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Reviewing DBT

Reviewing DBT

Dialectical Behavior Treatment (DBT) is a type of psychotherapy used to treat several disorders to help people regain control of their lives

In the many specific types of psychotherapy, there are many paths available for various disorders and issues. Under the umbrella of Cognitive Behavioral Therapy (CBT) is a more specific course of therapy first developed to treat Borderline Personality Disorder (BPD) but is now also used for the treatment of other kinds of mental health disorders. This more specific type of therapy is called Dialectical Behavior Treatment (DBT).

Research has shown that DBT appears to help reduce some of the worst problems associated with BPD such as repeated suicidal behaviors and therapy interfering behaviors in people in San Diego. Other uses for DBT are the treatment of the following:

  • Bipolar disorder
  • Eating disorders
  • Depression
  • Adolescents with high-risk behaviors

PsychCentral.com explains the theory behind the DBT approach, “Some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels.”

According to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices, “DBT is a cognitive-behavioral treatment approach with two key characteristics: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes. DBT emphasizes balancing behavioral change, problem-solving and emotional regulation with validation, mindfulness and acceptance.” Specifically, DBT teaches clients four sets of behavioral skills including the following:

  • Mindfulness
  • Distress tolerance
  • Interpersonal effectiveness
  • Emotion regulation

What Is DBT Therapy Like?

DBT can include group or individual therapy, the Mayo Clinic says, and it “uses a skills-based approach to teach how to manage your emotions, tolerate distress and improve relationships.”  DBT at its core is skills training, which takes place in a series of workshop-style sessions. Unlike weekly one-on-one traditional talk therapy, “these sessions may be more appealing and approachable,” Elena Premack Sandler writes for Psychology Today, “even though the cost and total time commitment may be similar, and there is undoubtedly homework outside of the sessions. Learning skills and applying those skills to real-life situations may just feel better than talk therapy — it’s more like a class than a doctor’s appointment, and perhaps people participating feel less like they’re being evaluated by someone else and more like they are helping themselves.” SAMHSA lists the five components of DBT including the following:

  • Capability enhancement (skills training)
  • Motivational enhancement (individual behavioral treatment plans)
  • Generalization (access to therapist outside clinical setting, homework and inclusion of family in treatment)
  • Structuring of the environment (programmatic emphasis on reinforcement of adaptive behaviors)
  • Capability and motivational enhancement of therapists

Why Is it Called DBT?

The word dialectical is used because of the issues involved in treating patients in San Diego with multiple disorders and to the type of thought processes and behavioral styles used in the treatment strategies, SAMHSA says. “Dialectics represent the mind’s way of understanding concepts by understanding and appreciating their polar opposites,” Dr. Charles H. Elliott writes on Psychcentral.com. Some of the concepts used frequently in psychology include self-esteem, trust, courage, honesty, rage, passivity, withdrawal, impulsivity, inhibition, blameworthiness and guilt. Dr. Elliott explains that dialectics, “are based in part on the fact that we cannot fully understand any of these abstract concepts without appreciating that they consist of bipolar opposites with a higher level of integration somewhere in between them.”

Where DBT Originated

A specific type of CBT, DBT, was developed in the late 1980s by psychologist Marsha M. Linehan. According to Dr. Allen J. Frances, Linehan realized through her own pain that she radically “had to accept herself just as she then was, but equally that she had to radically change herself in all sorts of different and difficult ways.”

DBT is the culmination of all Lineham learned from her own suffering, from her clinical training and from her subsequent clinical and spiritual experiences, Frances writes. “She taught therapists how to accept their patients and at the same time how to help them find in themselves the strength to make desperately needed changes.”

Everyone Can Benefit

Could some of the concepts at the core of DBT, such as acceptance and mindfulness, become a part of everyday thinking, even for people not in intensive treatment in San Diego? Yes, writes PsychCentral.com’s Margarita Tartakovsky. “DBT is used for specific treatments, but there are some techniques that even people not undergoing those can use and benefit from.” Some of these easy-to-do practices are included in the following

  • Mindfulness
  • Reality acceptance
  • Changing negative judgmental reactions

Explained by psychotherapist Sheri Van Dijk, mindfulness means, “living your life more in the present moment, instead of allowing yourself to be hijacked by the past and the future.” By practicing mindfulness, we become aware of our thoughts, feelings, actions and reactions.

The skill of reality acceptance focuses on accepting our daily experiences in San Diego and working to accept the more painful events that have happened, Van Dijk said. “Because fighting reality only heightens our suffering.” This is embodied by the popular phrase “it is what it is.” You just have to deal with it even if it’s uncomfortable.

Van Dijk’s third suggestion, nonjudgmental stance, is to change your negative judgmental reactions, which she says can increase our emotional pain. “So when you’re angry, irritated or frustrated,” she says, “pay attention to what judgment you’re making” and then focus on what is actual fact and what is emotion.

Learn More

To learn more about this and other types of treatment options in San Diego, you can call our admissions coordinators 24 hours a day, seven days a week at our toll-free helpline.