What is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT), developed by Marsha Linehan, Ph. in the 1980s, is a type of talk therapy originally designed for high-risk, suicidal people diagnosed with borderline personality disorder.

Today, DBT is used to treat people struggling with a range of complex and intense emotions, including substance abuse and addiction, PTSD, bipolar disorder, eating disorders, and depression. It is used in a variety of settings, including addiction treatment centers, community mental health programs, hospitals, and schools.

With the help of highly trained and certified therapists, people who tend to see the world in terms of black and white are able to learn strategies that replace all-or-nothing thinking with a more balanced approach to difficult emotions. 

Components of Dialectical Behavior Therapy

DBT has four main components:

Mindfulness

Patients learn to be more aware of their actions; live in the moment and accept life as it comes. Patients learn the importance of acceptance and balance.

Distress tolerance

Involves crisis survival skills and ways to overcome distressing events and thoughts instead of running away from them or acting on them.

Regulation of emotions

Patients improve their overall quality of life by learning to manage and modify intense emotions that have caused problems in the past. Difficult emotions are softened so that they are no longer overwhelming.

Interpersonal effectiveness

These are methods of communicating with other people in an effective, assertive and respectful manner, thereby reducing conflict in relationships.

How does DCT work?

DBT teaches patients new skills and strategies for navigating the challenges of everyday life. While one-on-one therapy and phone coaching are important, much of the training takes place in groups, which typically meet weekly for 24 weeks.

During group sessions, a therapist guides patients through new skills and regularly assigns homework. Role-playing helps patients practice newly learned ways of interacting with other people.

Dialectical Behavioral Therapy and Addiction Treatment

In addiction treatment, DBT helps patients cope with difficult emotions and manage cravings, reducing withdrawal symptoms that can lead to early discontinuation of drug and alcohol treatment. DBT can also help patients learn to identify and avoid situations that may trigger a relapse after completing treatment or rehab.

If you think dialectical behavior therapy might help, a mental health provider or addiction treatment center can offer suggestions. Make sure DBT practitioners are certified and experienced, with a master's or doctoral degree in psychology, counseling, or a related field. Otherwise, they may not have the proper training and do more harm than good.

DBT practitioners should be certified and experienced.

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