Dialectical Behavior Therapy (DBT): Know It All Better

DBT or Dialectical Behavior Therapy is a light of hope for persons with emotional dysregulation issues, aimed at helping clients learn structure that improves their coping skills. It was initiated as a therapy for BPD patients, though has proved beneficial across a spectrum of other disorders such as depression, eating disorders, substance use disorders, and self-inflicting behaviors. Fundamentally, DBT combines the strategies, which on the surface, may seem antithetical, to accept and change, the essence of DBT philosophy, which encourages the opposite and conflict-solving issues in one’s mind, mood, and action.

This article traces some of the basics of Dialectical Behavior Therapy or DBT to shed light on the effective ways of impacting on clients’ lives in a constructive manner. This presents the components of DBT, which include individual therapy, skills training and coaching and the interactions between them. Moreover, the present study is an attempt to explain what DBT is and under which circumstances different individuals can undergo this life-changing therapy, with the focus on its applicability to any given population group and psychological disorder.

What is Dialectical Behavior Therapy (DBT)?

So what is DBT therapy, Actually Dialectical Behavior Therapy (DBT) is a special type of cognitive behavioral therapy (CBT) which targets and helps people who seem to experience emotions in an extremely intense and extreme manner. The DBT therapy was first established during the 1970s by an American psychologist Marsha Linehan, who designed the therapy specifically for the BPD treatment. It has since expanded its function to cover different types of mental health disorders; these are depression, eating disorders, as well as substance use disorders.

The word dialectical means both elements of a pair on the same level. In DBT, this is about practical acceptance of the elements of the person’s life and his or her behavior at the same time embracing the possibility of change. Acceptance and commitment therapy is thus based on a dialectic of acceptance and change, which assists the person in decreasing the frequency of undesirable responses and building up better regulation of feelings.

DBT is more complex and practice-based including many aspects of cognitive-behavioral models including Exposure, Contingency, Cognitive , Solution, and Control. This structure consists of individual sessions, group sessions where the emphasis is put as to skills development, and a particular therapist consultation team which contributes to the individual’s improvement.

Based on the objectives of DBT one of it is to improve the quality of life of the patient. This is done by aiming at the maladaptive behavioral responses arising from dysphoria thus enabling patients to establish a proper mode for executing learnt skills. In this way, DBT has the goal to equip the patients with possibility to control their emotional reactions and have better life.

Key Techniques and Strategies in DBT

Core Mindfulness

Mindfulness in DBT is an important and profound part of the therapy as it is rooted in Eastern psychological and meditative traditions and involves elements that teach an individual to stay in the moment while also accepting one’s thoughts and emotions. They divided the skills into ‘’what’’ and ‘’how’’ skills. The “what” skills include observing, describing and participating whereby people are held to the responsibility of paying attention to, naming and getting immerse in their present world. The “how” skills consisting of avoiding judgment, cultivating one-mindfulness, and integrating effectiveness help to establish how to engage in situations in moderation.

Distress Tolerance

Distress Tolerance does not involve changing the intensity of the client’s painful feelings, but rather provides an effective method of managing the said feelings in extraordinary situations. The skills that are covered in this module include; self-comfort with the five senses, disregarding the thoughts, doing an element on the thoughts, and thinking it through: advantages and disadvantages. Techniques such as TIPP (Temperature, Exercise, paced breathing, Progressive muscle relaxation) are used to quickly help have a break from severe emotional misery by changing the physical symptoms.

Interpersonal Effectiveness

This component of DBT will help people to improve their interpersonal effectiveness concerning assertiveness and relationships. The skills that are taught are DEAR MAN for communication: Describe, Express, Assert, Reinforce, Mindful and Appear confident, Negotiate; GIVE for relationship: Gentle, Interested, Validate, Easy manner; and FAST for self-respect: Fair, Apologies, Stick to values, Truthful. They assist people in fulfilling personal needs in social relations.

Emotion Regulation

Emotion Regulation skills assist a person to avoid being upright with overwhelming emotions that may cause instabilities. This module provides approaches and methods to find and name feelings, augment the number of pleasant life events, and minimize the susceptibility to unfavorable feelings. It was also important to message with the patient how to better cope with the increased levels of arousal to use the rational techniques like the identification of the roles of emotion, reduction of emotional distress, and the monitoring of the current emotional state in the situation.
All these techniques and strategies are fundamental in DBT and help individuals overcome their mental health disorders and other life challenges with regard to interpersonal relationships, among others.

DBT Treatment Structure

DBT adopts a complex system for treating a patient that is aimed at targeting the different sectors of the patient’s life. It consists of the individual therapy, group therapy, as well as phone coaching therefore all of them are significant components in the therapeutic process.

Individual Therapy

Functions in the individual therapy sessions in DBT always involve a mindfulness practice either at the beginning or the end of the therapy session which takes between one and five minutes. It is pertinent to note that these sessions are conducted without fail irrespective of the phase of arriving at the treatment plan. The first one, named Stage I, is devoted to the enhancement of behavioral control and acquisition of skills necessary for regulating extreme feelings. Often conducted at this stage is a behavioral chain analysis to determine the antecedent and consequent of the subjects of concern.

