How does DBT work?

Dialectical Behavior Therapy (DBT) has borrowed and adapted many of its core concepts from a variety of evidence-based therapies. It is actually a variation of cognitive behavioral therapy (CBT), one of the most effective types of treatment for many concerns, especially anxiety-related difficulties. Although CBT works to connect your thoughts and behaviors, DBT emphasizes the influence of your emotions on your problems. Mainly, DBT focuses on effecting change while accounting for one’s safety and harmful urges. When engaging in Dialectical Behavior Therapy, it is especially important that you trust your therapist and feel understood. There are several methods of receiving DBT that can all be effective. The most strict or adherent form of DBT includes formalized programs with individual therapy as well as multiple types of group therapy. However, many individuals find it helpful to learn DBT in a less formalized way. For example, you may participate in a DBT group, receive structured individual DBT therapy, or simply learn about and practice DBT skills with your therapist in session. You should work closely with your therapist to determine if it would be best to participate in a formalized program versus a more integrated and individualized approach.

Regardless of the formality, Dialectical Behavior Therapy treatment generally involves structure and multiple stages. First, a client’s needs are prioritized based upon the most pressing and risky concerns. Suicidal behaviors or intense suicidal urges are addressed first, followed by self-injury or substance abuse. These difficulties are assessed and prioritized on a session-by-session basis before moving on to other skills and techniques. If these risks are not present, therapy is then focused on any struggles that could be getting in the way of one’s quality of life or ability to effectively engage in the Dialectical Behavior Therapy education. This is where the DBT skills are introduced. There are a variety of structured skills that target four different areas: mindfulness, distress tolerance, emotion regulation, and interpersonal skills. Mindfulness skills help to remain present, responsive, and expose ourselves to being with our emotions. These skills can decrease impulsive behavior and increase our ability to feel connected to our experiences. Distress tolerance skills are in place to make better decisions when feeling overwhelmed. For example, these skills can help decrease suicidal urges or other harmful urges. Emotion regulation skills provide a better understanding of how our feelings function and skills are geared towards helping to navigate our wants and needs in various relationships. These skills are useful for establishing boundaries, maintaining self-worth, and making effective connections.

Through learning and independently practicing the principles as well as the specific skills learned in the four areas of DBT, individuals usually feel more fulfilled, increase their self-respect, and achieve their individual goals.