What is Dialectical Behavior Therapy (DBT)?

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dialectical-behavior-therapyAmong the most effective treatments for chronic suicidal behavior is Dialectical Behavior Therapy, or DBT. The method was first used in the 1980s to treat suicidal patients but soon was discovered to be effective in a whole range of disorders including Post Traumatic Stress Syndrome, a condition that so many of our returning veterans face. But what is this treatment and how does it work?

Dialectical Behavior Therapy is a Type of Cognitive Behavioral Therapy.

People basically struggle with two types of disorders, those which are thought-based and those which are seated in our emotions or ideas. For instance, you might worry about a dentist appointment so much that you have an anxiety attack. The doctor may be able to lower your anxiety level by explaining the procedures and letting you know what to expect and how to cope with it. That is Cognitive Therapy. Or, you might suddenly begin to perspire and have headaches and feel sick without knowing why and your counselor will help you deal with the symptoms until the cause can be isolated. That is Behavioral Therapy. Cognitive behavioral Therapy combines these approaches.

What Does DBT Entail?

According to “Behavior Tech.com,” there are four components of Dialectical Behavior Therapy. The first is Skill Training Group. An instructor lectures and assigns homework teaching skills including Mindfulness which, according to “Psych Central.com” means being aware of your environment, observing, describing and participating.

The second skill is Distress Tolerance. This is different than many therapies because the common approach is to alleviate the distressing event but DBT focuses on tolerating the pain caused by the situation.

Third in the skills is Interpersonal Effectiveness. That means learning to ask for what you want or need, and being able to say no to requests without destroying relati0onships.

The last skill in this course is Emotion Regulation. This involves being able to change an emotion if you want to.

Along with Skill Training Group, people undergoing DBT receive Individual Therapy. This occurs once a week throughout the two years.

The third component is Phone Coaching. This is an emergency intervention similar to people calling Alcoholics Anonymous coaches when they need to know how to handle a pressing situation.

The last part of the therapy is for therapists. It is a support group to keep them motivated and on track. The group consists of peers, each of which is involved in the treatment program.

How Does the Term “Dialectical” Apply to this Therapy?

Dialectical means uniting two opposites. In DBT, the opposites are change and acceptance. Two of the skills taught focus on accepting the situations and two focus on changing aspects of them. DBT therapists accept their clients for who they are while understanding that they must change some behaviors to be successful in their lives. Most people receiving this treatment have multiple problems. Those that threaten life are addressed first, then the behaviors that threaten therapeutic goals, like not attending classes. Finally, therapists address the problems that inhibit clients from acquiring the basic skills.

There are many theories about therapy and many different approaches to emotional and mental illness. Some therapies are more effective than others when dealing with specific disorders. Dialectical Behavioral Therapy is an exciting field because it is effective for many problems.

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