Dialectical Therapy
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Dialectical behavioral therapy (DBT), also known as dialectical behavior therapy,is an approach within clinical psychology that aims to treat personality disorders and other mental health conditions. Dialectical behavioral therapy was developed out of the practice of cognitive behavioral therapy, or CBT. CBT helps people become aware of and work to adjust flawed thought patterns that cause unhelpful or distressing emotion and/or behavior. Dialectical Behavior Therapy also does this, and tacks on additional dialectical components and skills training. Depending on the symptoms or the challenges you’re experiencing in your life, dialectical behavioral therapy might be an effective therapeutic option to consider seeking.
Dialectical behavior therapy (DBT) was originally conceptualized by the psychologist Marsha Linehan. She saw that behavior therapy was effective for identifying negative thought patterns and changing them, but noticed that it lacked the component to help people learn how to handle situations when their emotions were heightened or intense.
Linehan wanted to develop a form of mental health treatment that could help people cope when they were experiencing more extreme emotional pain instead of turning to their unhealthy mechanisms, which is how DBT was born.
Dialectical behavioral therapy focuses on helping people learn to manage their emotional distress and intense emotions. It’s intended to equip the individual with a toolbox of behavioral skills to help them cope with pain and learn emotion control to manage emotions and other mental health problems. Dialectical behavior therapy skills training focuses on the following areas:
- Mindfulness skills, or being aware of and calmly accepting one’s feelings in the present moment to achieve emotion control
- Distress tolerance, or recognizing the painful emotions and managing them effectively and healthily with emotional control skills
- Interpersonal effectiveness, which involves learning how to better communicate with others and navigate their relationships
Research has found that comprehensive dialectical therapy can be a clinically effective treatment for a variety of mental health problems and conditions. DBT therapy is most commonly recommended for those with borderline personality disorder (BPD). This personality disorder is characterized by an intense fear of abandonment, impulsive and/or risky behaviors, wide mood swings, angry outbursts, rapid changes in self-identity, self harm, and suicidal threats or behavior. Dialectical behavioral therapy can help with these symptoms by assisting individuals in learning to improve their distress tolerance skills, emotional control, and adopt healthy coping skills through therapeutic intervention.
If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.
Dialectical behavioral therapy ongoing research
In addition, ongoing research is in progress to determine whether dialectical behavior therapy may also be a clinically effective treatment for disorders and mental health conditions like depression, anxiety, eating disorders including binge eating disorder, drug and alcohol dependence, and post-traumatic stress disorder. That said, theoretical and empirical observations suggest that virtually anyone can benefit from learning some dialectical behavior skills since everyone experiences difficult emotions and self-destructive behaviors from time to time that they may want to change with the help of therapy. Whether it’s used as the primary clinical treatment for a certain, specific condition depends on the individual and the professional opinion of their therapy provider.
DBT treatment may be used in conjunction with the use of medication for certain mental health issues or as a stand-alone treatment. It can take the form of individual therapy sessions, group sessions, or the combination of both. Contacting a licensed mental health professional is typically the best way to know how suitable dialectical behavior therapy might be for treating your particular situation.
Group DBT sessions may also be designed to teach healthier coping mechanisms and offer the opportunity to practice them in a communal setting.
If you believe that dialectical behavioral therapy could be helpful for you, connecting with a qualified mental health provider to discuss your situation more specifically is usually a good first step. You can search for "DBT therapy near me" to locate a therapist in your area or to see available DBT therapists if you prefer to meet with a therapist in person. Or, if you prefer the convenience of attending therapy sessions from the comfort of your own home, you might consider an online therapy platform like BetterHelp. The therapist you get matched with can evaluate you and let you know if online, individual dialectical behavior therapy sessions might be right for you, or if some other type or format of therapy may be better for your situation. One study suggests that online therapy may be more convenient and as safe and effective as in-person therapeutic treatment. Meeting with a qualified provider can help you find out what the best for you might be.
Dialectical behavior therapy training can be helpful for people in certain situations. Dialectical behavior therapy techniques can help individuals implement new emotion control strategies, and improve interpersonal skills and mindfulness skills. Speaking with a licensed online counselor can help you conclude whether dialectical behavior therapy, cognitive behavioral treatment, comprehensive validation therapy, or some other therapeutic intervention might be most effective for you.
DBT involves DBT skills training in six different areas. These six main points of dialectical behavior therapy include:
- Mindfulness
- Distress tolerance
- Interpersonal effectiveness
- Emotional regulation
- Balancing acceptance and change
- Radical acceptance
What does dialectical mean in dialectical behavioral therapy?
Marsha Linehan, the developer of DBT and founder of the Linehan Institute behavioral techniques, defines dialectical as “a synthesis or integration of opposites”.
DBT may not be as effective for certain mental health disorders. There has been conflicting research on the efficacy of DBT for obsessive compulsive disorder, panic disorder, and post traumatic stress disorder.
DBT is a complex form of therapy that is most effective when working with a therapist trained to provide comprehensive DBT therapy. However, you will practice DBT skills in your own life, and learn self-monitoring strategies that can help you to become more independent practicing this therapy over time.
The four major skills learned and practiced in DBT therapy include:
- Mindfulness
- Distress tolerance
- Interpersonal effectiveness
- Emotional regulation
What is dialectical behavior therapy (DBT), and how does it incorporate dialectics into treatment?
Dialectical behavior therapy is a type of talk therapy that embraces the idea of embracing the seemingly opposing ideas of acceptance and change. Helpful for managing intense emotions, it can be applied to many mental health conditions, and is often used to treat borderline personality disorder. Dialectics is reconciling two seemingly opposite concepts (i.e.: changing oneself, but also accepting oneself).
Emotional regulation strategies learned through DBT therapy have been found to be effective in reducing emotional lability in clients. In DBT pre-assessment, the therapist will identify the most serious self-destructive behaviors and address these first. They will then help the client identify their emotions, and create individualized strategies to help manage them. An important part of DBT skill building is homework, in which the client is expected to practice these new strategies in their own life, and learn to self-monitor.
DBT therapy uses the idea of radical acceptance to help the client learn emotional regulation and interpersonal skills in a way that does not create judgment. Dialectics is the idea that two seemingly opposing ideas can be true and pursued, most commonly the idea that you want to change, but you also accept who you are while creating that change.
What is dialectical behavior therapy (DBT), and how does it differ from other forms of behavioral therapy?
Dialectical behavior therapy is a form of cognitive behavioral therapy that was originally developed to treat borderline personality disorder, but treatment outcome literature showed that the emotion regulation strategies used in comprehensive DBT offered significant improvement for other mental health conditions including substance abuse and eating disorders.
The goal of DBT is to resolve the contradiction between self-acceptance and change to promote positive emotions, as well as healthy behavior and relationships. Both DBT and cognitive behavior therapy focus on changing thoughts and behavior, but the four DBT skills focus more heavily on emotional regulation and interpersonal relationships.
DBT teaches mindfulness training, emotional regulation skills, distress tolerance techniques, and interpersonal relationship strategies. Working with the therapist, the client will form behavioral targets and practice skills to meet their unique needs.
DBT skills training has been shown to be more effective in reducing self-injury and suicidal behavior in clients with borderline personality disorder than other forms of therapy.
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