Dialectical Behavior Therapy (DBT) was originally developed by Dr. Marsha Linehan as a comprehensive treatment program to treat chronically suicidal individuals suffering from Borderline Personality Disorder (BPD). During the past two decades, DBT has been found to be especially effective for individuals with suicidal and other severely dysfunctional behaviors.
DBT Skills Part 1: Introduction and Mindfulness Dialectical Behavior Therapy (DBT) is a powerful system with an amazing set of skills that can help you create and live the life you want.
Before developing DBT, Dr. Linehan first attempted to apply standard Cognitive Behavior Therapy (CBT) to the problems of adult women with histories of chronic suicide attempts, suicidal ideation, urges to self-harm,
and self-mutilation. After recognizing that standard CBT was not effective with this group of patients, Dr. Linehan and her research team made significant modifications to their approach, incorporating acceptance-based interventions and a “dialectical world view”–recognizing that everything is connected to everything else, change is constant and inevitable, and opposite perspectives can be integrated to form a more accurate perception of reality.
DBT is based on Dr. Linehan’s theory that the core problem in BPD is emotion dysregulation–a patient’s inability to effectively regulate intense emotional reactions. The focus of DBT is on helping patients learn and apply skills that will increase their ability to regulate intense emotion and decrease ineffective coping strategies. DBT typically includes a combination of individual psychotherapy and group skills training. Patients in DBT are asked to monitor their symptoms and utilize new skills on a daily basis. The four areas that are covered in DBT skills training include:
Randomized controlled trials have demonstrated that DBT is more effective than other forms of psychotherapy in the treatment of BPD and BPD with co-occurring substance abuse. Among other results, these studies found that patients receiving DBT were significantly less likely to drop out of therapy, were significantly less likely to engage in suicidal behaviors, had less medically severe behaviors, were less likely to be hospitalized, and had higher scores on global and social adjustment. For patients with co-occurring substance abuse, DBT was more effective than standard treatment in reducing drug abuse. Other research has shown DBT to be effective in treating a variety of other disorders, including chronic depression, anxiety, eating disorders, and substance abuse.
Source: Cognitive-Behavioral Treatment of Borderline Personality Disorder by Marsha M. Linehan. Guilford Press, 1993.
Psychotherapy, sometimes referred to as “talk therapy,” is a relationship in which the patient seeks professional help from a licensed provider to address difficult or troubling feelings, thoughts, attitudes and/or behaviors. In other words, the psychotherapist helps individuals make important changes in their lives. Psychotherapy is an effective treatment for a variety of psychological concerns. It can be a standalone treatment or combined with medications or other therapies. Your treatment team will work with you to determine which therapies offer you the best opportunity for improved health and well-being.
Psychotherapy can be helpful treatment for virtually all mental health problems and concerns, including:
Psychotherapy can also benefit those who haven’t been diagnosed with a psychological disorder. A licensed therapist can help you work through stress and other conflicts that we all face throughout life, such as medical or chronic illness, major life changes, grief, sleep problems and other issues.
Your first psychotherapy session typically involves the therapist gathering basic information about you and your goals for therapy. You'll be asked to fill out forms about your medical history, social history and current and past emotional/mental health prior to your visit. The therapist will review this information with you in your first session.
In your first few sessions with your therapist, you’ll work together on a treatment plan to make sure you agree on treatment goals, what type of therapy best meets your needs and how long treatment will last.
Your therapist will likely expect you to complete “homework” assignments between sessions—for example, worksheets, readings or behaviors to try. Evidence shows that patients who do between-session work tend to have better therapy outcomes.
Psychotherapy sessions typically last between 45 and 60 minutes, and their frequency will be determined by your individual needs. Typically, early sessions take place weekly or every other week. As symptoms improve, sessions tend to be spaced out.
Many patients begin to feel better or at least become more aware of their thoughts or actions after three to five psychotherapy sessions. A typical course of CBT lasts 10 to 16 sessions, but everyone is different and has different needs.
You’ll get the most out of psychotherapy if you’re open and honest in sessions and treat therapy as a partnership, ensuring that you and your therapist set goals together and both understand the major issues to address. It’s OK if you’re not prepared right away to open up about your emotions. Bringing out certain feelings takes time. Many don’t feel entirely comfortable with the process at first, and if this is the case, you can work with your therapist to make changes that will help you get the most out of the experience.