What is DBT?
Dialectical Behavior Therapy (DBT) integrates Cognitive Behavioral Therapy (CBT) with Eastern mindfulness practices. It is an evidence-based therapy that has proven effective in helping clients develop coping skills, reduce self-harm behaviors and improve negative patterns of thinking. Clients find DBT validating and empowering as it helps clients learn and apply skills to manage strong emotions and urges. DBT encompasses four modules of therapy:
Mindfulness: one definition of mindfulness is “to be attentive and aware, non-judgmentally.” The use of mindfulness is important in the application of DBT skills because learning to observe and describe emotions without judgment is a fundamental skill on which the others are constructed.
Distress Tolerance: this module teaches positive, healthy ways to accept and tolerate distressing emotions and situations without engaging in self-destructive or self-harm behaviors.
Emotion Regulation: teaches healthy strategies to manage uncomfortable and difficult emotions by helping client understand and accept his/her emotional experience. The result is increased tolerance for emotions, as well as a toolbox of skills to help manage impulses and destructive urges.
Interpersonal Effectiveness: the focus of this module is on learning to appropriately ask for what you want or say no in relationships. This helps clients reduce conflict in and more effectively manage and maintain relationships, all while preserving self-respect.
DBT is effective because clients who are engaged in this type of therapy typically have multiple problems that require attention plus a lack of skill in at least several of these problem areas. In DBT, the therapist uses a hierarchy of treatment targets to determine the order in which problems should be addressed. The following are treatment targets that a therapist will help the client target in DBT therapy: (www.behavioraltech.org)
- Life-threatening behaviors: First and foremost, behaviors that could lead to the client's death are targeted, including all forms of suicidal and non-suicidal self-injury, suicidal ideation, suicide communications, and other behaviors engaged in for the purpose of causing bodily harm.
- Therapy-interfering behaviors: This includes any behavior that interferes with the client receiving effective treatment. These behaviors can be on the part of the client and/or the therapist, such as coming late to sessions, cancelling appointments, and being non-collaborative in working towards treatment goals.
- Quality of life behaviors: This category includes any other type of behavior that interferes with clients having a reasonable quality of life, such as mental disorders, relationship problems, and financial or housing crises.
- Skills acquisition: This refers to the need for clients to learn new skillful behaviors to replace ineffective behaviors and help them achieve their goals.
Goals of DBT skills therapy include helping the client stay safe, creating a life worth living, and helping the client acquire the skills to do so.