Dialectical Behavioral Therapy (DBT)
“It is hard to be happy without a life worth living. This is a fundamental tenet of DBT. Of course, all lives are worth living in reality. No life is not worth living. But what is important is that you experience your life as worth living—one that is satisfying, and one that brings happiness.”
DBT (Dialectical Behavioral Therapy) is an approach originally created by Marsha Linehan, author of the DBT Skills Training: Manual, to adapt CBT to address people struggling with suicidal ideation, and later adapted for the issues common in individuals that meet the criteria for Borderline Personality Disorder. Since been shown to be effective with a range of other concerns as well that are listed below. DBT builds on traditional cognitive behavioural approaches with an added emphasis on emotion. It focuses on regulating the overwhelming emotions that often serve to undermine peoples functioning and introducing skillful ways to address situations that evoke strong emotional responses.
Theory
The “dialectical” nature of DBT means that a basic assumption of this approach is that people can accept themselves just as they are while also striving to make life-enhancing changes. Emotions and experiences deserve validation but are also amenable to change through greater insight and awareness, as well as implementing strategies and skills aimed at handling them better. When someone is emotionally dysregulated, this can distort their perspective of themselves and others and limit the choices they have for how to behave. DBT aims to help people cultivate “wise mind”, or the ability to bring together emotion and logic, so their thoughts and actions are not solely governed by overpowering emotion.
Techniques
DBT focuses on regulating strong emotions by way of mindfulness techniques, behavioural strategies and interpersonal communication skills. Therapy involves learning new skills in areas like emotion regulation, distress tolerance, and interpersonal communication. Clients can expect to be very active in the process of therapy, often completing worksheets or other exercises both with the therapist and as homework.
One such exercise often employed is behavioral chain analysis, wherein clients reflect on and gain insight about how they emotionally respond to situations and how they can alter their behavior to produce desired results.
Issues DBT has been proven effective for:
- Suicidality
- Self-injurious behaviours
- Substance use disorders
- Bulimia
- Binge eating
- Depression
Therapy Models
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