Dialectical Behavior Therapy DBT: What Is It?

DBT was developed in the late 1980s by Dr. Marsha Linehan and colleagues when they discovered that cognitive behavioral therapy (CBT) alone did not work as well as expected in patients with BPD. Dr. Linehan and her team added techniques and developed a treatment to meet the unique needs of these individuals. Dialectical behavior therapy (DBT) is a modified type of cognitive behavioral therapy (CBT). Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.

Through an interplay of science and practice, clinical experiences with multiproblematic, suicidal patients sparked further research and treatment development. Most notably, Linehan weaved into the treatment interventions designed to convey acceptance of the patient and to help the patient accept herself, her emotions, thoughts, the world, and others. As such, DBT came to rest on a foundation of dialectical philosophy, whereby therapists strive to continually balance and synthesize acceptance and change-oriented strategies.

What are the benefits and risks of dialectical behavior therapy (DBT)?

Dialectical Behavior Therapy was originally developed by psychologist Dr. Marsha Linehan in her work with women who had been hospitalized after attempting suicide or serious self-harm. The second important goal in the hierarchy of DBT is to keep patients in therapy. In our study, the drop-out rate amounted to 25%, which ranks slightly below the drop-out rate of 38% as found in a comparable study by Rathus and Miller [7, 9]. Taken together, with completion rates between 62% and 90%, this corresponds with the current literature on DBT [7, 9].

• In a study of depressed elderly patients who met criteria for a personality disorder,15 investigators compared an adapted version of DBT plus antidepressant medications to medications only.
• Without very skillful and effective parenting or child-rearing, the child has difficulty learning how to cope with such intense emotional reactions.
• DBT is typically used for individuals who have multiple mental health issues.
• This may pose a challenge for people who have difficulty keeping up with these assignments on a regular basis.

These include active listening skills, communication skills, critical thinking skills, problem-solving skills, empathy, nonverbal communication skills, and flexibility skills. Eating disorders are psychological conditions indicated by unhealthy eating habits such as binge eating or anorexia, bulimia, and others. The consequences of eating disorders are disastrous and life-threatening.

DBT Treatment Stages

The standard form of DBT consists of individual therapy, skills training group, phone coaching, and a therapist consultation team. Those in standard DBT attend therapy https://ecosoberhouse.com/article/alcohol-insomnia-causes-and-ways-to-eliminate/ and a skills training group weekly. The groups are designed to help those in treatment develop behavioral skills through group work and homework assignments.

Two of these trials (carried out in our research clinic) specifically targeted highly suicidal women with BPD, and we are in the midst of a third trial targeting the same population. In our first study, results favoring DBT were found in each DBT target area. In our second study, we compared DBT to a much stronger control condition, treatment by non-behavioral community experts (TBE). In comparison to TBE, DBT reduced suicide attempts by half, had less medically severe self-injurious episodes, lower rates of treatment drop-out, and fewer admissions to both emergency departments and inpatient units due to suicidality. In studies of substance dependent BPD patients conducted at our research clinic as well as at other sites, DBT has been found to be superior to control treatments in reducing substance use. DBT incorporates many of the techniques of cognitive behavioral therapy (CBT).

Differences Between DBT and CBT

Dialectical behavior therapy helps patients cope with their thoughts and feelings even when they leave the therapist’s office. “Phone coaching,” an essential component of DBT, is designed for just that. Phone coaching helps patients apply skills when they are having trouble doing so in the moment. Patients and therapists develop plans for when and how to use phone coaching. DBT treatment generally consists of therapy in individual and group settings, practicing skills outside of sessions (e.g., “phone coaching,” homework), and working with a therapist who participates in a consultation team.

DBT-A has significantly reduced behavioral incidents in comparison to treatment as usual [8]. During treatment, non-suicidal self-injurious behavior reduced significantly. Before the start of therapy, 8 of 12 patients had attempted suicide at least once. There were neither suicidal attempts during treatment with DBT-A nor at the one-year follow-up.

During DBT sessions, therapists often assist patients with behavioral skills, and then they can practice these skills in group sessions. She has a Master of Education and a Master of Arts degree in Psychological Counseling from Teachers College, Columbia University. Her areas of expertise include depression and anxiety, stress management, and cognitive behavioral and Dialectical Behavioral Therapy. Bisma has extensive experience counseling children, teens, and adults from diverse backgrounds and helping them deal with various life issues. Bisma currently works at Mount Sinai Hospital in the Psychiatric Department as a therapist and has a podcast called Therappuccino where she addresses various issues related to mental health. Individuals will be taught positive, healthy ways to deal with stress and general emotions that will occur from daily situations, and improve their overall relationships with loved ones and regulate their emotions.