The goal is to take negative thinking patterns and associated destructive behaviors, and transform them into positive thoughts, behaviors, and outcomes.
This approach has been particularly useful in treating addiction. In a DBT session, the client will talk with a therapist to identify the root causes of their problems. They’ll then take specific steps to change behaviors.
The point of dialectical behavior therapy is to create a controlled, safe environment to practice emotional regulation, either individually with a therapist or in a group setting. When in combination with group therapy, DBT helps people build skills for self-management in daily life.
DBT was originally developed to treat those with borderline personality disorder or who have ongoing thoughts of suicide. Now, in addition to treating these issues, dialectical behavior therapy is applied to the following conditions:
Skills that DBT focuses on building include:
DBT has been found effective for several mental and behavioral conditions. For example, at the Linehan Institute at the University of Washington, cutting-edge research found that DBT was helpful for people with borderline personality disorder (BPD), especially people who had severe suicidal thoughts and difficulty managing their emotions. The therapy has now been applied to other conditions with positive results.
Dialectical behavior therapy has been successfully used to treat eating disorders by helping people learn to:
These steps can also be applied to addiction treatment. People who struggle with substance abuse may experience high-stress situations as triggers to consume intoxicating substances. This can imbalance brain chemistry and make stress and anxiety, along with other mental health disorders, worse over time. By reducing anxiety, managing emotions, and reflecting on personal triggers for destructive behaviors, a therapist can guide their client toward controlling self-destructive behaviors like getting high or drinking too much.
DBT sessions can be used to create behavioral plans. These are particularly useful throughout treatment as well as during the first few years after completing the program.
More rehabilitation programs are focusing on aftercare plans with their clients. A daily, weekly, and monthly schedule centered on personal health and wellness has been linked to reduced problems with relapse. DBT’s behavioral plans address this.
In group DBT sessions, a therapist can cultivate group support and understanding for each individual journey. Group sessions can serve as a safe space to discuss problems and options for fixing them, helping participants to develop understanding of the shared human experience.
Each DBT session will involve homework assignments, roleplaying new ways of interacting with others, and practicing coping mechanisms and self-soothing skills to manage overwhelming emotions when upset.
Through sessions, participants will learn to:
DBT that is focused on changing substance abuse behaviors ideally starts with the client immediately quitting use of the drug. This should be done in conjunction with a medical detox program.
Just because you can safely quit using a drug does not mean you will not relapse. Relapses are not a moral failing. Nonjudgmental problem-solving sessions reinforce that behavioral change is good. DBT sessions can view relapse as a step on the overall journey to recovery rather than a failure.
Some sessions are adjusted depending on the client’s physical needs during detox. For example, those struggling with opioid addiction may take maintenance medications rather than demanding complete abstinence from all substances.
DBT is a subset of cognitive behavioral therapy. There is a lot of overlap in the two approaches, as both involve talking through problems to find underlying patterns of behavior and developing better coping skills or ways to change these behaviors.
Unlike CBT, dialectical behavior therapy focuses on changing interpersonal relationships and managing emotions. This is largely because this is a major component of borderline personality disorder, which is marked by large, dramatic mood swings that can lead to statements or attempts at suicide, stalking, or other disturbing and even illegal behaviors. These issues can obviously make it difficult to maintain relationships.
People who have BPD or eating disorders are at higher risk of developing substance abuse problems. Using DBT alongside other substance abuse treatments can help a wider range of people who struggle with drugs or alcohol. By addressing all co-occurring disorders simultaneously, people have a better chance at sustained recovery from substance abuse.
What Is DBT? (September 2016). Psychology Today.
Dialectical Behavioral Therapy (DBT). (January 2019). Healthline.
An Overview of Dialectical Behavioral Therapy. (June 2019). Psych Central.
Dialectical Behavior Therapy for Substance Abusers. (June 2008). Addiction Science & Clinical Practice.[/vc_column_text][/vc_column][/vc_row]