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Dialectical Behavioral Therapy
What is DBT?
Dialectical behavior therapy (DBT) treatment is a cognitive-behavioral approach that emphasizes skill-building that helps with emotional control. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships.

DBT theory suggests that some people become far more emotional, and become emotional quickly than the average persons.  Some people require a significant amount of time to become calm again.   These people experience extreme swings in their emotions, see the world in “black-and-white” shades, and seem to always be jumping from one crisis to another. Because few people understand such reactions — they don’t have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help in this task.

DBT and Mental Health Diagnoses:
People who need DBT skills are sometimes diagnosed with Borderline Personality Disorder, Bipolar Disorder, chronic Depression or Substance Abuse problems.

What is  DBT Treatment Like?   How is it Different from “Regular”Therapy?
•    DBT is Support-Oriented: It helps a person identify their strengths and builds on them so that the person can feel better about him/herself and about life.

•    DBT is Cognitive-based: DBT helps identify thoughts, beliefs, and assumptions that make life harder.  Some of these include:  “I have to be perfect at everything” and “If I get angry, I’m a terrible person.”   DBT helps people to learn different ways of thinking that will make life more bearable.  People who have DBT skills can say,  “I don’t need to be perfect at things for people to care about me,” and  “Everyone gets angry, and it’s a normal emotion.”

•    DBT is Collaborative:   DBT requires attention to the relationship between the client and the therapist. In DBT, people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them.

DBT asks people to complete homework assignments, to role-play new ways of interacting with others, and to practice skills such as soothing yourself when upset. These skills, which are a crucial part of DBT, can be taught in weekly individual sessions.  Ideally, they are taught in weekly lectures, reviewed in weekly homework groups, and are referred to in nearly every group. The individual therapist helps the person to learn, apply and master the DBT skills.  

How are Individual and Group Sessions Used in DBT?

Generally, Dialectical Behavior Therapy (DBT) may be seen as having two main components:

1. Individual weekly psychotherapy sessions emphasize problem-solving behavior for the past weeks issues and troubles that arose in the person’s life. Self-injurious and suicidal behaviors take first priority, followed by behaviors that may interfere with the therapy process. Quality of life issues and working toward improving life in general may also be discussed. Individual sessions in DBT also focus on decreasing and dealing with post-traumatic stress responses (from previous trauma in the person’s life) and helping enhance their own self-respect and self-image.  During individual therapy sessions, the therapist and client work toward learning and improving many basic social skills.

2. Weekly group therapy sessions are generally 2 1/2 hours per session and are led by a trained DBT therapist.  Group is where clients learn skills from one of four different modules: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness skills.  These skills can also be taught in Individual Therapy sessions if groups are not available.

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