What is Dialectical Behavioral Therapy?


An offering from the developer of Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT) was introduced to tackle psychological problems that could not be addressed by DBT. Marsha Linehan, the developer of this therapeutic model found this technique to be particularly efficacious in handling patients with borderline personality disorder.

The Core Principle of Dialectical Behavior Therapy

The approach of DBT to psychological issues stemming from negative behavior is that people who spend their childhood in a bad environment due to biological factors react abnormally to emotions. These patients often repudiate the cooperation integral to a successful therapy session. Such clients require a climate of unconditional acceptance and they have to see the therapist as an ally for the therapeutic intervention to be effective. In DBT, the therapist endeavors to validate the patient�s behavior and beliefs while informing him that some of them are maladaptive.

DBT in Individual and Group Settings

DBT is imparted in two components, group and individual therapy. In group sessions, the patient is taught the skills required to enhance the quality of life. On the other hand, an individual session will be aimed at identifying and discussing the issues that the client may have had to face in the past week; these are recorded on note cards and a treatment strategy is devised based on the patient�s concerns. Quality of life issues and skills are also discussed in the individual sessions which usually precede group therapy.

The Skill of Core Mindfulness

This is one of the core concepts on which DBT is based; mindfulness is defined as the ability to pay attention to the present moment without being judgmental or reacting to it based on past experiences. To put it simply, mindfulness is the capacity to live in the present while experiencing the emotions that the current situation invokes completely and with perspective. This is considered to be a foundation skill on which the other three skills of DBT are developed. It helps the client to adapt to new situations without being overwhelmed by the powerful emotions.

The Skill of Interpersonal Effectiveness

In interpersonal effectiveness training, clients are taught how to communicate effectively. The strategies used in this module are similar to those incorporated in assertiveness and interpersonal skills training sessions. They are aimed at helping the client to avoid interpersonal conflict and master the all important art of saying, �no�. This training is meant to help the client tackle situations where the objective is to change or to resist an attempt made by others to change the person in question, helping an individual to achieve his goals in any given situation.

The Skills of Distress Tolerance and Emotional Regulation

Emotional regulation training helps the client to deal with negative emotions, increases awareness of present state of mind, handle vulnerability to certain emotions and increases positive emotions. This training also helps the patient to pinpoint obstacles that hinder the process of changing negative emotions. Distress tolerance training helps the client to accept and deal with stressful situations calmly, non-judgementally and rationally, so that he/she can make good decisions instead of panicking in the face of distress.

Dialectical Behavior Therapy is a proactive approach to counseling that engages the patient and aids him/her in setting goals and focusing on achieving them. This form of therapy proves remarkably helpful in enhancing the quality of life and eliminating negative thought patterns.