Dialectical Behavioral Therapy (DBT)
The theory behind Dialectical Behavioral Therapy, or DBT, is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT theory suggests that some people’s arousal levels in such situations can increase far more quickly than the average person’s, attain a higher level of emotional stimulation, and take a significant amount of time to return to baseline arousal levels.
Components of DBT
- Support-oriented: It helps you identify strengths and builds on those strengths so that you can feel better about yourself and your life.
- Cognitive-based: DBT helps to identify thoughts, beliefs, and assumptions that make life harder: “I have to be perfect at everything.” “If I get angry, I’m a terrible person” & helps people to learn different ways of thinking that will make life more bearable: “I don’t need to be perfect at things for people to care about me”, Everyone gets angry, it’s a normal emotion.
- Collaborative: Our therapists will ask you to complete homework assignments, to role-play new ways of interacting with others, and to practice skills such as soothing yourself when upset. These skills, a crucial part of DBT, are taught in weekly lectures, reviewed in weekly homework groups, and referred to in nearly every group. Our therapists help you to learn, apply and master DBT skills.
The 4 Modules of Dialectical Behavior Therapy
Observe, Describe, and Participate are the core mindfulness “what” skills. They answer the question, “What do I do to practice core mindfulness skills?”
Non-judgmentally, One-mindfully, and Effectively are the “how” skills and answer the question, “How do I practice core mindfulness skills?”
- Interpersonal Effectiveness
The interpersonal response patterns –how you interact with the people around you and in your personal relationships — that are taught in DBT skills training share similarities to those taught in some assertiveness and interpersonal problem-solving classes. These skills include effective strategies for asking for what you need, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict.
- Distress tolerance
Distress tolerance skills constitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.
Distress tolerance behaviors are concerned with tolerating and surviving crises and with accepting life as it is in the moment.
Four sets of crisis survival strategies are taught:
distracting, self-soothing, improving the moment, and thinking of pros and cons.
Acceptance skills include:
radical acceptance, turning the mind toward acceptance, and willingness versus willfulness.
- Emotion Regulation
People with substance abuse history and/or mental health diagnosis can be emotionally intense and labile — frequently angry, intensely frustrated, depressed, and anxious.
This suggests that people grappling with these concerns might benefit from help in learning to regulate their emotions.
- Dialectical behavior therapy skills for emotion regulation include:
- Learning to properly identify and label emotions
- Identifying obstacles to changing emotions
- Reducing vulnerability to “emotion mind”
- Increasing positive emotional events
- Increasing mindfulness to current emotions
- Taking opposite action
- Applying distress tolerance techniques