindfulness is beneficial because it can help a client process what is happening in the moment and avoid letting their emotions control how they respond to a situation.
DBT Emotional Regulation
Emotional regulation works with DBT therapy because it helps clients who have dysregulation with their emotions. This is often seen in the DBT therapy population, such as in clients with borderline personality disorder. These individuals can have a very hard time effectively coping with emotions and stress.
DBT Distress Tolerance
Distress tolerance works to help patients in DBT therapy work through painful events in their life instead of running away from those feelings. Distress tolerance teaches patients that painful situations are a part of life, and having coping mechanisms to deal with these is essential to a healthy life. Some distress tolerance techniques include self-soothing, distraction, improving the moment and looking at the pros and cons.
DBT Interpersonal Effectiveness
A lot of people who need DBT therapy have difficulty in interpersonal relationships because they don’t have the skills necessary to be in a relationship. Interpersonal effectiveness helps someone in DBT therapy learn how to draw boundaries with others and advocate for themselves.
DBT phone coaching allows for a therapist to help a client in real time. Sometimes, a client in DBT will have a problem identifying what skill to use during a difficult situation. Phone coaching gives the client in-the-moment support that helps them correctly use the skills they’ve learned.
DBT therapist consultation is meant to be therapy for therapists. Therapists who are DBT providers work with patients who can be difficult to treat, and these therapists need extra support from colleagues. Therapist consultation helps therapists stay motivated and capable of providing the best care possible to clients who are in DBT therapy.
What Conditions Is DBT Used For?
Although DBT is primarily used for those with borderline personality disorder, there are many other diagnoses that DBT treatment can work for. DBT focuses on reframing emotions, accepting where someone is currently at and developing healthier coping mechanisms. These skills can be helpful in managing other mental health disorders as well.
DBT for Anxiety
People who suffer from anxiety can have a hard time regulating their emotions. This can cause them to be overwhelmed by the emotions they experience. DBT can help someone with anxiety learn to regulate their emotions and use mindfulness skills.
DBT for Depression
Someone who is suffering from depression may have a hard time dealing with their emotions or the situation that is causing them to feel sad or depressed. DBT skills training and techniques such as mindfulness, radical acceptance and distress tolerance can all be helpful for someone who is trying to overcome depression symptoms.
DBT for Bipolar
Those who are diagnosed with bipolar disorder tend to have a harder time regulating their emotions and have strong reactions to negative situations. DBT targets emotion dysregulation and can help improve emotion regulation and mood fluctuation in someone with bipolar disorder. DBT group skills training, mindfulness, emotion regulation and distress tolerance skills are all parts of DBT that can be beneficial to someone with bipolar disorder.
DBT for Borderline Personality Disorder
BPD is a mental health condition that causes people to have unstable moods and behavior as well as difficulty functioning in everyday life. DBT can help someone with BPD change maladaptive behaviors and develop coping skills such as mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness.
DBT for Eating Disorders
Those with eating disorders, specifically binge eating disorder (BED), have been found to have difficulty regulating emotions. They may use negative behaviors like binging, purging and restricting as coping mechanisms for difficult situations. DBT can help these individuals create new coping mechanisms and learn skills like mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness.
DBT for Addiction
DBT can be an effective treatment for those struggling with chronic addiction and substance abuse. The opposing ideas in DBT — change and acceptance — can come into play when working to abstain from substances. A DBT therapist can help a client work toward stopping substances completely, which would be the change, while also acknowledging that setbacks and relapses occur, which would be the acceptance. This can help patients feel supported during their recovery journey while they also focus on the goal of not engaging in their addiction.
Other Diagnoses DBT Is Used For
DBT can be effective for managing many other mental health conditions as well, including:
What To Expect in DBT Therapy
The thought of entering any type of treatment can be nerve-wracking if you don’t know what to expect. In DBT treatment, there are both individual and group therapy sessions. In each type of therapy, a therapist teaches skills that are practiced in and out of therapy sessions.
In individual therapy, a trained DBT therapist will work with an individual to create and maintain motivation for change. They will look at how to handle setbacks in progress and how to use the skills learned in everyday life.
