Dialectical Behavior Therapy (DBT)

When Is Dialectical Behavior Therapy Used?

Your therapist will assess your needs and discuss the symptoms you have. This treatment, which was once used exclusively for borderline personality disorder, is more versatile today. Therapists can modify and use this strategy to help people with a range of mental health disorders, including:

• Borderline personality disorder
• Suicidal behavior
• Self-harm
• Post-traumatic stress disorder
• Substance use disorders
• Extreme anxiety
• Depressive moods
• Eating disorders, including binge eating disorder and bulimia

DBT is helpful in these situations for several reasons. Specifically, it helps with conditions thought to be associated with unhealthy and problematic efforts to control negative, but intense emotions.

Instead of depending on strategies and techniques to address the underlying cause of the problems, DBT provides strategies for how to deal with what’s happened or is happening now. It’s more focused on coping mechanisms in these difficult situations.

What Happens in DBT?

After meeting with your therapist and discussing your symptoms, you’ll develop an individualized treatment strategy to address the symptoms you have. DBT may be one of several types of therapies used.

Your therapist will explain the goal of DBT to you. That is to find a balance between validation, or the acceptance of what is happening, and the benefits of change for you. You’ll create specific goals to work on and then learn new skills that support better emotional regulation.

Most of the time, therapy will focus on the following types of sessions over a period of time.

• An initial assessment to create a broad foundation from which you will work
• Individual therapy involves one-on-one conversations with your therapist to express yourself and explore your emotions and thoughts.
• Skills training, conducted in group and individual therapy sessions, helps you build practical skills to improve how your mind processes these situations.
• Crisis coaching may be provided over the phone. That can be effective, for example, if you are struggling at that moment with emotional pain and need help. Virtual therapy could offer immediate help.

What happens in individual therapy?

The most intense type of treatment received is during individual therapy sessions. These are often 40 minutes or up to an hour. During them, you’ll feel safe and supported. Most sessions have specific goals, including:

• To keep you safe. This may include reducing suicidal thoughts and behaviors. It may also address self-harming behaviors you’ve experienced or spoken about in the past.
• To limit the reach of behaviors. You’ll discuss ways to limit how those behaviors get in the way of your life and responsibilities, and why they may be limiting productive therapy.
• To improve the quality of life. This treatment helps to address what’s behind your progress. It might include mental health conditions and relationship struggles.
• To replace negative thoughts and behaviors. You will learn specific strategies to replace the unhelpful and negative behaviors with those that are healthier.

You’ll spend time processing what you learn during individual therapy. Consider keeping a journal to document what your thought processes are. You may also be encouraged to keep a chart that allows you to track emotions and the actions you take resulting from them. This may seem straightforward, but seeing this information on paper or in a phone app helps your brain to make critical connections.

Group Therapy with DBT

DBT is also a therapy provided in group therapy. You’ll work within a small group of your peers to build skills. This isn’t necessarily about your specific needs but rather the skills most people with mental health disorders can use to improve reactions and behaviors. During skills training, you’re working to improve your ability to manage mental health every day.

Some of the strategies often included in DBT training include:

• Distress tolerance development. The focus in this type of skill session is to understand and manage emotions in high-stress situations without reacting with harmful behaviors.
• Mindfulness. The practice of mindfulness is very important to overall mental health. It allows you to be fully aware and focused on being present in what you are doing. That means you’re not worrying about the past or the future.
• Emotional regulation. This is one of the most important benefits of DBT and the most challenging skill to learn. You will learn to understand, be aware of, and then control your emotions to facilitate a better outcome.
• Communication building. During these sessions, you’ll learn how to process what your needs and wants are and then communicate that in a more effective way. It also teaches how to set boundaries so that you’re always respecting yourself and others.

Group therapy happens over time. You’ll engage in education, interactive demonstrations, and open conversations within your group. For many, it’s very beneficial because it presents real-world strategies for overcoming challenges.

Dialectical Behavior Therapy FAQs

What are the benefits of DBT treatment?

Many people see significant improvement over time with DBT residential treatment centers. This may include less risk of self-harm, fewer days spent in a hospital psych ward, less dependency on alcohol or drugs to control symptoms, and improved mood.

Is DBT right for everyone with a mental health disorder?

It’s not always the ideal treatment plan, which your therapist will consider with you. You also must be ready to make positive changes and fully committed to therapy. That includes completing follow-up therapy and even doing homework. You also must be ready and able to focus on the present rather than just addressing the past.

Does DBT actually work?

DBT works well for many people, but it takes consistency. Most people begin to see real improvement after six months and sometimes a year of continuous care. However, from your first session, you’ll learn critical strategies that can help you to be more aware and start better understanding the best ways to manage stress, trauma, and emotions. Every session creates an opportunity for improvement.