What is DBT or dialectical behavior therapy?

Dialectical behavior therapy (DBT) is a type of talk therapy meant for people who feel their emotions very intensely. It is based on cognitive behavioral therapy (CBT). Cognitive behavioral therapy (CBT) is also a type of talk therapy. It helps people understand how their thoughts affect their feelings and actions.

“Dialectical” means to combine opposing ideas. Dialectical behavior therapy (DBT) teaches people to accept their current reality and behaviors while helping them learn to change unhelpful behaviors.

American psychologist Marsha Linehan developed DBT in the 1970s.

What is the purpose of dialectical behavior therapy (DBT)?

Dialectical behavior therapy (DBT) is beneficial for individuals who have a hard time controlling and managing their emotions.

DBT is beneficial for the treatment and management of almost any mental health disorder, such as:

• Borderline personality disorder (BPD).
• Self-harm.
• Suicidal behavior.
• Post-traumatic stress disorder (PTSD).
• Substance use disorder.
• Eating disorders, such as binge eating disorder and bulimia.

Note that DBT is effective in treating these conditions because each is thought to be associated with issues that arise from unhealthy or problematic efforts to control intense, negative emotions. Rather than relying on efforts that cause problems for the person, DBT teaches people healthier ways to cope.

How do I find a DBT therapist? 

You can see different therapists, including psychiatrists, medical doctors, nurses, psychologists, social workers, and family therapists. 

Finding the right therapist can take time, including for DBT therapy. Keep trying. Ask people you trust for recommendations. This could be your primary care doctor, a friend, or a family member. 

You can also look online for therapists through local and state psychological associations.

Make sure that any therapist you would like to see is state-certified and licensed as a mental health professional and treats your area of concern (such as eating disorders, borderline personality disorder, self-harm, etc).

Many therapists' websites include the conditions and problems they treat. If you need clarification, call or email the therapist's office before you make a decision.

Below are some questions to ask from DBT therapist:

• What training do you have in DBT?
• Do you provide full DBT, or do you offer an adapted version? If you don’t offer full DBT, can you explain why?
• Are you part of a DBT consultation team?
• What is your policy on making calls and sending emails during the week?
• How much time will you ask me to commit to the therapy process?

How does dialectical behavior therapy (DBT) work?

The main goal of DBT therapists is to help you accept yourself and your challenges while also encouraging positive change. You will learn how to better control your emotions from your therapist.

DBT usually includes four types of sessions:

1. DBT pre-assessment.
2. Individual therapy.
3. Group skills training.
4. Telephone crisis coaching.

1. DBT pre-assessment:

Your therapist may provide an assessment before beginning DBT. They will determine whether DBT is appropriate for you by questioning and informing you how DBT works. If you decide that DBT is the proper therapy for you, they will ask you to commit to the treatment and the duration of treatment.

2. Individual DBT therapy:

Individual DBT therapy includes weekly sessions with your therapist. Each session lasts about 40 to 60 minutes.

The main goals of individual DBT therapy sessions are:

1. To help keep you safe by reducing suicidal and self-harming behaviors, if needed.
2. To limit behaviors that interferes with effective therapy.
3. Helping you achieve your goals while enhancing the quality of your life by dealing with some blockage to your progress, such as mental health conditions or other relationship issues.
4. Help in learning new skills to replace unhelpful behaviors.

Your therapist will probably ask you to maintain a diary of your emotions and behaviors and look for behavior patterns. You take this diary to sessions so you and your therapist can decide what you will work on for those sessions.

3. DBT Skills Training in Groups:

During these sessions, you will learn techniques from your therapist in a group. This is different from group therapy, where people discuss their problems. Think of it as a classroom setting focused on teaching and learning.

• DBT skills help improve your daily life: Your therapist will teach you four main skills. One of these skills is mindfulness, which means being aware and focused on the present instead of worrying about the past or future.
• Distress tolerance: Distress tolerance is the ability to understand and manage your emotions amidst difficult or stressful situations; you do not react with abusive behaviors.
• Interpersonal effectiveness: This is the ability to understand how to ask for what you want and need yet set boundaries while maintaining respect for the self and others.
• Emotion regulation: This refers to being informed, more conscious, and better controlling of your emotions.

4. Telephone crisis coaching:

DBT offers telephone crisis coaching to aid in daily life. It allows one to call one's therapist at predetermined times for help between sessions.

Some instances where you might want to call your therapist include:

When in a situation of immediate crisis: Such as having the urge to harm yourself. Thats way, when you want to employ your newly learned DBT skills but need some guidance regarding the process.

However, they will establish limits on what times you can make the call, such as a specific set amount of time during any given day.

Crisis coaching is available when and as needs arise. The calls are very often short in duration and cannot supplant work done in individual or group sessions.

What are the advantages and disadvantages of dialectical behavior therapy (DBT)?

Numerous studies have shown that dialectical behavior therapy, or DBT, is beneficial in treating mental health conditions. For those with borderline personality disorder, specifically, DBT leads to:

• Reduced self-harm behaviors and anger.
• Fewer days of inpatient hospitalization.
• Reduced drug and alcohol use.
• Improved depressive symptoms.

However, DBT is only for some, and it can be tough. DBT is more likely to help you if you:

• Are dedicated to making positive changes.
• Are ready to commit to therapy and complete your homework assignments.
• Are willing to focus on your present and future rather than your past.
• Feel comfortable attending some sessions in a group with others.

What is the duration required for dialectical behavior therapy?

Dialectical behavior therapy (DBT) generally takes at least six months to a year. However, no two individuals are alike, and the complexities of mental health issues make them more complex. You can't expect that after a year of DBT, you'll be symptom-free or won't have those problematic behaviors.

Most therapists feel that treatment for borderline personality disorder is usually often for several years.

Try not to get discouraged by how long it may take until you can better manage your feelings and emotions and find a better quality of life. The significant fact is that you want to seek help. Any gain is a good gain.

When should I visit my therapist or healthcare provider while undergoing DBT?

This is important: you should attend all scheduled individual DBT sessions and group skill training.

If you are in a crisis, such as thinking about suicide, and you can do so, you should contact your doc

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