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Understanding Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a specific type of cognitive-behavioral psychotherapy developed in the late 1980s and is used as a type of talking treatment. It's has been adapted to help people who experience emotions very intensely. DBT is a therapy designed to help people suffering from mood disorders, as well as, those who need to change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, and substance abuse.

This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviors to help avoid undesired reactions. DBT assumes that people are doing their best but lack the skills needed to succeed and/or are influenced by positive reinforcement or negative reinforcement that interferes with their ability to function appropriately.


What are the goals of DBT?

The goal of DBT is to help individuals learn to manage their difficult emotions by letting themselves experience, recognize and accept them. Then as one learns to accept and regulate their emotions, they also become more able to change their harmful behaviors.

What does ‘dialectics’ mean?

Dialectics means trying to balance opposite positions and look at how they go together. For example, in DBT, you will work with your therapist to find a good balance between:

Ø Acceptance – accepting yourself as you are.

Ø Change – making positive changes in your life.


Acceptance techniques

Acceptance techniques focus on understanding yourself as a person, and making sense of why you might do things such as self-harm or misuse drugs. A DBT therapist might suggest that this behavior may have been the only way you have learned to deal with the intense emotions you feel.


Change techniques

DBT therapists use change techniques to encourage you to change your behavior and learn more effective ways of dealing with your distress. They encourage you to replace behaviors that are harmful to you with behaviors that can help you move forward with your life.

Characteristics of DBT

Ø Support-oriented: It helps a person identify their strengths and builds on them so that the person can feel better about him/herself and their life.

Ø Cognitive-based: DBT helps identify thoughts, beliefs, and assumptions that make life harder & helps people to learn different ways of thinking that will make life more bearable.

Ø Collaborative: It requires constant attention to relationships between clients and staff. In DBT people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them. DBT asks people to complete homework assignments, to role-play new ways of interacting with others, and to practice skills such as soothing yourself when upset. These skills, a crucial part of DBT. The individual therapist helps the person to learn, apply and master the DBT skills.


Generally, dialectical behavior therapy (DBT) may be seen as having two main components:

1. Individual weekly psychotherapy sessions that emphasize problem-solving behavior for the past week issues and troubles that arose in the person’s life. Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance their own self-respect and self-image.

2. During individual therapy sessions, the therapist and client work toward learning and improving many basic social skills.

3. Weekly group therapy sessions, generally 2 1/2 hours a session and led by a trained DBT therapist, where people learn skills from one of four different modules: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills are taught.


To get the most out of DBT requires a certain leap of faith and willingness to have your thinking and behaviors challenged. It is totally different to any other type of therapy; it's hard work, but over time and with effort, life starts to get better. If you are looking for a DBT Therapist, please call us at (256) 824-9171 or visit our website at www.envisionarycounseling.com or www.hsvpcs.com.


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