| Dialectical Behavior Therapy |
| What is Dialectical Behavior Therapy? Dialectical Behavior Therapy (DBT), is an outpatient therapy which targets serious problem behaviors which interfere with having a life worth living. Many of these behaviors are attempts to deal with intense emotions that seem impossible to control. The behaviors themselves, including suicidal and self-harm actions, substance use and abuse, binge eating or withdrawing from life, to name just a few, often begin as attempts to cope. Over time these behaviors create their own set of serious problems. Often the individual feels out of control. A DBT therapist helps identify where, how, when and why the problem behaviors occur and what other, more skillful behaviors might work in the same situation. These more skillfull behaviors are learned in DBT skills training, a class which accompanies individual or couples therapy. DBT skills training teaches how to identify, label, experience and regulate emotions, and how to interact more effectively with ourselves and others. DBT has been shown to be effective in randomized clinical trials to reduce suicidal and self-harm behavior, psychiatric hospitalizations, anger, hopelessness and dissociation while increasing certain coping skills for women with borderline personality disorder. DBT has been adapted to treat substance dependence, eating disorders, depression in the elderly, and antisocial personality disorder. DBT has also been used with adolescents, families, couples, and in crisis and emergency servies, and in inpatient, day treatment, residential and forensic settings. How Does DBT Work? Standard outpatient DBT consists of both individual therapy of one hour per week and psychosocial skills training, usually offered in a 90 minute class. Individual therapy focuses on the events of the week and how to decrease targeted problem behaviors while increasing use of skills. Skills training is a class which includes lecture and discussion, homework and behavioral rehearsal on a wide array of skills organized into four modules. The modules are mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. It takes a minimum of six months to complete the skills training curriculum, but it is usually recommended that an individual allow one year to thoroughly learn the skills. Similarily, serious problem behaviors are unlikely to disappear quickly even with the best motivation. An additional component of DBT is consultation among DBT therapists to remain balanced in applying the strategies. The combination of individual therapy, skills training and consultation is what makes DBT a comprehensive treatment. CAN DBT HELP ME? Below are nine questions. If you answer yes to any five of them, DBT could be the treatment for you. If you answer yes to only one or two, DBT may not be as helpful, though another form of behavior therapy may be recommended. 1-Do you ever have suicidal thoughts or self-harm urges or behavior? 2-Do you experience severe mood swings? 3-Would you consider yourself to be impulsive in a problematic way? 4-Are your close relationships often turbulent? 5-Do you fear being abandoned by someone you love? 6-Are you troubled by feelings of emptiness? 7-Do you question who you really are? 8-Is anger a problematic emotion for you? 9-Do you ever lose track of time (dissociate), feel paranoid, or hear voices? Behavior therapy can help with: � panic � addictions � trauma � dissociation � phobias � obsession/compulsion |
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