Dialectical Behavior Therapy (DBT) is a form or derivative of cognitive-behavioral therapy created by Dr. Marsha Linehan. It was developed originally for people with borderline personality disorder (BPD) to help manage intense emotions and behaviors.
Over time, it’s proven effective for treating a variety of mental health and psychiatric conditions and substance use issues in addition to BPD.
We’ll break down what DBT is and explore the conditions it’s commonly used to treat.
What is DBT?
DBT, or Dialectical Behavior Therapy, is a structured approach based on cognitive-behavioral therapy that emphasizes balancing acceptance and change.
It’s built around four core skills: mindfulness, which helps individuals stay grounded in the present; distress tolerance, which equips people to handle crises without impulsive reactions; emotion regulation, which focuses on managing and understanding emotions; and interpersonal effectiveness, which improves communication and relationship skills.
DBT typically includes individual therapy sessions, group skills training, and phone coaching to provide comprehensive and flexible support.
What Conditions is DBT Used to Treat?
Borderline Personality Disorder (BPD)
DBT was initially developed to treat BPD, a condition characterized by intense emotional swings, self-harm behaviors, and unstable relationships.
DBT focuses on skills like emotional regulation, distress tolerance, and interpersonal effectiveness. It helps individuals regain control over their emotions and build healthier connections with others.
Substance Use Disorders
For individuals struggling with addiction, DBT provides tools for addressing emotional triggers and replacing harmful coping mechanisms with healthier alternatives.
Skills like distress tolerance and mindfulness help with cravings and managing withdrawal symptoms, reducing the likelihood of relapse.
Depression and Anxiety:
DBT is highly effective for treating depression and anxiety by teaching techniques for emotional regulation and mindfulness.
These are tools that can empower individuals to get a better understanding of their feelings and manage them more effectively, reducing the intensity and frequency of their symptoms.
Post-Traumatic Stress Disorder (PTSD):
People with PTSD often experience overwhelming distress and emotional instability.
DBT helps build coping strategies for distressing memories, improves emotional resilience, and fosters a greater sense of stability in daily life.
Eating Disorders:
DBT supports individuals with eating disorders by addressing emotional triggers and teaching needed skills to develop a healthier relationship with food.
It helps to reduce impulsive behaviors so they can then be replaced with mindful, intentional actions.
Bipolar Disorder:
Managing the extreme highs and lows of bipolar disorder can be challenging.
DBT assists by teaching emotional regulation strategies and interpersonal skills, helping individuals maintain stability and build stronger relationships.
The Dialectical Behavior Therapy (DBT) Process
Dialectical Behavior Therapy (DBT) is a structured, step-by-step therapeutic approach.
Here’s how the process typically works:
Assessment and Goal Setting
The therapist starts with a comprehensive assessment to understand the individual’s challenges, history, and treatment goals.
The client and therapist work together to define specific goals.
Therapy Structure
DBT combines multiple components to ensure comprehensive care:
Weekly one-on-one sessions focus on personal challenges, progress, and applying DBT skills to real-life situations.
- Group Skills Training: Clients attend group sessions to learn and practice the four core DBT skills:
- Mindfulness: Staying present and fully engaged in the moment.
- Distress Tolerance: Managing crises without impulsive or destructive behaviors.
- Emotion Regulation: Understanding and controlling intense emotions.
- Interpersonal Effectiveness: Building healthy, assertive relationships while maintaining self-respect.
- Phone Coaching: Between sessions, clients can talk to their therapist for guidance on using DBT skills during challenging situations.
Core Philosophies
DBT emphasizes two key principles throughout treatment:
Clients are encouraged to accept their current circumstances and emotions without judging them.
At the same time, DBT focuses on building skills to create meaningful and lasting changes in behavior and thought patterns.
Stages of Treatment
DBT is typically divided into four stages to address progressively deeper challenges:
- Stabilization: Focus on reducing harmful behaviors (e.g., self-harm, substance use) and creating a sense of safety.
- Exploration: Address underlying emotional and relational challenges, such as trauma or unresolved conflicts.
- Skill Building: Strengthen problem-solving abilities, enhance emotional resilience, and improve quality of life overall.
- Fulfillment: Focus on achieving personal goals, developing a sense of purpose, and maintaining the progress made during treatment.
Homework and Practice
Clients are often assigned homework to practice DBT skills in everyday life.
This could include keeping a diary card to track emotions, behaviors, and triggers or using specific techniques, such as mindfulness exercises or distress tolerance strategies, during challenging moments.
Monitoring Progress
Progress is regularly reviewed in individual sessions to evaluate the effectiveness of DBT skills and make adjustments to the treatment plan as needed.
The process is collaborative between a therapist and a client.
By integrating structured sessions, practical tools, and ongoing support, DBT offers a clear path toward emotional stability, improved relationships, and a healthier, more balanced life.
Why is DBT Effective?
DBT is an evidence-based therapy that has been proven effective for a range of conditions.
It combines acceptance strategies with practical skills. This combination helps individuals to acknowledge their current struggles while working toward meaningful change.
By facilitating a collaborative relationship between therapist and client, DBT creates a safe and supportive environment for growth.
The therapy is also tailored to each person’s unique needs, ensuring it addresses their specific challenges and goals.
This personalized approach, along with its strong research backing, makes DBT a powerful tool for recovery and emotional well-being.
FAQs About Dialectical Behavior Therapy (DBT)
1. Who can benefit from DBT?
DBT is beneficial for individuals struggling with intense emotions, self-harm, suicidal thoughts, substance use disorders, or conditions like borderline personality disorder (BPD), PTSD, eating disorders, depression, and anxiety.
It’s also effective for people who feel overwhelmed by their emotions or have difficulty managing relationships.
2. How long does DBT take?
DBT programs typically last between six months and a year, but the duration can vary depending on individual needs and progress.
Some people may require extended therapy to continue developing and maintaining their skills.
3. Is DBT only for people with borderline personality disorder?
No. While DBT was initially developed for BPD, it has since been adapted to treat a wide range of mental health and addiction issues.
4. What’s the difference between DBT and traditional CBT?
CBT focuses mostly on changing negative thought patterns and behaviors, whereas DBT incorporates acceptance strategies along with change.
DBT also emphasizes mindfulness, emotion regulation, and interpersonal skills, making it particularly effective for individuals with intense emotions or complex mental health challenges.
5. Can DBT be used alongside other treatments?
Yes. DBT is often integrated into comprehensive treatment plans that may include medication, other types of therapy, or holistic approaches like mindfulness practices.
This is particularly common in dual-diagnosis treatment programs for mental health and addiction.
6. Do I have to attend both individual and group sessions?
Most DBT programs include both individual therapy and group skills training as core components.
The combination provides personalized support while teaching practical skills in a supportive group setting. However, some adaptations of DBT may be tailored to specific needs.
How to Access DBT at Soledad House
Soledad House offers comprehensive treatment programs, including Dialectical Behavior Therapy (DBT), as part of its evidence-based approach to healing.
We specialize in dual diagnosis treatment, providing support for individuals facing both mental health challenges and addiction.
Our personalized care ensures that each client’s unique needs are addressed through therapies like DBT.
If you’re ready to take the first step toward a healthier, more balanced life, contact Soledad House today for a consultation. Our team is here to guide you on your journey to recovery.
