is DBT and is it the right approach for you?
Dialectical Behavioral Therapy or DBT is a
cognitive behavioral approach focusing on those who struggle with
an inability to navigate their emotions in every day situations.
Specifically, it is for those who view the world in black and
white terms, have extreme emotional responses to stresses, and
who struggle to maintain relationships because of emotional instability.
The goal of DBT is “to help individuals change behavioral,
emotional, thinking and interpersonal patterns associated with
problems in living.” This is accomplished by focusing on
different areas of distress and identifying coping tools to manage
Is it right for me or my child?
This approach may seem straightforward and
easy to implement. Those that benefit the most from this approach
to therapy suffer when they are unable to center their emotions
or tolerance levels to a baseline that is reasonable for them
or those around them. If this is the case, it is important to
find a therapist certified in DBT.
DBT is now more accessible in group and individual
In the 1970s, Dr. Marsha Linehan and her team
began adding acceptance-based or validation strategies to the
change-based strategies of CBT. In the course of weaving in acceptance
with change, Linehan noticed that another set of strategies –
dialectics – came into play. Dialectical strategies give
the therapist a means to balance acceptance and change in each
session. In the 1990s, DBT approaches were standardized, studied,
and mental health professional began training on these approaches
in the past decade.
What is involved in DBT therapy?
There are several approaches to DBT Therapy
but the most common is individual and group therapy. Individual
therapy focus on skills to be learned, practiced and monitored
to address struggles successfully. This therapy often includes
weekly homework and diaries to monitor the practice of DBT skills.
DBT groups reinforce the practice of DBT skills as well as provide
support from peers with these emotional struggles. While Individual
and Group settings are the most frequent, some additional focused
and team approaches are available for complex situations.
areas of focus in DBT
DBT includes four sets of behavioral skills.
- Mindfulness: the practice
of being fully aware and present in this one moment
- Distress Tolerance: how
to tolerate pain in difficult situations, not change it
- Interpersonal Effectiveness: how
to ask for what you want and say no while maintaining self-respect
and relationships with others
- Emotion Regulation: how
to change emotions that you want to change
There is increasing evidence that DBT
skills training alone is a promising intervention for a wide variety
of both clinical and nonclinical populations and across settings.
“In my experience of training for
and working with DBT approaches, focusing on these four behavioral
skills have brought real change in individuals I have worked with.
While mindfulness and distress tolerance are generally known concepts
in our society, the inability to control your emotions can be
a challenge, but for some, like a client of mine, they find that
their emotions are “like a rollercoaster; once it gets going,
you can’t control the ride.” Building emotion regulation
skills allows for an understanding of the emotion and a way to
alter that emotional thought to be more centered. In times where
emotions are “out of control”, relationships can be
altered and/or unhealthy relationships can be formed. The use
of interpersonal effectiveness skills allows for a person to examine
a situation, focus on the conflict and identify ways to minimize
the conflict in the moment. Furthermore, relationships are examined
and tools are created to identify healthy relationships as well
as ways to minimize unhealthy relationships. It is not easy work,
but it does lead to change.” – Jamie Blum, LCSW-C,
CPE Clinic, LLC