Dialectical Behavior Therapy (DBT)
Our therapy programs at Laguna Shores Recovery will help our patients understand their addiction and why it began. Our dialectical behavior therapy in Dana Point develops a balance between thoughts, emotions, and behaviors. This will help to build a foundation for a healthier life.
Around the world, mental health has become one of the most worrisome issues. Dialectical behavior therapy (DBT) is one of the most efficient treatments for many mental health issues. Through DBT skills training, individuals who suffer from mental health conditions and substance use challenges can address harmful behaviors and develop healthy habits.
What is Dialectical Behavior Therapy (DBT)?
Dialectical behavior therapy (DBT) is a form of psychotherapy that has been shown to be effective in the treatment of alcohol and substance abuse. Developed by Dr. Marsha Linehan in the 1980s, DBT is a cognitive behavioral therapy that aims to help individuals learn new skills to cope with difficult emotions and behaviors.
Dialectical behavior therapy is one type of therapy treatment for psychological illnesses. It is a fully comprehensive approach that deals with the thoughts, emotions, and behaviors of people. The major aspects of DBT include acceptance and conflict-solving for any kind of problematic issue.
It is mostly concerned with creating a balance between conflicted thought patterns and opposite forces. This is where its name “dialectical” comes in. DBT helps a patient accept the problem and then provides opposite alternatives to help that patient. So, a major part of this type of therapy includes acceptance and change.
What is Dialectical Behavior Therapy Used to Treat?
Be Brave. Get Help.
DBT Techniques in Alcohol and Substance Abuse Treatment
This involves focusing on the present moment and becoming more aware of one’s thoughts, feelings, and surroundings. Mindfulness techniques can help individuals develop a greater sense of self-awareness and control over their behaviors and emotions.
This involves teaching individuals how to cope with difficult emotions and situations in a healthy and adaptive way, rather than turning to substances as a means of coping.
This involves learning how to identify and manage strong emotions in a healthy way, rather than letting them control behavior.
This involves teaching individuals how to communicate their needs and boundaries effectively, and how to navigate relationships in a healthy way.
These skills are typically taught through individual therapy sessions, as well as group skills training classes. Research has shown that DBT is an effective treatment for individuals with substance abuse disorders, as it helps them develop the skills necessary to cope with difficult emotions and situations without turning to substances as a means of coping. If you or a loved one is seeking treatment for substance abuse, it may be worth considering a treatment program that incorporates DBT as part of the treatment plan.
Three Major Concepts of Dialectical Behavior Therapy
- Change is inevitable in nature
- Conflicts arise in life all the time
- Many things in life are interconnected either with our emotions or thought process
There are three major components of dialectical behavior therapy that help the therapist and client build up a good therapeutic relationship. These include the following:
DBT aims to support the needs of the client. The client and therapist work as a team to work toward fixing the problem that the client wants to work on. It helps the client to make sense of themselves and the world around them.
Dialectical behavior therapy (DBT) is collaborative in the best possible nature as it requires several relationships when coming to therapy. It requires a relationship between the therapist and client, along with a set of additional professionals who deal with other issues the client has.
It usually entails working with psychiatrists, social workers, and support staff in addition to the therapist. Dialectical behavior therapy also requires the completion of homework assignments and tasks to achieve the goals set at the start of counseling. The therapist guides the patient to put it all together and learn the skills needed to manage the patient’s condition.
A major chunk of dialectical behavior counseling is about working on one’s thoughts. Negative thoughts that hurt a patient need to be looked at and corrected. The techniques in DBT help people have control over their emotions and thoughts
Steps in Dialectical Behavior Therapy
Individual counseling is one of the most important aspects of dialectical behavior therapy. At the start, the therapist works on building a collaboration with the client to make the therapeutic process work better. Every session with the therapist is based on an agenda. At times, the session is divided into three parts, namely:
- First 10 minutes for previous homework and progress discussion
- 25 minutes for the current agenda discussion
- 10 minutes for an overview and any other discussion
Severe symptoms such as suicidal ideation, self-injury, and other self-harming behaviors are given priority during treatment. These symptoms which can lead to injury and death must be addressed before working on the less severe symptoms.
