What is Dialectical Behavior Therapy (DBT)?

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What is Dialectical Behavior Therapy (DBT)?

Dialectical behavior therapy is a research-based approach to psychotherapy, known as talk therapy, used to treat various conditions, including substance use disorders, depression, self-harm, and eating disorders.

What is DBT, then?

DBT is a modified form of CBT (cognitive behavioral therapy) that has the following primary goals:

  • Showing you how to live in the moment.
  • Developing healthier coping techniques for stressors.
  • Learning to regulate your emotions more effectively.
  • Improving your relationships with others.

A DBT definition: coping with challenging emotions rather than attempting to avoid them.

Dialectical behavior therapy makes the following assumptions:

  • All things are interconnected.
  • Change is not only constant but unavoidable.
  • If you integrate opposites, you can formulate a closer approximation of reality.

A licensed behavioral therapist will use those assumptions to help you to strengthen skills in the following key areas:

  1. Distress tolerance
  2. Mindfulness
  3. Emotional regulation
  4. Interpersonal effectiveness

How Does DBT Work?

Dialectical therapy approaches many mental health conditions as conditions of emotion dysregulation, focusing on emotions and how they can contribute to flawed behavior patterns. In DBT sessions, you will learn how to recognize, understand, identify, and regulate your emotions. You will also discover how to deal with interpersonal situations that trigger painful or negative emotions.

In preparation for weekly one-to-one sessions, you will complete a self-monitoring form or online form that charts your moods, behaviors, and skills. You will rank the intensity of emotions like pain, fear, anger, sadness, or suicidal thoughts. Additionally, you will use a skills checklist to note how often you engaged in health practices like radical acceptance, soothing, or distracting to reduce your vulnerability or change your actions.

During individual DBT sessions, your therapist will identify treatment targets for the session, help you to perform a behavioral analysis, and discuss the consequences of your actions. You will then establish superior methods of dealing with emotional problems.

DBT Approach

The DBT approach involves a course of treatment that includes:

  • Individual therapy sessions.
  • Skill-focused group sessions.

Weekly one-to-one sessions last for one hour, while group sessions involve four to ten people meeting with a DBT practitioner for two hours once weekly.

The DBT approach is skills-based and present-oriented. You can expect homework assignments as well as group sessions, offering you ample opportunities to put what you learn into practice.

DBT specifically focuses on providing therapeutic skills in four key areas.

1) Mindfulness

Mindfulness was one of the central elements of dialectical behavioral therapy from its inception. It remains foundational and serves as the first module of DBT.

The simple concept of mindfulness involves paying close attention to the present. This concept is sometimes expressed as living in the moment.

While learning the skill of mindfulness, you’ll also explore how to embrace your emotions and thoughts.

There are two specific sets of skills your therapist will help you to master:

  • What: You will learn to accurately observe the environment.
  • How: You will learn how to maintain focus in the face of adverse or negative environments.

2) Distress tolerance

Distress tolerance is the second module of DBT. In this module, you’ll consolidate the what and how skills you acquired in the opening mindfulness module of therapy.

The aim of the second module is to help you to cope more confidently with stressful situations using positive behaviors.

3) Emotion regulation

Emotion regulation is the third module of dialectical behavioral therapy.

You will learn how to stop yourself from being perpetually driven by emotions. Instead, you’ll discover how to keep your emotions in check, invaluable if you’re battling alcohol use disorder or substance use disorder.

4) Interpersonal effectiveness

The final module of dialectical behavioral therapy imparts vital interpersonal skills.

Your therapist will show you how to better identify your needs, and to seek assistance if those needs are not being satisfied.

Other skills you’ll learn in the fourth module of DBT include conflict management – learning to say no to people, situations, or behaviors that do not serve your recovery goals

Who Can Benefit from DBT?

DBT can be an effective therapeutic modality for those with the following conditions:

  • Substance abuse disorder
  • Alcohol use disorder
  • Anxiety disorder
  • Major depressive disorder
  • Bipolar disorder
  • PTSD (post-traumatic stress disorder)
  • BPD (borderline personality disorder)
  • Eating disorders like bulimia or anorexia
  • Suicidal thoughts or behaviors
  • Mood swings
  • Relationship problems
  • Impulse control problems

What is DBT Like?

DBT is delivered in individual and group settings over the course of months or years, depending on the condition it is used to treat.

DBT Program Methods

  • Group dialectical behavioral therapy: You get the chance to learn crucial behavioral skills through role-playing exercises and homework assignments.
  • Individual dialectical behavioral therapy: You will work closely one-to-one with a qualified therapist to adapt the behavioral skills you learn to the problems and challenges you are facing.
  • Phone or remote dialectical behavioral therapy: For anyone unable or unwilling to engage with face-to-face DBT, it is possible to attend sessions on the phone or online.