Stage II may however entail highly charged work for example, exposure based interventions for trauma. In these phases, therapists work on aims that facilitate the move towards the life worth living by the patient.

Group Therapy

Organization of groups in DBT is essential and serves as a reasonable supplement to the individual sessions since they help to acquire new skills. These meetings are closer to class sessions rather than therapy ones because here, people learn the important skills without having to address emotions between the attendees. Some of the skills that are covered include awareness, relationship, mood, and interpersonal skills. Every group session is kicked off by a mindfulness activity, and the overall length of the skills training is 24 weeks, although many patients may revisit the cycle to reinforce learning.

Phone Coaching

A special aspect of DBT therapy is phone coaching, which provides the patient with the opportunity to turn to the therapist for help between sessions. This component enables patients to call their therapists concerning emergent issues and self-apply DBT skills in real life. Usual phone calls are very short, designed to review the application of skills rather than going over problems in detail. This support is necessary in averting a crisis and also in strengthening the application of acquired skills when things get tough. The therapists are well taught to handle these calls in a very professional way such that the conversation only revolve around the issue and does not stray.

These above mentioned DBT skills, namely individual and group therapy and phone coaching offered in DBT support patients not only to the acquire the above skills and understand how to go about it in handling their lives, but also to implement them in a better way in order to lead a far more balanced and meaningful life.

Who Can Benefit from DBT?

Dialectical Behavior Therapy (DBT) in general is an immensely useful therapy regardless of the type of presented psychological disorders. Therefore, it is useful in treating many disorders since it exposes the patient to various ways of handling painful feelings and taken to reduce conflicts in interpersonal relationships. In this paper, the authors highlight the various specific populations that should receive DBT.

Individuals with BPD

Closely linked with unstable moods, impulsive behaviour and obviously, interpersonal relationships, patients suffering from BPD. DBT, initially formulated for the treatment of BPD, is still the best evidence for the treatment of this condition. Studies show that DBT has a positive impact in decreasing emotions like mood swings, conflicts with other people and episodes of self-harm among others. One should, however, note that approximately 77% of patients lose the criteria for BPD diagnosis if they experience DBT.

Individuals with PTSD

Emotion dysregulation state is common among people with Post-Traumatic Stress Disorder (PTSD). A combination of DBT has been useful in the treatment of PTSD particularly, the one that resulted from Sexual Abuse in Childhood; this has been done for both inpatient and outpatient. The therapy enables patients to handle pathological worrying by acknowledging them and control of the emotions; leading to a decrease in the severity of the symptoms of PTSD and improved functioning.

Individuals with Eating Disorders

Anorexia nervosa, bulimia nervosa and binge eating disorder are mental health disorders that manifests itself through abnormal eating habits and emotional suffering. DBT helps to treat these conditions because the acquired skills target the key problems of emotional dysregulation and distress intolerance. Thus, group and individual DBT sessions allow patients to use them as the basis for learning these skills, thus facilitating their recovery.

Individuals with Substance Use Disorders

DBT’s principles are also beneficial for the treatment of SUDs when there is a comorbidity with other mental disorders including BPD. The therapy relieves the demand for substances and improves the management of moods decreasing the risk for a relapse. Research has demonstrated that those patients, who have been administered with DBT for SUDs, improve their ability to deal with substance use and adhere to a treatment plan.

Therefore, due to the elements of structure and an application of skills in the process of treatment, DBT can be identified as efficient when treating each person with various psychological problems. DBT, therefore, helps to create acceptance of one’s current state and action for change at the same time enabling one to afford all that is required to have a healthy state.

Conclusion

Thus, by analyzing the DBT approach in the context of the discussed material, we have contributed to explaining the main concepts, versatility of the intervention method, and the transformative effect of DBT for those experiencing psychological disorders. The empirical premise of DBT alongside the recent statistic analysis work and research findings further tends to the effectiveness of DBT in dealing with an array of mental health disorders extending from Borderline Personality Disorder, behavioral analysis, biosocial theory, suicidal behavior and substance use disorders.

In addition to the aforementioned ideas, which are constituent components of DBT theory, these findings suggest not only a better understanding of DBT’s methodologies but also confirm the value of its integrated strategies aimed at the principles of emotional management, mindfulness, anger control, and interpersonal skills.

When considering the more general picture, one can note that DBT is not only about specific interventions; it is a paradigm for approaching human suffering, thus promoting both acceptance and change. The therapy’s adaptability to various conditions and demographics underscores its utility in contemporary mental health practices. With ongoing studies and clinical trials continually enriching our understanding and application of DBT, the therapy’s role in advancing mental health support, mindfulness skills, dialectical philosophy, commitment to change, therapist support, self-monitoring, commitment strategies, crisis survival skills, structuring the environment, emotion vulnerability, emotion-focused treatment, invalidating environment behavior, parasuicidal behavior, and cognitive-behavioral interventions remains indispensable.