Dialectical Behavioral Therapy (DBT): Balancing Acceptance and Change

Dialectical Behavioral Therapy (DBT) In Vancouver, BC

Dialectical Behavioral Therapy (DBT): Balancing Acceptance and Change
Dialectical Behavioral Therapy (DBT) is a type of cognitive-behavioral therapy initially developed by Dr. Marsha Linehan in the late 1980s. It was originally designed to treat individuals with borderline personality disorder (BPD) and those exhibiting chronic suicidal behavior. Over time, its applications have expanded to treat other conditions, including eating disorders, substance use disorders, and post-traumatic stress disorder (PTSD).

Key Points about DBT

Dialectical Philosophy

The term “dialectical” refers to the process of finding the truth through integrating opposite positions. In the context of DBT, this means balancing the seemingly opposite strategies of acceptance and change to bring about positive outcomes.

Core Components

DBT typically consists of individual therapy, group skills training, phone coaching, and therapist consultation. The skills training component is particularly emphasized, where clients learn various coping techniques.

Skills Training Modules: DBT encompasses four main skills modules:

Mindfulness: Focuses on improving the ability to be present in the current moment.
Distress Tolerance: Aims to enhance coping skills for surviving during crisis times and accepting life as it is.
Emotion Regulation: Offers strategies to manage and change intense emotional reactions.
Interpersonal Effectiveness: Provides techniques to communicate and navigate conflicts effectively.

Validation and Challenge

Therapists practicing DBT work to validate clients’ experiences, while also challenging them to modify dysfunctional behaviors.

Behavioral Targets

DBT sets clear hierarchies for treatment targets, with life-threatening behaviors (like suicidality or self-harm) being addressed first, followed by behaviors that interfere with therapy, and then by quality-of-life issues.

Phone Coaching

A unique aspect of DBT is the inclusion of phone coaching, allowing clients to call their therapists between sessions for guidance on applying skills to real-life challenges.

Therapist Consultation Team

DBT therapists typically work as part of a consultation team. This team meets regularly to support each other, maintain motivation, and ensure that therapists are competent and adhering to the treatment model.

Evidence-Based Treatment

DBT has been extensively researched and found to be effective for reducing self-harming behaviors, hospitalizations, and improving overall functioning in individuals with BPD. Its efficacy has also been explored and established for other disorders.

In Short

DBT offers a structured, multi-faceted approach to therapy that emphasizes both acceptance and change. Its emphasis on skill-building, combined with the support mechanisms for both clients and therapists, makes it a robust therapeutic model, especially for individuals struggling with severe emotional dysregulation.