Dialectical Behavioral Therapy For Mental Health

As mentioned, DBT was originally meant to treat borderline personality disorder (BPD), but it has been adapted to treat other mental health conditions. It helps people who have an issue with emotional regulation or are showing self-destructive behaviors. DBT can help treat individuals who are suffering from:

• Depression
• Binge-eating
• PTSD (post-traumatic stress disorder)
• Bulimia
• Bipolar disorder
• Substance use disorder (SUD)
• Generalized anxiety disorder (GAD)
• Major depressive disorder (MDD)
• Suicidal behavior

4 Key Skills Learned In Dialectical Behavioral Therapy

There are 4 main strategies and techniques that the therapist focuses on in DBT sessions. These skills include:

Mindfulness

Mindfulness aims to improve the individual’s ability to accept and be present “at the moment.” This helps you pay attention to what’s happening inside you (thoughts, feelings, sensations, and impulses). This includes using your senses to also be aware of what’s happening around you (what you see, feel, and touch) without being judgmental.

Mindfulness skills help you focus on using healthy coping skills when you’re experiencing emotional pain. This can help you remain calm and avoid taking part in automatic negative thought patterns and impulsive behavior

Distress Tolerance

This is meant to increase tolerance for negative emotions instead of trying to escape them. Distress tolerance techniques help prepare you for intense emotions and cope with them. These  DBT techniques help you handle a crisis:

• Distraction
• Improving the situation
• Self-soothing
• Thinking of the pros and cons of not tolerating the stress

Emotional Regulation

Emotion regulation is a strategy that lets you maneuver through intense feelings more effectively. The skills learned will help you:

• Identify problems contributing to emotional distress
• Learn how to cope with these intense feelings
• Use techniques and coping skills to regulate your emotions

Emotional regulation is used to manage and change the emotions that are extremely intense and causing a problem in a person’s life. When you can recognize and cope with powerful negative emotions, it reduces your emotional susceptibility so you can have more positive emotional experiences.

Interpersonal Effectiveness

Interpersonal effective techniques allow a person to communicate with others in a way that’s:

• Assertive
• Maintains self-respect and self-esteem
• Improve communication skills
• Strengthen relationships with friends and family

You’ll learn to listen and communicate more effectively and deal with challenging people.

How Does Dialectical Behavioral Therapy Work?

The term “dialectical” comes from the theory that bringing two opposites together in therapy –acceptance and change–brings about better results than either one alone. A unique feature is its focus on acceptance of an individual’s experience as a way for therapists to reassure them and balance the work necessary to change negative behaviors. For example, DBT therapists accept their patients as they are while also acknowledging that they need to change.

During dialectical behavioral therapy, you and your therapist will work together to resolve the obvious contradictions between self-acceptance and change to bring about positive changes.

Part of the process includes offering validation which helps people become more likely to cooperate. At the same time, they are less likely to feel distressed at the idea of change.

In practice, the therapist confirms that a person’s actions make sense within the framework of their personal experiences. However, the therapist doesn’t necessarily agree with the patient that the actions are the best method to solve a problem. In DBT, you’ll learn how to do the following:

Accept And Change Your Life For The Better

You’ll learn methods to accept and tolerate the circumstances of your life, emotions, and yourself. You’ll also build skills that can help you make positive changes in your behaviors and interactions with other people.

Examine Behavioral Patterns

You will learn to analyze destructive behavior patterns or problems and replace them with more effective and healthy ones.

Improve Cognitive Understanding

You’ll focus on changing your unhelpful thoughts and beliefs.

Learn How To Better Collaborate

You’ll learn to effectively communicate and work together as a team (group therapist, therapist, psychiatrist).

Learn And Improve Important Skill Sets

You’ll learn new skills that can strengthen your capabilities, such as life and coping skills.

Support

You will be encouraged to identify your positive strengths and features and expand and use them.

4 Components of Dialectical Behavioral Therapy

Dialectical behavioral therapy has expanded to become an evidence-based psychotherapy method that is used to treat many disorders.  There are four elements of comprehensive DBT:

1. Group skills training: People are taught behavioral skills in a group setting. The group is run like a class and people are assigned homework to practice using the skills in everyday life.
2. Individual therapy: One-on-one sessions with the therapist where the patient’s learned behavioral skills are adjusted to their challenges. It is focused on strengthening the person’s motivation and helping to apply the skills to specific issues and situations.
3. Phone coaching: Individuals call the therapist between sessions to get help with a difficult situation. It’s focused on giving the client at the moment coaching on using the skills to cope with situations that come up in their everyday life.
4. Consultation team: Health care providers (therapist, group therapist, psychiatrist) to stay motivated and discuss patient care. It’s meant to be therapy for the therapists and to support DBT providers in their work with individuals with often severe, complex, hard-to-treat disorders.