The relationship built at the beginning of the process helps with every future step. So, the trust developed between the therapist and client helps address the problems and improve the quality of the patient’s life.
One of the reasons dialectical behavior therapy (DBT) is gaining so much praise is its inclusion in group therapy. DBT focuses on collaborating with a group so that all group members can help the others. The group counseling sessions are mostly 1 to 1.5-hour sessions which are led by a therapist with training in DBT. Here, people learn skills from the four modules of dialectical behavior therapy, namely:
- Mindfulness
- Interpersonal Effectiveness
- Distress Tolerance
- Emotional Regulation
Dialectical Behavior Therapy Myths Debunked
Myth: It Treats the Problem Too Slowly
DBT is considered a fast-paced and efficient therapy. It usually goes on for 8-12 sessions depending on the case in consideration.
Myth: It is Hard for a Patient to Learn the Skills
It is a common misconception that dialectical behavior therapy only works for those well-versed in therapy approaches. This is not true, as DBT is an easy approach that is also collaboration-based, meaning the therapist is always there to provide clarification for all concepts.
Four Modules of Dialectical Behavior Therapy
Mindfulness skills are the most important part that patients are taught in the therapeutic process of dialectical behavior management. Mindfulness generally means acknowledging your thoughts and getting to know what kind of thoughts you are having most of the time. It also means analyzing one’s thoughts without any sort of judgment.
Interpersonal effectiveness in DBT focuses on the interpersonal skills of people. At times when people are distressed, they tend to avoid socialization, and their personal relationships are also affected. The interpersonal effectiveness skills in dialectical behavior therapy help the person improve his relationships. Clients are encouraged to work on important relationships. Many people are taught assertiveness and problem-solving strategies for personal issues.
There are many people with borderline personality disorder and bipolar disorder who are good at socialization. However, they might not be good at using their interpersonal skills when needed. Many of these people are either too blunt or at times not very assertive, causing them emotional turmoil. Thus, interpersonal skills focus on those situations and are taught one by one in this module.
One of the techniques in this module is the DEAR MAN rule:
- Describe
- Explain
- Assert
- Reinforce
- Mindful
- Appear Confident
- Negotiate
Distress Tolerance
This technique helps the client to validate the distress in a non-threatening and non-judgmental way. The core concept behind this module is that a person will be able to deal with their distress only when they are able to see it clearly, without judgment.
One of the techniques of distress tolerance include TIPP:
Temperature
Paced Breathing
Intense Physical Sensation
Paired Muscle Relaxation
Emotion Regulation
The goals of emotional regulation include:
- Identification, labeling, and understanding of emotions
- Decrease in unwanted emotions
- Decrease in emotional vulnerability
Emotional regulation skills include the following:
- Identification and labeling of one’s emotions
- Being mindful of emotions
- Seeing the facts of emotional responses
- Behavior analysis of a person
- Problem solving
- Respect towards emotions
- Management of extreme emotions
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- Aadil, M., Cosme, R. M., & Chernaik, J. (2017). Mindfulness-based cognitive behavioral therapy as an adjunct treatment of attention deficit hyperactivity disorder in young adults: a literature review. Cureus, 9(5)
- Dialectical Behavioral Therapy for Adults with Mental Illness: A Review of Clinical Effectiveness and Guidelines.
- Azizi, A. Borjali, A., & Golzari, M. (2010). The effectiveness of emotion regulation training and cognitive therapy on the emotional and additional problems of substance abusers. Iranian Journal of Psychiatry, 5(2), 60.
- Tharaldsen, K. B., & Bru, E. (2012). Evaluating the mindfulness-based coping program: an effectiveness study using a mixed model approach. Mental illness, 4(1).
Matthew Beck B.A, M.A, LMFT 
