What is DBT?
DBT treatment is accepted by the American Psychological Association (APA) and the National Institute of Mental Health Health (NIMH). This evidence-based therapy is based on the assumption that a patient’s problems are caused by a deficit of skills.
Cognitive behavior therapy works well for mental issues such as depression and anxiety. However, it does not work best for those suffering from personality disorders, especially borderline personality disorder (BPD).
Dr. Marsha Linehan observed that patients with BPD are extremely sensitive, meaning they react in a strong and intense way. Feelings of invalidation bring out these powerful reactions. This can make the suggestions of acceptance and change a conflicting agenda. It is tricky to accept and change something without invalidating the patient’s experience.
Her therapy enhancements were made to challenge the emotional dysregulation and self-destructive behaviors associated with BPD. She introduced a new therapeutic approach with new techniques, called dialectical behavior therapy.
The term dialectic is defined as a philosophical mode of argument. This therapy consists of a back and forth mode. The DBT therapist will accept and validate an experience and response, and challenge them on another. This makes it easier for the patient to tolerate requests and challenge their mode of thinking.
This new emphasis on acceptance and validation is perhaps one of the most significant improvements when it came to her patient’s emotional needs. This change was to counterbalance the traditional CBT approach to change those states.
The standard dialectical behavior therapy model is composed of two primary forms of treatment. This includes weekly individual therapy sessions and weekly group therapy sessions.
What is DBT Used to Treat?
The most common mental health issues DBT is used to treat include:
- Borderline personality disorder (BPD)
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Suicidal behaviors
- Attention deficit hyperactivity disorder (ADHD)
- Bipolar disorder
DBT and Eating Disorders
Emotional dysregulation plays a crucial role in eating disorders. DBT skills have been proven to be effective at reducing binge eating and purging behaviors. For instance, diagnostic remission rates for eating disorders amongst suicidal women with BPD are about 64%.
Dialectical behavior therapy helps these patients cope more effectively with their emotions that lead to certain eating behaviors. It also helps them to understand the patterns that lead them to their destructive eating habits. Learning the skills to tolerate and reduce difficult emotions without turning to food is what DBT can help achieve.
DBT and High-Risk Patients With PTSD
PTSD is a mental health disorder characterized by memories, avoidance, and emotional numbing of past traumas. A four-stage model is used for patients with PTSD.
The first stage focuses on a sense of control over suicidal thoughts and behaviors. The second stage utilizes DBT Prolonged Exposure (DBT PE) protocol, developed by Dr. Melanie Harned. The last two stages are made to help patients take control of their day-to-day activities. This is so they can work on the feeling of freedom and joy that life has to offer.
The four skills that apply to DBT skills training include:
- Interpersonal effectiveness
- Emotional regulation
- Distress tolerance
Mindfulness skills are about developing self-awareness skills and living in the present. It teaches the patient about the reasonable, emotional, and the wise mind.
The reasonable mind uses logic and functions according to rules. The emotional mind provides information and meaning on the importance of things. The wise mind creates balance, which patients are taught how to turn to the wise mind when necessary.
Interpersonal effectiveness skills help patients with social interactions, especially when engaged in conflict. These skills involve a series of steps to follow, which gives them access to function the wise mind.
Emotional regulation skills help the patient to understand and cope better with their intense emotions. The patient learns how emotions work and the relationship between an interpretation and the related emotion, urges, or impulses.
Distress tolerance skills are when the patient encounters a crisis and has the ability not to make things worse. Those struggling with BPD usually have a hard time dealing with a crisis situation. These techniques help them move through difficult times and not engage in self-destructive behavior. This is a strong skill set to have that demonstrates acceptance and a non-judgemental attitude.
Evidence Supporting DBT
Dr. Linehan and her colleagues published the first randomized controlled trial of dialectical behavior therapy in 1991. They saw vast improvements for women with BPD, who also engaged in suicidal behaviors. Previously, this clinical population was looked at as untreatable.
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ORANGE COUNTY MENTAL HEALTH TREATMENT
Here in Orange County, we specialize in diagnosing and treating a wide range of mental health conditions. If you think you could be diagnosed with borderline personality disorder or another mental health issue, contact us now.
We utilize dialectical behavioral therapy so that you can achieve long-lasting skills to overcome your mental health disorder. Our specialized care team welcomes all patients with open arms, so start your journey today.