Why Do DBT Skills Help Mental Health Disorders?

The reason why DBT teaches skills to help an individual cope with problems, rather than just addressing them, is because problem behaviors evolve. These behaviors become a way to cope with a situation or to solve a problem. Even though it could be a temporary relief in the short term, it doesn’t help in the long term.

DBT assumes that people are trying their best and that they need to learn behaviors in different situations. It helps with the abilities of the individual by teaching different skills. These skills will allow the person to handle situations in everyday life, or manage challenges that get overwhelming.

Treatment Focuses of Dialectical Behavioral Therapy

Individuals who receive DBT usually have several problems that need treatment. DBT uses a ranking of treatment targets to help determine the order in which problems should be treated. In order of priority, the treatment targets are:

• Life-threatening behaviors: First and most important, behaviors that could result in the client’s death are addressed. This includes suicide conversations, suicidal thoughts, and all types of suicidal self-harm.
• Therapy-interfering behaviors: Any behavior that interferes with the client receiving productive treatment. These behaviors might be on the part of the client or the therapist. It may be appointment canceling, coming late to therapy sessions, and being non-cooperative in working towards the goals of the treatment.
• Quality of life behaviors: This classification includes any other type of behavior that inhibits clients from having a reasonable quality of life. This includes disorders, financial or housing emergencies, or relationship problems.
• Acquisition of skills: This refers to the client’s need to learn new skillful behaviors to replace behaviors that have not been effective in helping them reach their goals.

What’s The Difference Between DBT And CBT?

Cognitive-behavioral therapy (CBT) is one of the most commonly practiced types of psychotherapy. The focus of CBT is to teach you how your feelings, thoughts, and behaviors influence each other. As an example: if you think that people don’t like you (thought) you might avoid social environments (behavior) and end up feeling lonely (feeling). But CBT teaches you how to use these relationships to your advantage. A positive change in one element (behavior or thought) can lead to positive changes in all elements. CBT is typically short-term and goal-focused.

Dialectical behavioral therapy is a specialized form of cognitive-behavioral therapy. DBT builds on the foundation of CBT to help strengthen its effectiveness and target specific issues the founder of DBT saw as deficiencies in CBT. These include the relationship between social factors and individual thoughts and behaviors.

On the other hand, DBT emphasizes social and emotional characteristics. It was developed to help individuals deal with extreme or unstable emotions and harmful behaviors. Such as the way a person interacts with others in different relationships and environments. The theory is that some people are likely to react more intensely and unusually toward emotional relationships, particularly those found in romantic, family, and friend relationships.

Cost-Effectiveness Of Dialectical Behavioral Therapy

There is growing evidence that shows that DBT reduces the cost of treatment. The American Psychiatric Association in 1998 estimated that DBT decreased costs by 56% when comparing the treatment year with the previous year in a community-based program. Notably, reductions were seen in decreased:

• Face-to-face contact with emergency services (80%)
• Days in hospital (77%)
• Partial hospitalizations (76%)
• Crises bed days (56%)

This reduction in hospital costs ($26,000 per client) outweighed the outpatient services cost increase ($6,500 per client) by far.

This cost-effectiveness also lasts past the treatment year as seen in an examination in a VA hospital setting (2014). It was found that veterans who received DBT treatment had substantially decreased the use of outpatient mental health services in the following year by 48%. More importantly, the study showed that using high-cost inpatient services decreased by 50% and duration of stay by 69%.

Getting Started at Lido Wellness Center

The best way to find out if DBT is right for you is to talk to a professional who has been trained in the DBT method. They can evaluate your symptoms, history of treatment, and therapy goals to see if it’s a good choice for you.

Similar to other talk therapies, it takes time and effort to reap the benefits of DBT and CBT skills. But once the skills are mastered, with the guidance and support of your DBT therapist, you will find that your new skills become second nature to you. They are tools that will last a lifetime.

If you think you or a loved one could benefit from DBT, it’s important to talk to a trained mental health professional. That being said, it’s not easy to find DBT therapists, but our team at Lido Wellness Center are experienced professionals, trained in DBT and CBT, as well as several other treatment approaches. Contact us today. There is no reason to continue suffering from a disorder that can be treated.