For example, the American Psychiatric Association (1998) estimated that DBT decreased costs by 56% – when comparing the treatment year with the year prior to treatment – in a community-based program. In particular, reductions were evident by decreased face-to-face emergency services contact (80%), hospital days (77%), partial hospitalizations (76%), and crises bed days (56%). The decrease in hospital costs (~$26,000 per client) far outweighed the outpatient services cost increase (~$6,500 per client).
The final component of DBT is interpersonal effectiveness, which aims to teach individuals to communicate in healthy and respectable ways. This technique aims to help individuals think about some of the helpful things they can do to manage their behavior and emotions so that they do not act impulsively or risky, with potentially negative consequences. Marsha Linehan developed DBT in the 1980s to help people with suicidal thoughts who often had a diagnosis of borderline personality disorder (BPD). In some places, however, a complete DBT treatment program may be hard to find. But even without a full program, some therapists will use DBT techniques in their sessions.
What is Dialectical Behaviour Therapy (DBT)?
Over the years, it’s been adapted to help with a range of mental health issues, some of which may co-occur with learning and thinking differences. DBT was initially designed to treat people with suicidal behavior and borderline personality disorder. But it has been adapted for other mental health problems that threaten a person’s safety, relationships, work, and emotional well-being.
Cognitive behavioral therapy tries to identify and change negative thinking patterns and pushes for positive behavioral changes. DBT therapists are supported by a team of other therapists while providing treatment to clients. This keeps the treating therapist motivated and helps to prevent burnout. They allow therapists to discuss client cases as a group and to brainstorm treatment strategies. DBT provides clients with access to their therapist (typically by phone) between therapy sessions. The purpose of these calls is to allow the therapist to coach a client—in real time—through difficult circumstances in which the client can practice their newly learned skills.
Related Programs & Services
While DBT has shown promising results for many individuals, it’s important to acknowledge that it may not be effective for everyone. Linehan et al. (1991) conducted the first randomized controlled trial of the effectiveness of DBT on women with BPD. The therapist can give guidance on how to cope dialectical behavioral therapy with a situation as it is happening. The overall goal of this contact is to coach the client on how to put their DBT skills into practice whenever required. The group leaders will also assign homework to aid the clients in practicing the skills they have been taught in their everyday life.
To demonstrate interpersonal effectiveness, clients are often given roleplay scenarios to practice assertiveness skills. This may involve refusing an unreasonable request or asking to have a need met appropriately. This skill can help individuals prepare for intense emotions they may experience and use distraction techniques to help decrease feelings of distress (e.g., listening to music or going for a walk). As people experiencing issues with their mental health may encounter a lot of distress, the component of distress tolerance in DBT is important to learn how to manage upsetting situations. Through emotional regulation, people are taught that they may experience intense emotions, but they can choose how to react to them in a healthy way. 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.
What is DBT Used For?
Dialectical behavior therapy (DBT) usually takes at least six months to a year. However, each person is unique, and mental health conditions are complex. You shouldn’t expect to be completely free of symptoms or no longer have problematic behaviors after one year of DBT. If you struggle to manage painful emotions or experiences like stress, anger, and rejection, dialectical behavior therapy (DBT) can help. Group skills training typically runs once a week for two-hour sessions for the duration of the therapy. The therapist does this by applying dialectical, validation, and problem-solving skills to enable the clients to learn to be their own managers of personal life challenges.
- Although it may be difficult and time-consuming to find the right DBT therapist for you, it’s important to keep trying.
- Most clinicians, including Dr. Linehan, the developer of DBT, believe that treatment for BPD can often take several years.
- In addition, the skills and strategies taught in DBT are balanced in terms of acceptance and change.
On its website, you can learn about core DBT skills, research about DBT and its effectiveness, or find a DBT provider. There are a few helpful ways you can prepare yourself for your first DBT session, says Shah. First, it’s important to manage your expectations and bear in mind that therapy is typically not a quick fix. The therapist teaches skills in a group setting and assigns homework as a way to practice new strategies.
DBT specifically focuses on providing therapeutic skills in four key areas. If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. DBT is complex, and it’s generally not something that people can do on their own without the guidance of a trained therapist. The idea is to distract yourself by allowing your emotions to follow your body. Some of the strategies and techniques that are used in DBT include the following. If your therapist is unavailable, call the Suicide and Crisis Lifeline at 988.
However, this type of therapy is now used to treat people with a variety of mental health conditions. DBT includes four behavioral skill modules, with two acceptance-oriented skills (mindfulness and distress tolerance) and two change-oriented skills (emotion regulation and interpersonal effectiveness). To address this function, standard DBT includes a therapist consultation-team meeting, for which DBT therapists meet once per week for approximately 1 to 2 hours. The team helps therapists problem-solve ways to implement effective treatment in the face of specific clinical challenges (e.g., a suicidal patient, a patient who misses sessions). A couple of studies have examined DBT for women with BPD in community settings, such as a community mental health center and a VA hospital. In a community mental health setting, Turner6 compared a modified version of DBT that only included individual therapy to a client-centered therapy control condition.
Components of DBT
However, there are some things you can do on your own to help you develop new coping skills. For example, mindfulness, breathing exercises, and progressive muscle relaxation are all skills you can utilize to improve your ability to tolerate distress. In practice, the therapist validates that an individual’s actions “make sense” within the context of their personal experiences without necessarily agreeing that the actions are the best approach to solving a problem. Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook. Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary.
Thus, DBT was developed to help people with DBT manage these core symptoms by providing them with skills to reach their goals. DBT is premised on the idea that many problems are based on a skill deficit, and that by giving clients better skills they can live a happier and more productive life. Each lesson includes a short video and then an exercise with an accompanying worksheet. Many readers use them between sessions with their therapist or you can use them as a self-study course to do on your own.