Group Sessions

DBT group therapy sessions are not the same as regular group therapy sessions in which you discuss your problems with others. Group skills sessions help you to enhance your ability to cope in everyday life. The therapist will teach the core skills of DBT in these sessions – mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation.

Individual Sessions

A therapist will deliver weekly individual DBT therapy sessions lasting for 40 to 60 minutes.

In individual DBT sessions, you can achieve the following:

  • Limit behaviors that interfere with therapy.
  • Reduce self-harming or suicidal behaviors.
  • Replace unhelpful behaviors with new skills.
  • Improve quality of life and reach treatment goals.

You will chart your emotions and behaviors in a diary to help identify any patterns of destructive actions. Your therapist will use this diary as the basis of individual sessions.

 What Does Dialectical Behavior Therapy Treat?

DBT was first used in the late 1980s when Dr. Linehan discovered that CBT alone did not work as expected for the treatment of BPD (borderline personality disorder). By adding techniques to CBT, the treatment team developed a new form of CBT to meet the specific needs of BPD patients.

DBT Uses

Although initially developed with the treatment of borderline personality disorder in mind, research shows that DBT can also be beneficial for many mental health disorders and for most types of addictions.

Mental Health Disorders

DBT therapy mental health can be effective for the following conditions:

  • GAD (generalized anxiety disorder)
  • Major depressive disorder
  • ADHD (attention-deficit hyperactivity disorder
  • PTSD (post-traumatic stress disorder)
  • Eating disorders
  • Non-suicidal self-harm
  • OCD (obsessive-compulsive disorder)
  • Suicidal ideation

DBT for Addiction

DBT-based therapy works especially well for the treatment of addiction, but why is this?

Well, your dialectical behavioral therapist will work closely with you to help you directly address and resolve harmful and negative behaviors preventing you from improving your life.

When applied within the framework of addiction treatment programs, DBT therapy illuminates the ways in which substance use impacts the overall quality of life. The DBT clinician will also encourage healthy target behaviors, including:

  • Alleviating the physical pain of detox and withdrawal.
  • Working to minimize cravings for drink or drugs.
  • Avoiding triggers and cues associated with substance use.
  • Reinforcing positive behaviors.
  • Reducing substance use.
  • Eliminating behaviors that encourage substance use.

Frequently, negative behaviors present as a coping mechanism for bad situations or bad feelings. Using substances to self-medicate the symptoms of anxiety or depression is an example of this. DBT sessions can help you to develop healthier and more effective methods of coping with stress. As you start understanding DBT, you will also learn to be more mindful and how to master your emotions rather than being emotionally driven.

DBT also encourages acceptance and change, and in this way it is unique among talk therapies applied as behavioral interventions.

If you are engaging with DBT for addiction treatment purposes, you will be pushed to quit using drugs or alcohol immediately.

When DBT treatment is used for the purposes of addiction recovery, the therapist will help you  to stop using drink or drugs immediately. At the same time, DBT acknowledges the reality of relapse. Data shows that relapse rates for alcoholism or drug addiction are between 40% and 60%. What we see here is the dialectic aspect of DBT in the form of a union of change and acceptance, a pair of opposing forces. Viewed through the lens of dialectical behavioral therapy, relapse is a solvable problem and not the end of the line. Indeed, relapse will be used to help you further evaluate the thoughts and behaviors that triggered a relapse. With that done, your therapist will help you to repair any damage while underscoring the benefits of sustained sobriety.

We hope that today’s DBT info has helped you to define DBT and determine what is DBT treatment. 

Dialectical Behavior Therapy at Ohio Community Health

All of the Cincinnati drug & alcohol addiction rehab programs we offer at Ohio Community Health provide access to DBT treatment as a component of a treatment plan for drug addiction or alcoholism. We also offer treatment programs for mental health disorders like depression, anxiety, and PTSD that co-occur with addiction. We also specialize in the dual diagnosis treatment of co-occurring disorders.

Choose the type of program that best fits the severity of your addiction and your personal circumstances. We provide therapy at the following levels on the American Society of Addiction Medicine’s continuum of care:

  • PHPs (partial hospitalization programs)
  • IOPs (intensive outpatient programs)

Kickstart your recovery at Ohio Community Health Recovery Centers and benefit from a personalized array of science-backed treatments that include dialectical behavior therapy. Reach out today by calling 513-757-5000 for immediate assistance and more information on DBT behavioral therapy.

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