Today, dialectical behavioral therapy is a part of the techniques of cognitive-behavioral therapy. It focuses on combining two points: acceptance and change.
Dialectical behavioral therapy aims to help the patient manage emotions, cope with stressful situations, and harmonize their relationships with others. During a course of dialectic behavioral therapy, a specialist helps the patient realize that a situation that he or she perceives as painful and hopeless can be observed from different perspective.
It may depend on different views on this issue. Dialectical therapy originates from the philosophical method of dialectics, in which the law of struggle and the unity of opposites is advanced. With the help of a dialectical approach to a problem situation, a person learns to weigh all pros and cons, and then choose the point of view that will enable him or her to act most pleasingly. Thus, the therapist and patient are working on resolving the contradictions between self-acceptance and their change.
People who undergo a course of dialectical therapy learn how to change their behavior for the better, using four key strategies:
– focusing on the present. Following the dialectical behavior therapy workbook, they have to understand that their life is coming through at the present moment, and there is no need to think about the past or to predict the future much.
– self-acceptance and the formation of the ability to stand the current crisis situation correctly and without severe nervous breakdowns.
– strong communication skills. They are about how to maintain confidence in communication. For example, they should not forget about comfort on an emotional level and be able to say no in the case of necessity. Moreover, at the same time, it is necessary to maintain relationships healthily and positively.
– emotional state management, which is considered to be a recognition and overcoming of negative experiences (for example, anger) and reducing the vulnerability of the emotional sphere due to the emphasis on positive emotions.
In dialectical behavior psychotherapy and following a dialectical behavior therapy workbook, there are three levels, which are typically used to work with a patient. They are the following:
1) Group therapy. It is carried out to form communication skills and emotions management skills. Usually, group members meet once a week, with the session lasting approximately two and a half hours. During each meeting, group-oriented exercises are performed, role-playing games can be held, there may be homework assignments. Group therapy can significantly help to improve the patient’s condition.
2) Individual therapy. It is carried out weekly (the duration of the session is approximately 40-50 minutes). In the process of individual orientation sessions, the therapist and patient talk about the difficulties and barriers that may appear in group therapy sessions, or stress situations from the patient’s everyday life. The therapist helps the patient take a dialectical approach to resolve the problem and find the best way out of the situation.
3) Psychological assistance on the phone. If the patient finds himself or herself in a stressful situation during which he or she loses the ability to overcome their own emotions, he or she has the opportunity to find support from the therapist immediately. On the phone, the conversation usually lasts about 15 minutes.
Dialectic behavioral therapy techniques were developed and elaborated in the late 1980s as a method of treating people with a borderline personality disorder. The creator of dialectic therapy, Dr. Marsha Linehan, was a professor at Washington University. The lady suffered from a borderline personality disorder. After she was hospitalized and kept under sedation for two years to prevent attempts at self-harm, Linehan was able to create a concept that ultimately brought her on the path to recovery.
However, since then, this type of therapy has been adapted to treat other disorders in cases where the patient exhibits self-destructive behavior. Dialectic behavioral therapy techniques have been effective in activities with the following diseases: depression, alcohol and drug addiction, a post-traumatic disorder in a stressful situation, eating disorder and different affective disorders.
Wise mind is a combination of emotional mind and rational mind which considers both emotions and rationality. It’s important to be driven by a wise mind when taking actions and making decisions.
Emotions play an important role in our lives. They all serve for some purposes. Those emotions that are related to anxiety, like fear, can make sense to protect ourselves. But sometimes they are not productive at all. They get unmanageable and lead to anxiety disorders.
DBT helps to learn applicable emotional skills to deal with difficult feelings. So an individual becomes capable of regulating and controling emotions that arise.
The specialists who are dealing with various dialectical behavior therapy techniques are sure that, in general, there are three main stages of dialectical psychotherapy.
At the first stage, it is necessary to remove behavioral patterns that threaten the patient’s life (self-destructive or suicidal behavior) as well as attitudes that interfere with psychotherapy and reduce the patient’s quality of life. At this stage, the work of the therapist can also be aimed at improving the behavioral skills of patients.
