Patients identify and rate the intensity of emotions they experience each day—fear, shame, sadness, anger, pain, suicide attempts, and more—and space is provided to discuss emotional experience in more detail if needed. Dialectical Behavioral Therapy (DBT) is a treatment developed by psychologist Marsha Linehan to help patients who suffer from emotional dysregulation which results in self-destructive behaviors. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. In summary, DBT is a comprehensive, cognitive-behavioral treatment originally designed to help suicidal women. Persons interested in learning more about DBT might begin with Linehan’s1 comprehensive treatment manual. In addition, Behavioral Tech, LLC () offers periodic workshops on DBT.

Dialectical Behavioral Therapy

There are specific techniques used that differentiate DBT from other types of therapy. While there are numerous techniques that can be used, a few are more common than others. The four main components that make up DBT are distress tolerance, interpersonal effectiveness, mindfulness, and emotional regulation. To date, there have been nine published randomized controlled trials and five controlled trials of DBT (view all publications).

Why Finding a Culturally Sensitive Therapist is Important

As a trained behaviorist, Dr. Linehan focused on treating specific behaviors. Together with her colleagues, she concluded the patient had a borderline personality disorder. The main goal of Dr. Linehan’s research was to observe whether patients could benefit from CBT. After all, CBT Dialectical Behavioral Therapy was developed in the 1960s for the treatment of depression and some other mental health problems. She wanted to see whether patients with BPD could also benefit from this therapy. That’s why this therapy teaches two seemingly opposite strategies such as acceptance and change.

This applies to both female adults and adolescents diagnosed with BPD symptoms [6, 7, 25]. Non-suicidal self-injury, suicide gestures and suicide attempts, are easier to remediate with medication, psychotherapy or a combination of both [27]. Furthermore, a 1-year open trial by Goldstein et al. could demonstrate a significant improvement in suicidality and non-suicidal self-injurious behavior in adolescents with bipolar disorder [9].

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This hypothesis is also based on the improvement of both the Global Level of Functioning and the reduction of the need for treatment as assessed by the therapist. One year after the end of therapy, seven out of twelve adolescents could not be diagnosed with any current psychiatric DSM-IV axis-I diagnoses. At that time, four patients showed two psychiatric DSM-IV axis-I diagnoses while one patient showed one (see Table 1).

  • Behavior that disrupts DBT—like tardiness or skipping sessions—would be addressed next, followed by behavior that impacts quality of life.
  • However, there are some things you can do on your own to help you develop new coping skills.
  • Dialectical behavioral therapy is a specific type of psychotherapy that requires additional training by mental health professionals.
  • Depression is a serious mood disorder indicated by a persistent feeling of sadness, despair, helplessness, and loneliness.

Phone use is encouraged, but it’s not intended to be something that’s abused. You can’t continuously reach out to go over things that you’re working on in therapy without trying to put your new DBT skills into practice on your own. If you begin to use the calls as a crutch, they will be addressed in your regular therapy sessions. There’s a strong emphasis on the training DBT therapists must undergo.

Learning to manage and tolerate stress

Mindfulness focuses on increasing experiential attention and awareness into the here and now.Mindfulness is practiced throughout the course of treatment and aids in utilization of the other skills. DBT is a type of therapy that’s often used to reduce symptoms of BPD, but it has some other uses as well. Over the phone, your therapist will guide you through how to use your DBT skills to tackle the challenge at hand. Intense emotions and rapid mood changes can make it hard to relate to others.

Dialectical Behavioral Therapy

In DBT, dialectical strategies help both the therapist and the client get unstuck from extreme positions. In this video, learn how dialectical strategies keep the therapy in balance and help clients reach their ultimate goals as quickly as possible. ​2) Structure the Environment with Case Management in Individual Therapy –  Case management strategies help the client manage his or her own life, such as their physical and social environments. The therapist applies the same dialectical, validation, and problem-solving strategies in order to teach the client to be his or her own case manager.

The same review also showed that DBT is effective in the management of depression, binge eating disorder, substance use disorders, and bulimia nervosa. Other conditions for which DBT is an attractive approach include trichotillomania, ADHD, bipolar disorder, and PTSD. The distinct reduction of suicidal and non-suicidal self-injurious behavior during therapy is reflected in the rating of the DSM-IV borderline criteria assigned to these symptoms. The adolescents made clear progress in the DSM-IV criteria “unstable and intense interpersonal relationships”, “identity disturbance” and “impulsivity”. These criteria were explicitly discussed in the multi family skills training group and solution strategies were developed in the training modules Distress Tolerance Skills and Emotion Regulation Skills.

  • The adolescents’ quality of life, measured by using ILC, improved clearly from the start of therapy to one year after therapy.
  • Some believe this combination of techniques is part of what makes DBT so effective.
  • Interpersonal effectiveness includes working through conflict, listening well, and clearly asking for what you need.
  • This specific skill is considered as the foundation, a patient will not be taught any other skill sets within DBT classes until they have a full grasp of being a mindful person.

To date, there are no empirically validated treatments of good quality for adolescents showing suicidality and non-suicidal self-injurious behavior. Risk factors for suicide are impulsive and non-suicidal self-injurious behavior, depression, conduct disorders and child abuse. Behind this background, we tested the main hypothesis of our study; that Dialectical Behavioral Therapy for Adolescents is an effective treatment for these patients. The good news about DBT is that because it’s a type of cognitive behavioral therapy, it’s not uncommon for therapists to be trained in it.