Although fairly new to psychotherapy, DBT is one of the most researched treatments for borderline personality disorder and other mood disorders. It has been shown to be significantly effective in reducing suicidal ideation common to those diagnosed with BPD, as well as improving a client’s ability to resist acting impulsively in stressful situations.
DBT is based on cognitive behavioral therapy (CBT), which has been used effectively for many years to treat individuals with mood and anxiety disorders. CBT is not effective for everyone - particularly for people who engage in self-injury, attempt suicide frequently, or struggle with intense emotions. Dr. Marsha Linehan adapted traditional CBT by adding therapeutic work focused on validation, acceptance and dialectics to meet the unique needs of these patients.
The overall goal of DBT is to help clients create a “life worth living.” Clients are encouraged to define what a "life worth living" looks like for them, and it varies from client to client. As a group then, clients work toward addressing problem behaviors that are barriers to accessing that life.
CBT helps clients understand the relationship between their thoughts, feelings and behaviors. While traditional CBT asks clients to change unhealthy thinking patterns and maladaptive behaviors, DBT also validates a client's lived experience and acknowledges the truth in the client's point of view.
DBT treatment also teaches clients to recognize what they have the power to change and what they must learn to accept. If they must accept the experience of pain, clients learn skills to cope with it. As they practice those skills, clients learn that they can stand the pain and still live a meaningful life.
The "dialectical" part of dialectical behavior therapy helps clients challenge rigid thinking patterns and discover that the "truth" is often more gray than black-and-white. A friend can be late for an appointment AND still respect you. You can make a mistake AND still be a good person. If you cannot tolerate your boss, can we look at the other side of the coin and see if the reverse could also be true to some extent?
Clients participating in DBT therapy receive weekly one-on-one counseling sessions with their primary counselor, participate in skills groups, and have access to 24 phone coaching as needed. Clients also complete homework assignments and are asked to apply DBT skills learned in group to real-life experiences.
DBT skills are taught in four modules:
- Emotion Regulation
- Distress Tolerance
- Interpersonal Effectiveness