The second stage is determined to improve the patient’s condition after he or she has coped with severe behavioral disorders, but, nevertheless, is in a state of “silent despair.” At this stage, special attention is paid to problems that are associated with traumatic events that were previously experienced by patients.
The third stage deals with the transition to “ordinary misfortune and happiness,” while the patient, with the support of the therapist, solves the problems that arise in his daily life.
The goal of the fourth stage is to overcome the feeling of inferiority and the formation of “the ability to experience sustainable satisfaction with life.”
Clinical observations suggest that patients undergoing dialectic therapy have significantly fewer depressive symptoms. They are less likely to be hospitalized, have fewer thoughts of suicide, and are much less likely to show self-destructive behavior. When dialectic psychotherapy has been recommended to people who suffered from substance abuse, a decrease in the use of narcotic substances has been noted. A positive effect is also observed when this type of therapy is carried out with patients who have eating disorders (bulimia) or who are aggressive.
DBT workbook helps people to deal with emotions that overwhelm them. When the feelings become too intense and get out of control, dialectical journal can help to calm down.
DBT journal is typically used to track progress in getting main DBT skills, such as distress tolerance, emotional regulation, mindfulness, and interpersonal effectiveness. Productive changes are easier made when one can observe own success.
CBT puts emphasis on the influence that thoughts, feelings and behavior make on each other. On the contrary, DBT is focused more on emotions regulation, mindfulness, and acceptance.
CBT teaches individuals to recognize when their thoughts get problematic, and provides techniques to redirect such troublesome thoughts. While DBT assists in finding ways to accept emotions, feeling safe, and regulating potentially destructive behavioral patterns.
DBT encourages participation in skills training sessions that usually take place in a group setting in four modules. DBT clients also meet on a weekly basis with a DBT therapist.
DBT is sometimes criticized for having some limitations. Practicioners say that the researches on the efficacy of this therapy had small sample sizes. Critics explain that more researches must be done to find out whether DBT is effective for complex mental health issues. In addition, any of the DBT studies lasted up to a year. So it’s not known if chronic conditions can benefit from DBT.
Among the advantages of DBT there are decrease of self-destructive behavior, teaching productive behavior skills, reducing PTSD, anxiety and depression symptoms.
Currently DBT is in high demand. It’s important to know, that the DBT-LBC program is the only approved treatment program in the United States that provides therapists with a high quality training. Thus, all who want to use DBT in thier practice need to get certified through the DBT-LBC. To become a therapist in DBT, one needs to pass an exam first.
Finding a good therapist is always a problem and it gets especially complicated when you do not get local advice or cannot read the reviews. Here we will try to present several places across the United States with good reviews where you could find assistance using dialectical behavior therapy.
– Boston Child Study Center
– Group Psychotherapy Center at Massachusetts General Hospital
– Arbour Hospital
– Silver Compass Counseling
– The American Institute for Cognitive Therapy
– Metro NY DBT Center
– Psych Hospital NYC
Union Square Psychotherapy
– Portland DBT Institute
Camelot’s Delco Academy
– Center for Anxiety & Behavior Therapy
– River City Integrative Counseling
– Columbia Mental Health Clinic
– Nystrom & Associates
– The Oak Center for DBT & Counseling Services
– Atlanta DBT Center
– East Atlanta Counseling
– Emory CAMP Services
– Bloomfield DBT of Michigan
– Pine Rest Traverse City Clinic
– Detroit Behavioral Institute
– Nashville Psychotherapy Institute
– Penn Psychiatric Center
– Options Behavioral Health Hospital
– Selah House
– Crossroad Child & Family Services
– Chicago DBT Institute
– Family Institute
– DBT Center Chicago
– The Center for Mindfulness and Behavior Therapy
– PACE Mental Health Houston
– Katy DBT Center
– The Center for Success and Independence
– Houston OCD Counseling
– Denver DBT and Psychotherapy Center
– Denver ABA Autism Center
– Cherry Creek Psychotherapy
– San Francisco DBT Center
– DBT Center of Marin
– The Wise Mind Institute
– DBT Center of the South Bay
– The Camden Center
– DBT Center Los Angeles
Surely there are many more places and centers you may find and visit but those we have listed have great reviews. If you are interested in this type of therapy and location is good for you, feel free to try it out.