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Dialectical Behavior Therapy (DBT)

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy—or DBT—is a form of therapy that helps individuals to live in the moment and reduce emotional distress. Closely related to Cognitive-Behavioral Therapy (CBT), DBT provides clients with coping mechanisms for tolerating stress and regulating emotions, ultimately improving their relationships with themselves and others. 

In the late 80s, psychologist Marsha Linehan noticed there were no effective treatments available to individuals struggling with borderline personality disorder (BPD) and suicidal ideation. Therefore, she developed DBT out of necessity, with the goal in mind of helping borderline and self-harming individuals to improve emotional and cognitive regulations. 

DBT is especially effective for those struggling with mood or personality disorders because it helps clients gain the clarity and strategies for coping that allow them to adjust their reactions to undesired outcomes. And though initial scientific research supported its use for BPD primarily, the approach has since been adopted by clinicians to treat a wide range of mental health conditions. Today, DBT is used in therapy to target symptoms associated with depression, PTSD, eating disorders, and substance abuse. 

How Does DBT Work?

There are four components to Dialectical Behavior Therapy: emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Each one of these elements is designed to help clients become aware of their reactions and behaviors while developing essential skills for coping. The main idea behind the central components of DBT is that, if we can learn to live in the present moment, we’re better able to observe, learn from, and adjust our emotional responses. 

Throughout DBT sessions, a therapist collaborates with the client to create positive change and work towards self-acceptance. Learning strategies to not simply tolerate but to accept adverse life circumstances is an important part of Dialectical Behavior Therapy as clients begin the process of recognizing destructive behaviors and thoughts that perpetuate internal distress. 

Because DBT allows clients to become more and more comfortable with self-acceptance and adversity, they can successfully change counterproductive thoughts and replace destructive coping mechanisms with healthy ones. And by incorporating the biosocial theory—which ascribes personality disorders and mental illness to biologically-determined factors that are brought out by environmental stimuli—DBT works to validate and normalize each individual’s experience. 

Dialectical Behavior Therapy is arguably a more complex approach to behavioral techniques than other methods. But this may speak to its effectiveness in treating depression and self-destructive behaviors where other modalities may not have been sufficient. 

How DBT Factors Into My Approach To Therapy

Starting out my career in a community mental health setting where intensive DBT was implemented, I have incorporated this approach into my therapy practice for a number of years now. Throughout this time, I’ve seen first-hand how Dialectical Behavior Therapy helps individuals struggling with severe and chronic symptoms. And, as a certified drug and alcohol counselor, I can attest to DBT’s effectiveness when it comes to treating clients with substance abuse issues in particular. 

However, the coping, emotional regulation, and distress tolerance toolbox is valuable for just about any individual, and I find that it’s easy to translate this approach among a wide range of clients. I even incorporate Dialectical Behavior skill sets into therapy for clients who see me for relatively mild symptoms of depression, anxiety, and other disorders. 

Throughout the counseling process, I aim to build a trusted connection with my clients and provide them with a safe and nonjudgmental space to explore their emotions and stress responses. Because DBT relies so much on the cultivation of very specific and interrelated skill sets, I believe it to be an incredibly empowering model for therapy, arming clients with coping mechanisms that they can continue to use throughout the rest of their lives. 

While DBT remains the primary treatment used for the more severe and chronic cases that I see, I often incorporate elements of Cognitive-Behavioral Therapy and mindfulness into sessions. In my experience, these approaches allow individuals to observe and detach from their emotions so that they are better prepared to do the work of regulating themselves in DBT. For clients grappling with substance abuse, I find that DBT works especially well in conjunction with motivational interviewing, which is another therapy technique centered around empowerment and behavioral change. 

Living with a personality or mood disorder, symptoms of depression and anxiety, or self-destructive impulses—including substance abuse—is exhausting and emotionally depleting. But if you can do the work of identifying your emotions and evaluating your internal response, you’ll be more likely to adjust your behaviors before they become harmful, problematic, and damaging to your relationships. 

Dialectical Behavior Therapy really works, and I invite you to join me in cultivating the skills needed to set you on a path to relief and inner peace. 

You Can Regain Control Over Your Stress Responses

If you or someone you know is struggling with a personality or mood disorder, suicidal ideation, or other emotional and behavioral challenges, DBT is a demonstrated therapy that can help you to understand and regulate distress. To learn more about DBT or to schedule a free, 15-minute consultation, call (616) 835-0215 or contact me. I look forward to hearing from you. 

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