I’m here to tell you about the highly effective treatment called Dialectical Behavior Therapy: the goals of the treatment, who it treats, and how it works.
DBT is a treatment that has been around since the 1970’s and at that time was most widely known to treat Borderline Personality Disorder and highly suicidal people. It is still effective in those areas and has evolved both in treating additional mental health symptoms, as well as in the research supporting the treatment.
Who does DBT help?
It helps people who have an overall sense of dysregulation in a variety of areas. Let’s talk about those five areas.
The main two areas of dysregulation are emotions and relationships. Emotions includes feeling more sensitive or reactive than others and taking longer to settle down or return to that baseline prior to the emotion that you experienced. Relationships includes chaotic, up and down relationships that may move from thinking the world of someone to wanting to end the relationship.
Other areas of dysregulation include a sense of self (not knowing values, beliefs, preferences), behaviors that feel out of control, and thoughts that are commonly extreme and lead to problem behaviors.
What are the goals of DBT?
The main goal is to help people build a life worth living, which can look differently person to person. It’s determining what would make your life meaningful and choosing behaviors to target throughout treatment to help you live more in line with your values and goals.
People learn more about themselves, how to understand oneself in any given moment, how to stay in control of their emotions and ineffective behaviors, how to think more curiously and non-judgmentally, and how to build more worthwhile relationships.
How does DBT work?
Let me first tell you what the D and B stand for in DBT, as they make up some of the roots of the treatment. The D is about being dialectical, learning how to have two opposites that can be true at the same time. The main dialectic in DBT is acceptance (people are doing the best they can in any given moment, acceptance to the moment) and change (people might need to do better, get more motivated, and try harder, working on changing the situation). People in DBT are consistently learning to hold dialectics and living a lifestyle of being able to find the dialectic, the kernel of truth in an opposing side. The more flexible and dialectical one is in thinking and acting, the more regulated they are.
The B stands for Behavior, and in DBT one is learning the concepts of behaviorism. How to become your own behavior guide, changing behaviors you don’t want and increasing behaviors you do want. The concepts of behaviorism are universal and affect all living things. It is not just little kiddos that like stickers and rewards! DBT helps one choose behaviors to target each session to reach the goals and continues moving onto new behavior changes until reaching life worth living goals.
Another main tenet of DBT is mindfulness. This isn’t in the acronym but is at the roots of DBT. Mindfulness includes paying attention, being aware in a non-judgmental manner. DBT is a first treatment to put mindfulness into therapy. Mindfulness has grown to an evidence-based practice in psychotherapy and is linked to a wide number of physical and mental benefits. Mindfulness is practiced in all parts of DBT throughout the entire treatment- learning to be mindful overall, mindful in relationships, mindful to emotions and thoughts. Some may even develop a formal mindful practice while in DBT.
DBT includes skills training in the following areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. One may participate in full DBT with weekly group, individual sessions, and phone coaching, or one may choose to participate in the skills portion only of DBT. There are great benefits to all in learning DBT skills – you don’t need to be suicidal or have a personality disorder.
DBT therapists generally have specialized training emphasize an open, collaborative relationship with clients. As DBT has evolved, the training among therapists has also varied and is not all equal. It is important to fully understand the treatment and the varying training if you are looking for the most highly trained and qualified clinician and adherent DBT services. This can be difficult to understand when seeking treatment. Kim is a Linehan Board Certified, DBT clinician (the highest level of training by the creator of the treatment, and at the time of writing one of six clinicians in the state of Wisconsin).
Contact me if you or your loved one are looking for an assessment for DBT or are ready to start DBT today.