February 7, 2019
What is DBT and How Does it Work?
Written by Joel Salvaggio
Borderline Personality Disorder and Dialectical Behavioral Therapy
Borderline Personality Disorder is known as a pervasive disorder characterized by difficulties in regulation emotion. BPD can show up in a variety of contexts. Essentially, someone with BPD is an impulsive person who cannot connect with people easily. Some common characteristics of Borderline Personality Disorder can be known as having extreme swings in their emotions, having black-and-white thinking and seem to jump from one crisis to another. In addition, those with BPD experience a fear of real or imagined abandonment and have a harder time returning to a stable baseline after an emotionally triggering event. Those with BPD may have participated in self-injurious behaviors or suicidal ideation to cope with these emotions. Because few people understand such reactions, methods for coping with these sudden, intense surges of emotion have been limited to none. However, when one clinician struggled to find a solution for her patients, DBT was born.
What is DBT?
Dialectical Behavioral Therapy (DBT) is a type of treatment modality that emphasizes the psychosocial aspects of treatment and was originally designed for the diagnosis of borderline personality disorder (BPD), but has also been known to treat other disorders such as substance abuse, and process addictions. Dialectical Behavioral Therapy was initially developed in the 1980s by Dr. Marsha Linehan when she learned that cognitive behavioral therapy alone didn’t work as well as expected in patients that have BPD. Throughout this process, Dr. Linehan and her team added modalities and techniques that would meet the needs of these patients, and help them provide structure and balance to get back to a life worth living.
DBT is intricate and detailed – but simple. The therapy has four standard modes:
Individual Therapy – Typically, individual treatment is conducted weekly with a licensed therapist and is used to maintain the client’s motivation. Most often, the therapist uses validation and dialectical strategies and provides the client with a safe space to process destructive thoughts.
Phone Coaching – Phone coaching can be a vital component of DBT and helps patients generalize skills they’ve learned in training to everyday life. The duration of these calls are usually short, between 10 and 20 minutes, however the frequency of the calls should decrease with the amount of time involved in DBT.
Skills Training – Skills training can be one of the most crucial and implemented modes of DBT which is meant to be structured and psychoeducational. During this mode, clients focus solely on obtaining to new skills to regulate emotions, enhancing their capabilities and generalizing these skills to other aspects of their lives. Skills can be taught in individual sessions, however group sessions tend to be preferred and more beneficial as members of the group tend to learn and work cohesively together. Trainings usually last up to two hours and the first hour is used to review homework from the previous session, whereas the second hour focuses on new skills. DBT skills training has four specific modules which include:
- Emotional Regulation
- Distress Tolerance
- Interpersonal Effectiveness
Each module tends to last five to seven weeks, however at times can be altered depending on the facility or the needs of the patients.
Consultation Team – The consultation team is comprised of therapists who meet weekly for case consultation and support to maintain the integrity of the treatment. The consultation team essentially gives therapists and clinicians community to rely on each other, help reduce burnout, and discuss how to address behaviors that the therapist and patient are collaborating to extinguish.
Benefits of DBT
Whether someone has been diagnosed with Borderline Personality Disorder or not, anybody can benefit from DBT. Moving between acceptance and change, DBT has a proactive, problem-solving approach that teaches the skills needed to control intense emotions, improve relationships, manage distress, and reduce self-destructive behaviors. Additionally, as a proven therapy module it can help anybody progress forward in their life despite negative thinking or self-talk.
Founded as a groundbreaking approach, DBT can help patients uncover
Want to learn more about DBT?
St. Christopher’s Addiction Wellness is hosting an STC Seminar on Wednesday February 20th and Thursday, February 21st. Presented by Eric Schmidt, MSW, LCSW, MBA of New Roads Behavioral HEalth, this seminar is a great opportunity to learn more and start your training in DBT methodologies.
All are welcome. Click here to learn more: http://bit.ly/STCDBTTraining1
If you or a loved one is struggling with substance use diso, call 877-782-4747. We’re available 24/7 and can provide information on treatment programs, help with insurance, and answer questions about the treatment process.