Dialectical Behavioral Therapy

Dialectical Behavioral Therapy

Dialectical Behavioral Therapy (DBT) is a therapeutic approach that combines elements of Cognitive-Behavioral Therapy (CBT) with mindfulness techniques. It was originally developed by psychologist Dr. Marsha Linehan in the late 1980s to treat individuals with Borderline Personality Disorder. Since then, it has been adapted for various other mental health conditions, such as mood disorders, eating disorders, and substance use disorders.

Central to DBT is the concept of dialectics, which involves the integration of seemingly contradictory elements. In therapy, this means finding a balance between acceptance and change, validating the client’s experience while also encouraging personal growth. 

DBT incorporates principles from behavioral therapy, focusing on identifying and changing maladaptive behaviors. Clients work with their therapists to set specific, measurable, achievable, relevant, and time-bound (SMART) goals.

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Mindfulness is a core component of DBT, emphasizing non-judgmental awareness of the present moment. Clients learn to observe their thoughts and emotions without getting overwhelmed or reacting impulsively. Mindfulness skills include meditation, deep breathing, and other relaxation techniques in order to foster distress tolerance. This helps individuals cope with crises and intense emotions without resorting to self-destructive behaviors. Techniques include distraction, self-soothing, and improving the moment.

DBT teaches clients effective communication skills, assertiveness, and the ability to navigate interpersonal relationships. It focuses on striking a balance between achieving personal goals and maintaining positive relationships. Clients learn to identify and manage intense emotions by understanding the function of emotions and applying strategies to regulate them. This includes recognizing and labeling emotions, as well as modifying the factors that contribute to emotional distress.

The concept of the “middle path” encourages clients to avoid extreme thinking and behaviors. It promotes finding a balance between acceptance and change, acknowledging that life is filled with gray areas rather than black-and-white thinking.

The therapeutic relationship in DBT is collaborative and validating. Therapists balance acceptance and change strategies, providing unconditional positive regard while also challenging and encouraging growth.

DBT is typically delivered in both individual therapy sessions and group skills training sessions. The combination of individualized treatment and skills training helps individuals build skills and a growth mindset, even in the face of significant challenges and emotional dysregulation. It has been found to be effective in treating a range of mental health issues, and its principles are often integrated into other therapeutic approaches.