What is Dialectical Behavior Therapy (DBT)?

Dialectical behavior therapy (DBT) is a type of talk therapy (psychotherapy). It’s based on cognitive behavioral therapy (CBT), but it’s specially adapted for people who experience emotions very intensely.

Cognitive behavioral therapy (CBT) is a type of talk therapy that helps people understand how thoughts affect emotions and behaviors.

“Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors.

What is dialectical behavior therapy (DBT) used for?

Dialectical behavior therapy (DBT) is especially effective for people who have difficulty managing and regulating their emotions.

DBT has proven to be effective for treating and managing a wide range of mental health conditions, including:

• Borderline personality disorder (BPD).
• Self-harm.
• Suicidal behavior.
• Post-traumatic stress disorder (PTSD).
• Substance use disorder.
• Eating disorders, specifically binge eating disorder and bulimia.
• Depression.
• Anxiety.

It’s important to note that the reason DBT has proved effective for treating these conditions is that each of these conditions is thought to be associated with issues that result from unhealthy or problematic efforts to control intense, negative emotions. Rather than depending on efforts that cause problems for the person, DBT helps people learn healthier ways to cope.

DBT Procedure Details

How does dialectical behavior therapy (DBT) work?

The main goal of therapists who use dialectical behavior therapy (DBT) is to strike a balance between validation (acceptance) of who you are and your challenges and the benefits of change. Your therapist will help you learn new skills to improve emotion regulation.

DBT pre-assessment

Your therapist may offer an assessment before starting DBT. They’ll determine how suitable DBT is for you by asking you questions and explaining how DBT works.

Individual DBT therapy

Individual DBT therapy involves weekly sessions with your therapist. Individual DBT therapy sessions have the following goals:

• To help keep you safe by reducing suicidal and self-harming behaviors, if applicable.
• To limit behaviors that get in the way of productive therapy.
• To help you reach your goals and improve your quality of life by addressing what’s blocking your progress, such as mental health conditions or relationship issues.
• To help you learn new skills to replace unhelpful behaviors.

DBT skills

DBT skills aim to help enhance your capabilities in day-to-day life. The four skills your therapist will teach include:

• Mindfulness: This is the practice of being fully aware and focused in the present instead of worrying about the past or future.
• Distress tolerance: This involves understanding and managing your emotions in difficult or stressful situations without responding with harmful behaviors.
• Interpersonal effectiveness: This means understanding how to ask for what you want and need and setting boundaries while maintaining respect for yourself and others.
• Emotion regulation: This means understanding, being more aware of and having more control over your emotions.

Risks / Benefits

What are the benefits and risks of dialectical behavior therapy (DBT)?

Dialectical behavior therapy (DBT) has been proven to help people with their mental health conditions in several studies. For people with borderline personality disorder, in particular, DBT results in:

• Less self-harm behavior and anger.
• Fewer days of inpatient hospitalization.
• Less drug and alcohol misuse.
• Improved depressive symptoms.

Excerpted from “What is Dialectical Behavior Therapy (DBT)?” from the Cleveland Clinic. Read the full article online.

Source: The Cleveland Clinic |  What is Dialectical Behavior Therapy (DBT)?, https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt | © 2023 Cleveland Clinic. Last reviewed April 2022.

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