Dialectical Behavior Therapy (DBT)

DBT is a type of addiction treatment that began as a treatment for Borderline Personality Disorder. It promotes the acceptance of difficult thoughts, emotions, and behaviors, focusing on validation, and finding a balance between acceptance and change in order to reduce unhealthy behaviors. It tries to increase motivation to change, focus on an individual’s strengths, and apply what has been learned in therapy to real-life situations.

DBT has been shown to be effective in treating a wide range of disorders, such as substance dependence, depression, PTSD, and eating disorders. The goal of DBT is to help people build a life that they deem worth living. Clients and therapists work together to set certain goals that are meaningful to the clients, and this often means working on ways to replace harmful behaviors with effective, positive behaviors.

A standard DBT program has five components and each of them is intended to meet a specific function:

  1. Enhance capabilities by offering skills training. This focuses on teaching clients behavioral skills and is frequently taught in groups. These groups work much like classes where group leaders teach the skills and assign homework which helps clients practice the skills they learned in their everyday lives. Groups meet on a weekly basis for about two and a half hours and it takes 24 weeks to get through the curriculum.
  2. Improve motivation through individual psychotherapy. This focuses on enhancing clients’ motivation and helping them apply the skills to specific challenges and events in their lives. This usually takes place once a week for the duration of the program and it runs concurrently with the skills training.
  3. Assure generalization to the clients’ natural environment through in-the-moment coaching. The goal is to teach clients to use their DBT skills to effectively cope with difficult situations that arise in their everyday lives. Clients can call their therapists between sessions to receive coaching when they need help the most.
  4. Structure the environment through case management. These strategies help clients better manage their lives, such as their physical and social environments. This allows the clients to take control, and the therapist will only intervene when absolutely necessary.
  5. Enhance the therapists’ capabilities and support their motivation with the help of a DBT consultation team. The DBT consultation team focuses on the people providing DBT, such as individual therapists, group leaders, case managers, and other who help clients with their treatment. In a way, this is like therapy for the therapist, and this is especially important when they are treating people with severe and complex disorders.

DBT has been shown to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, and depression, as well as improving social and global functioning.