Sunday 30 April 2017

Dialectical Behavior Therapy: For More Than Borderline Personality Disorder

Psychology TherapyDialectical Behavior Therapy (DBT), developed by Marsha Linehan in the late 1980’s is a specific type of cognitive behavioral therapy that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD).  It is now considered the treatment of choice for individuals with characteristics associated with symptoms of BPD such as impulsivity, interpersonal problems, emotion dysregulation, self-harm, and chronic suicidal behaviors.

Dialectical Behavioral Therapy is a type of cognitive therapy that focuses on the balance between acceptance and change. DBT works with individuals to validate their pain and suffering while developing skills to make the changes needed to have a life worth living. The term “dialectical” refers to the philosophy of synthesizing two opposing perspectives or ideas that can exist simultaneously, such as acceptance and change.

A key component of DBT is skills training. DBT has 4 modules of skills, mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. Each module helps individuals develops skills to manage their life more effectively and develop improved quality of life. The skills training and treatment of DBT is applicable to people with a wide range of mental health conditions to improve overall well-being, emotion management, and decrease negative emotions and distress. Therefore, DBT treatment or DBT informed therapy may be beneficial for individuals with depression, anxiety, eating disorders, addiction, and post-traumatic stress disorder.

DBT for Depression

Dialectical Behavior Therapy has skills to address specifically for people struggling with depression. DBT teaches mindfulness helping individuals learning to live in the moment rather than the past. DBT teaches increasing pleasurable activities to empower people to add more joyous experiences to their lives. DBT also teaches behavior activation and opposite to emotion action. These are evidence based tools for depression and it helps to know what works.

DBT for Anxiety

Dialectical Behavior Therapy gives individuals concrete ways to live in the present moment. It teaches people to observe, describe, and participate in the moment. For individuals with anxiety this can be particularly challenging. DBT focuses on mindfulness and how to use these skills to decrease the intensity of negative emotions so feelings become manageable.

DBT for Eating Disorders

Dialectical Behavior Therapy has been adapted for treating individuals with eating disorders and focuses on skills that increase mindfulness, appropriately regulate emotion, and safely tolerate distress. DBT helps individuals identify the trigger and utilize skills to avoid the eating disorder behavior.

DBT for Addiction

Dialectical Behavior Therapy has an adaptation for individuals with substance use disorders. The skills can be applied to understanding “dialectical abstinence,” which encourages abstinence (change) but acknowledges that should a relapse occur that recovery is still possible and progress was still made (acceptance). DBT-SUD focused on mindfulness (one day at a time and non-judgmental stance), distress tolerance, and emotion regulation skills to help individuals develop long term recovery skills. The skills can also be applied to other types of addiction than just substances such as gambling.

DBT for Post-Traumatic Stress Disorder

Dialectical Behavior Therapy is shown to help clients with PTSD decrease the frequency and intensity of symptoms. DBT teaches distress tolerance skills to manage crisis, such as grounding skills, and mindfulness skills to bring individuals to the present. DBT can address and decrease dangerous behaviors common among survivors or trauma; DBT helps individuals develop effective interpersonal skills for setting boundaries and learning trust the self; and DBT teaches skill to regulate emotions or other symptoms of PTSD on a daily basis.  

DBT is a skills focused treatment based on CBT and learning theory and it is not diagnosis specific. DBT is currently used and a highly effective treatment for an array of mental health issues. If you think DBT could be for you don’t hesitate in seeking a therapist trained to offer Dialectical Behavior Therapy.



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