The need for addiction treatments is significant and ongoing. One option is dialectical behavior therapy or DBT. Like cognitive behavioral therapy (CBT), DBT helps people develop healthier ways to cope with stress while teaching them tools to regulate their emotions and improve their relationships.
Originally, DBT was intended to help individuals experiencing suicidal and self-destructive behaviors. But it has been adapted to support various conditions, including addiction.
What is Dialectical Behavioral Therapy?
Like CBT, dialectical behavioral therapy is a form of talk psychotherapy. DBT was developed by an American psychologist, Marsha Linehan, in the 1970s. It helps people to accept the reality of their life and their behaviors. DBT also teaches individuals ways to change their lives and unhelpful behaviors. The word dialectical means combining opposite ideas, such as acceptance and change. By combining these two, people can achieve better results.
One particularly unique aspect of DBT is how it focuses on showing the individual how to accept their experience as a way for their therapist to reassure them. This acts as a balance to the work the person needs to do to change their negative behaviors.
The way DBT is conducted typically includes individual therapy and group skills training. There is also a phone coaching component if needed for any crises between sessions and a consultation group for health care providers to stay motivated and discuss the patient’s care. Additionally, individuals agree to do homework to practice their new skills. Homework includes completing daily “diary cards” that track more than 40 emotions, urges, behaviors, and skills.
What Can Dialectical Behavioral Therapy Treat?
The uses for DBT have evolved, but it appears to be particularly useful for those with multiple diagnoses or high-risk, tough-to-treat individuals. Others who can benefit from this form of therapy include those dealing with:
- Borderline personality disorder (BPD)
- Suicidal behavior
- Post-traumatic stress disorder (PTSD)
- Substance use disorder
- Eating disorders, specifically binge eating disorder and bulimia
DBT helps with this variety of conditions because many stem from unhealthy or problematic efforts the individuals use to control intense and negative emotions. In many cases, DBT can help them learn healthier ways of coping.
DBT works best when people are committed to making positive changes in their life. They also must be prepared to engage with therapy and do the required homework. A willingness to focus on the present and the future, not the past, is also vital. Finally, the person should also feel able to take part in group sessions.
DBT Strategies and Techniques
Living in the present and not dwelling on the past is a major component of DBT, which is why mindfulness plays a significant role in therapy. Mindfulness is used to:
- Help the person pay attention to their thoughts, feelings, sensations, and impulses
- Use the individual to tune in to their senses about what’s happening around them in a non-judgmental way
- Encourage someone to slow down and focus on using healthy coping skills during emotional pain
- Stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior
Another component of DBT is distress tolerance. Distress tolerance techniques help a person be better equipped to manage their intense emotions while also empowering them via a more positive long-term outlook. This technique teaches ways to handle a crisis, such as distraction, self-soothing, improving the moment, and thinking of the pros and cons of not tolerating distress.
Interpersonal effectiveness focuses on learning to listen and communicate more effectively, including becoming more assertive in relationships. It can also involve ways to deal with challenging people and teaching self-respect and respecting others.
Emotional regulation is the final technique used in DBT. It teaches the individual how to navigate powerful feelings more effectively, particularly by learning to identify, name, and change their emotions.
Stages of Dialectical Behavior Therapy
The four life skills that DBT works on — mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation — are worked on in four stages:
- Stage 1: Treats the most self-destructive behavior, such as suicide attempts or self-injury.
- Stage 2: Begins to address quality-of-life skills, like how to regulate emotions, tolerate distress, and achieve more interpersonal effectiveness.
- Stage 3: Focuses on improved relationships and self-esteem.
- Stage 4: Promotes more joy and relationship connection.
Treatment can last for six months to a year. It is a time-intensive treatment due to the time spent on regular sessions, homework, and phone counseling sessions. For some conditions, time spent in DBT may need to be extended even more. Even after DBT, individuals should not expect to be completely free of symptoms or no longer display any problematic behaviors. It is essential not to get discouraged and to focus on the fact that getting help is the important thing. Whatever progress the individual makes is positive in terms of their ability to manage their emotions better and have a better quality of life.
Bridges of Hope’s treatment philosophy is based on a comprehensive and integrated approach to addressing all issues related to substance use and mental health disorders. Utilizing therapeutically proven, evidence-based clinical practices, Bridges of Hope provides superior patient care in Indiana through its all-inclusive treatment services.