DBT group therapy is also led by a trained DBT therapist. Group therapy offers a supportive setting where clients can practice the skills they’ve learned in both individual and group therapy. During group sessions, it is expected that all individuals participate and be encouraging to others.
DBT therapy can also include telephone sessions if needed. Clients are able to speak with their DBT therapist in between therapy sessions if a crisis occurs and they are struggling to use their skills in that situation.
Effectiveness of DBT
DBT has been proven to be effective for mental health concerns such as anxiety, depression, bipolar disorder, borderline personality disorder, eating disorders, addiction and others. DBT works to improve emotional regulation and distress tolerance, and it leads to positive outcomes for those who suffer from these disorders.
DBT helps patients enhance their ability to develop healthy coping mechanisms and improve overall emotional regulation. DBT has been proven to be the most beneficial treatment for borderline personality disorder, and it continues to be explored as a treatment option for other disorders.
Online DBT Therapy
With teletherapy becoming a new and popular setting for psychotherapy, you may wonder how DBT fits into this new landscape for treatment. The good thing about DBT is that a part of this modality has always been done virtually via telephone. Since phone counseling is a component of DBT, DBT-trained therapists are used to conducting effective therapy remotely.
Therapy is also virtual for many providers now, so sessions can transition to an online platform if necessary. Certain apps may even have support for those in DBT treatment. The Nobu app has various tools that can supplement your treatment, including mindfulness training, journaling prompts and more. The app can even connect you with a licensed therapist for an additional fee.
DBT Therapy at The Recovery Village Cherry Hill at Cooper
DBT is integrated into the addiction treatment program at The Recovery Village Cherry Hill at Cooper. While addiction treatment begins with an evaluation and possible medical detox, psychotherapy — specifically DBT — is an important part of treatment that should be continued well beyond inpatient treatment. Clients often continue their DBT treatment in outpatient settings and throughout the long-term aftercare stage.
If you or someone you love is suffering from addiction and has not had success with other types of treatment, The Recovery Village Cherry Hill at Cooper can help. Contact us today to speak with our admissions team and learn about treatment options that can work well for your situation.
- Chapman, A.L. “Dialectical behavior therapy: current indications and unique elements.” Psychiatry, September 2006. Accessed May 25, 2022.
- University of Washington “Dialectical Behavioral Therapy.” Accessed May 25, 2022.
- InformedHealth.org. “Institute for Quality and Efficiency in Health Care.” September 8, 2016. Accessed May 25, 2022.
- Dimeff, L., Linehan, M.M. “Dialectical behavior therapy in a nutshell.” The California Psychologist, 2001. Accessed May 25, 2022.
- Nickelson, Cheryl A. “Key Elements of Dialectical Behavior Therapy.” St. Catherine University, May 2013. Accessed May 26, 2022.
- Cisler, J.M., et al “Emotion regulation and anxiety disorders.” Current psychiatry reports, June 14, 2012. Accessed May 27, 2022.
- Lynch, Thomas; et. al. “Dialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study.” American Journal of Geriatric Psychiatry, February 2003. Accessed May 27, 2022.
- Cleveland Clinic. “Therapy (DBT): What It Is & Purpose.” April 19, 2022. Accessed May 27, 2022.
- Eisner, L., et al. “Dialectical Behavior Therapy Group Skills Training for Bipolar Disorder.” Behavior therapy, January 26, 2017. Accessed May 27, 2022.
- May, J.M., et al. “Dialectical behavior therapy as treatment for borderline personality disorder.” The mental health clinician, March 8, 2016. Accessed May 27, 2022.
- Wisniewski, L., et al. “Dialectical Behavior Therapy and Eating Disorders: The Use of Contingency Management Procedures to Manage Dialectical Dilemmas.” American Journal of Psychotherapy, 2015. Accessed May 27, 2022.
- Dimeff, L., et al. “Dialectical behavior therapy for substance abusers.” Addiction science & clinical practice, June 2008. Accessed May 27, 2022.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.