How Helpful Is Dialectical Behavioral Therapy?
Discover how dialectical behavior therapy can improve mental health and help treat addiction in this comprehensive article.
What Is Dialectical Behavior Therapy?
Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy (CBT). It is an evidence-based treatment that helps people manage emotions and stress. DBT is a talk therapy specially adapted for people who feel intense feelings to help them accept their emotions, develop new skills to manage them, and improve their quality of life.
An essential part of DBT therapy is the practice and mastery of DBT skills, such as mindfulness, to help reduce harmful behaviors and improve mental health.
What Does Dialectical Mean?
The term “dialectics” is based on the premise that everything is made up of opposites and dialogue between opposing ends (acceptance and change in the case of DBT) can bring fruitful results. Three assumptions can be deduced from the dialectics theory:
Everything is linked together
- Change is constant
- Opposing ends can be integrated to uncover the truth
Multiple Solutions Idea
The information above forms the basics of DBT. If you understand dialectics, you can begin to recognize that there are multiple solutions to a given issue and that two seemingly incompatible ideas can coexist.
Dialectical thinking involves saying things like, “I messed up, and I can try to make things better” rather than “I messed up, but I can try to make things better.” It involves integrating opposites to make a change.
Marsha Linehan and the Creation of DBT
Marsha Linehan worked to develop dialectical behavior therapy in the late 1970s as a treatment for multiproblematic, suicidal women.
Linehan introduced a treatment approach intended to convey the patient’s acceptance and help them accept their emotions and the world. As a result, DBT was built on the basis of dialectical theory, where therapists constantly work to balance and combine change and acceptance-focused techniques.
Biosocial Theory
According to the DBT Biosocial Theory, some people are genetically predisposed to feel things more intensely than others.
To break it down, we have the bio and the social. It would be rational to assume the emergence of maladaptive behavioral patterns when pairing biological vulnerabilities with invalidating social situations.
The Principles of DBT
The core principles of dialectical behavior therapy include the following:
Support-Oriented: Clients are assisted in recognizing and capitalizing on their strengths to build self-confidence.
- Collaborative: Patients work together with their therapists to resolve issues.
- Cognitive-Based: DBT aids people in recognizing patterns in their assumptions, beliefs, and attitudes that make life more challenging.
Five Functions
For DBT to be comprehensive, it must adhere to five fundamental functions. These include:
Improving clients’ motivation
- Teaching and enhancing clients’ skills
- Generalizing skills to natural environments through homework, phone, and email consultation, review of therapy tapes, or in vivo interventions
- Structuring the treatment environment
- Motivating and improving therapists’ capabilities to offer effective treatments
Difference Between CBT and DBT
While DBT is a type of CBT, a proper understanding of both behavioral therapies will uncover some differences. The primary distinction is that dialectical behavior therapy emphasizes balance and the interplay between acceptance and change (dialectics), while cognitive behavioral therapy emphasizes harmful thought patterns and their redirection. We can further bolster the distinctions between CBT and DBT in the two headings below:
Inside Out: Cognitive behavioral therapy works from the inside out. By changing negative thought patterns on the inside, a person can develop positive habits and boost their mental health.
- Outside In: Unlike CBT, dialectical behavioral therapy works from the outside in. By learning DBT skills, people are equipped with tools to help them manage intense emotions to take control of their life.
What Can DBT Help Treat?
Generally, DBT can be effective for the following disorders:
- Posttraumatic disorder (PTSD)
- Disruptive behaviors
- Mood swings
- Suicidal behaviors
- Depression
- Anxiety
- Anger issues
- Eating disorders
Borderline Personality Disorder (BPD)
Dialectical behavioral therapy was developed initially to treat borderline personality disorder (BPD) and remains an effective and successful therapeutic treatment option. For example, one study examining thirty-one patients with BPD who received DBT and nineteen who received treatment as usual (TAU) found that the DBT group showed more significant improvements and reduced self-injurious behaviors than the TAU group. Additionally, 42% of those who received DBT were considered clinically recovered after four months.1
Eating Disorders
Nevertheless, it is also effective in treating some psychiatric disorders. For instance, one study found that, after twenty weeks, DBT greatly decreased the occurrence of binge/purge episodes in patients with bulimia nervosa.2
DBT for Adolescents
Furthermore, families can adopt DBT for teenagers with psychiatric disorders to help reduce problematic behavior patterns. Research has shown that DBT decreases hospitalization rates and effectively treats adolescents with BPD, depression, suicidal ideation, eating disorders, bipolar disorder, and impulsive and aggressive behavior.3
How Is DBT Helpful for Addiction Treatment?
Self-destructive behaviors and dysfunctional emotions typically fuel addiction. Consequently, the instability caused by long-term drug or alcohol use can worsen these behaviors.
Participating in dialectical behavior therapy and mastery of dialectical behavior therapy skills will help clients manage their emotions and cope with life stressors in a way that contributes to healthy living. One study found that DBT significantly reduced drug use, had greater retention rates, and resulted in better global and social adjustment compared to TAU.4
The scope of DBT in addiction treatment includes:
DBT for Drug Rehab: DBT can help people recovering from substance use disorder achieve and maintain sobriety by addressing emotional, physical, and environmental triggers that could bring about drug abuse.
- DBT for Alcohol Rehab: Dialectic behavioral therapy is employed in alcohol rehab to help people in recovery develop coping skills and reduce self-destructive tendencies.
- DBT to Build Sober Living Skills: DBT promotes sobriety by equipping clients with tools to manage triggers and emphasizing the need to change environments that contribute to drug and alcohol abuse.
Dialectical Behavioral Therapy at San Diego Detox
If you or your loved one is ready to pursue treatment opportunities, such as DBT, we are ready to help guide you. At San Diego Detox, your health, wellness, and long-term sobriety is our top priority. Don’t hesitate to reach out today and begin healing.
Behavioral Components of DBT
DBT includes a skills training group. One of the most important components of DBT is learning about and practicing each dialectical behavior therapy skill in a skills group while discussing scenarios with other group members.
Therapists can employ several DBT techniques and components based on each patient’s needs and ability to apply them. These techniques or DBT skills are taught in therapy for clients to practice and master to improve their quality of life.
The four main dialectical behavior therapy techniques will be detailed below.
Core Mindfulness
Mindfulness is one of the major DBT skills people develop from DBT therapy. Mindfulness involves focusing on the present and what is happening internally (within the self) and externally (within the surrounding environment) in a non-judgmental way.
When experiencing emotional distress, mindfulness skills can help people slow down and concentrate on employing appropriate coping mechanisms.
Distress Tolerance
Unfortunately, distress is inevitable in life. Nonetheless, DBT teaches patients how to accept their current situation through distraction, self-soothing, and coping techniques.
Emotion Regulation
People can deal with intense emotions more successfully if they have good emotion control. The ability to recognize, name, and modify emotions will be aided by the abilities acquired in DBT therapy.
Interpersonal Effectiveness
Interpersonal effectiveness can be defined as maintaining a healthy relationship and still being able to articulate demands and say no when necessary. This skill helps people listen, respect, understand, and communicate with others more.
