Dialectical Behavior Therapy DBT: How It Works, What It Helps, and More

Four RCTs1–4 reported high dropout rates with the potential to disrupt the baseline randomization effect resulting in a bias of the reported results. In all the RCTs,1–5 there were no modalities to control or standardize concurrent therapy. Thus, access to different parallel medications and psychotherapy regimens suggests that the reported treatment efficacy from the RCTs may not be due precisely to the interventions under study. Taken together, more robust studies are needed to confirm the effectiveness of the DBT or DBT-based interventions in the mentally ill patient populations targeted by the RCTs1–5.

Extreme reactive emotions are quite effective when a person is facing imminent threat or danger, but not as helpful in relationships or at work. DBT was developed in large part to help people experiencing extreme emotions gain the necessary skills to manage them and improve their lives. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. The biosocial theory attempts to explain how issues related to borderline personality develop. The theory posits that some people are born with a predisposition toward emotional vulnerability.

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The evidence shows effectiveness in reducing self-harm, more treatment adherence, less time in treatment, fewer serious episodes, and patients have reported feeling better. The information on the diary card lets the therapist know how to allocate session time. Life-threatening or self-injurious behavior takes priority, not surprisingly.

In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. The standard form of DBT consists of individual therapy, skills training group, phone coaching, and a therapist consultation team. Those in standard DBT attend therapy and a skills training group weekly. The groups are designed to help those in treatment develop behavioral skills through group work and homework assignments.

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DBT is a comprehensive treatment that includes many aspects of other cognitive-behavioral approaches, such as behavior therapy (i.e., exposure, contingency management, problem solving, and stimulus control), cognitive restructuring, and other such interventions. The four DBT skills (mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation) are taught in separate group skills training modules. The standard DBT training schedule begins with two weeks of mindfulness training followed by five- to seven-week training modules in distress tolerance, interpersonal effectiveness, and emotion regulation. A two-week module of mindfulness training is interspersed between each five- to seven-week module.

Dialectical Behavioral Therapy

DBT is a complex treatment modality that makes many demands of therapists and requires extensive training to be administered in the way it was developed and tested. Finding the right therapist is often a time-consuming task, and DBT therapy isn’t any different. Talk to people you trust to https://ecosoberhouse.com/ give you a referral for a therapist who uses dialectical behavior therapy, whether it’s your primary healthcare provider or a friend or family member. The intervention of interest in all the included RCTs1–6was DBT either in its standard form or adapted to suit the targeted patient group.

DBT Made Simple: A Step-by-Step Guide to Dialectical Behavior Therapy – Sheri Van Dijk

It may be especially effective in treating borderline personality issues, posttraumatic stress, self-harm, and suicidality. Plus, you learn to avoid situations that typically trigger strong emotions and pursue events that boost positive emotions. There is often a prompting event, followed by interpretation, body changes in response to the emotions, and action urges. It includes a section on the theory and research behind DBT and how it grew from traditional CBT approaches, as well as strategies for working with clients, an explanation of the four skill modules, and several handouts, case examples, and some sample therapy dialogue. It walks the reader through descriptions of DBT and how it can help, introductory exercises, and more advanced skill chapters. This can be an excellent resource for any individual considering DBT or for therapists to recommend to their clients.

Dialectical Behavioral Therapy

In our first study, results favoring DBT were found in each DBT target area. In our second study, we compared DBT to a much stronger control condition, treatment by non-behavioral community experts (TBE). In comparison to TBE, DBT reduced suicide attempts by half, had less medically severe self-injurious episodes, lower rates of treatment drop-out, and fewer admissions to both emergency departments and inpatient units due to suicidality. In studies of substance dependent BPD patients conducted at our research clinic as well as at other sites, DBT has been found to be superior to control treatments in reducing substance use. The following section involves a discussion of some of the critical and unique elements of DBT.

What skills does DBT develop?

In these sessions, your therapist will teach you skills in a group setting. This isn’t to be confused with group therapy, in which you discuss your problems with others. Think of it more like a teaching and learning session in a classroom setting. Your therapist will likely ask you to keep a diary to track your emotions and actions and to look for patterns of behavior. You’ll bring this diary with you to your sessions so you and your therapist can decide what to work on for each session.

  • By Michelle C. Brooten-Brooks, LMFT

    Michelle C. Brooten-Brooks is a licensed marriage and family therapist, health reporter and medical writer with over twenty years of experience in journalism.

  • Therapists teach patients mindfulness skills in skills training, encourage mindfulness in individual therapy, and often practice mindfulness themselves.
  • If you’re interested in learning more about Dialectical Behavior Therapy, as a client, therapist, or just a curious person, there are several books available.
  • Dialectical behavioral therapy focuses on high-risk, tough-to-treat patients.

Practice observing your emotions, describing and accepting them but not allowing yourself to be overwhelmed by them. Focus on building and maintaining positive relationships, and give mindfulness a try to savor positive experiences. This can lead to an effective or dysfunctional expression of emotions, which can have a wide range of consequences. To work on describing emotions, try to describe the qualities of your emotions and pay attention to things that may interfere, like secondary emotions that spring from the original emotion. You can work on your skills related to interpreting emotions by completing a writing challenge described here. If you’re interested in learning more about Dialectical Behavior Therapy, as a client, therapist, or just a curious person, there are several books available.

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