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Dialectical Behavior Therapy (DBT) Skills

DBT is a therapy practice rooted in self-acceptance, awareness, and resiliency.

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What is DBT?

Dialectical behavior therapy (DBT) is a type of talk therapy designed to help individuals with mental health conditions learn how to understand and regulate their emotions. The goal is to encourage self-acceptance and improve interpersonal relationships through validation and behavior changes. 

DBT involves individual therapy, group skills training, and ongoing coaching. The one-on-one time is usually a weekly session with a psychiatrist, psychologist, or therapist, while group therapy is an interactive session that allows people to practice their behavior skills in a safe environment. For any issues that arise between appointments, there is always crisis coaching.

Teen and therapist talking about DBT skills

The skills taught in DBT

DBT is taught as a series of skills to help individuals manage uncomfortable thoughts, feelings, and behaviors. Some of these skills include: 

Mindfulness

One of the core components of DBT is building mindfulness skills that help you become aware and accepting of the current moment. DBT teaches mindfulness from two perspectives: what to focus on and how to be more mindful.

The “what” skills encourage a person to remain in the present, to be aware of their emotions and thoughts, and to separate their emotions from thoughts. The “how” skills focus on how to employ mindfulness skills and effectively overcome barriers to mindfulness. 

Distress tolerance

Distress tolerance teaches individuals how to use healthy coping techniques to navigate difficult situations. Instead of defaulting to destructive behaviors such as self-isolating or self-harm, distress tolerance empowers people to accept the current situation and adopt a more positive long-term outlook. This can come in handy when you're feeling physical or emotional pain, or when you're finding it hard to be productive.

Several examples of distress tolerance skills are:

  1. Self-soothing
  2. Paced breathing and muscle relaxation
  3. Weighing pros and cons
  4. Radical acceptance (accepting reality as it is)

Interpersonal effectiveness

Interpersonal effectiveness combines social skills, listening skills, and assertiveness training to empower individuals to better understand their needs and communicate that information to others.

Goals for interpersonal effectiveness include learning how to: 

  1. Ask for things that you want or need
  2. Work through challenging and conflict 
  3. Say no when appropriate
  4. Improve your self-respect 

Emotional regulation

Emotional regulation offers people a chance to deal with their emotions before those emotions lead to unhealthy feelings or behaviors. This component of DBT teaches a person that they have the power to choose to recognize and change their emotions in order to avoid giving into emotional urges.

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Who can benefit from DBT?

DBT was originally developed in the 1980s to treat suicidal individuals with borderline personality disorder (BPD). Since then, DBT continues to be a leading treatment for individuals with a primary diagnosis of BPD.

It’s also been adapted to help people with other mental health conditions, including:

  1. Eating disorders (including anorexia nervosa, binge eating disorder, and bulimia nervosa)
  2. Major depressive disorder 
  3. Substance use disorders
  4. Generalized anxiety disorder
  5. Self-harm 
  6. Obsessive-compulsive disorder 
  7. Post-traumatic stress disorder 

DBT vs CBT

Wondering how DBT is different from another common form of therapy called cognitive behavioral therapy (CBT)?

DBT is actually a type of CBT, so the two methods share similar theories about challenging negative thoughts and behaviors. They differ, however, when it comes to time, emphasis, and practice setting.

  1. Time: CBT is a shorter form of treatment, lasting anywhere from 5 to 20 sessions. DBT, however, is a long-term option that typically lasts 6 months but can continue for years. 
  1. Emphasis: CBT is a logic-based approach that helps individuals utilize critical-thinking skills to reach their therapy goal. For example, a person will work with their therapist to identify negative thoughts and behaviors, then develop helpful tools to cope with those patterns. 

While CBT emphasizes behavioral change, DBT focuses more on the emotional and social aspects of therapy. The goal is to help individuals accept themselves, manage emotions, cope with discomfort, and avoid destructive behaviors.

  1. Setting: CBT is a one-on-one therapy that takes place at an office or virtually. DBT also includes individual sessions, but prioritizes group work as well. 
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How do I know if DBT is right for me?

Not sure if DBT is right for you? DBT is considered a suitable treatment for individuals who feel that their emotions are often overwhelming, debilitating, or interfering with work, school, or goals.

Other reasons to consider DBT include:

  1. Diagnosis of borderline personality disorder
  2. Struggles with self-harm or chronic thoughts of suicide
  3. Severe mood swings
  4. Overwhelming feelings of hopelessness or emptiness
  5. Identity issues
  6. Alcohol and drug abuse, unsafe sexual behavior, or other high-risk behaviors 
Teen with major depressive disorder talking to her therapist

How to handle an emergency

Dialectical behavior therapy is an effective solution for treating a variety of mental health conditions and symptoms—including self-harm and suicide attempts.

Some people may see improvement within a few sessions, but others require long-term therapy before experiencing benefits. If you're having suicidal thoughts or require immediate support, visit your local emergency department or crisis center, or call one of the following resources.

  1. The National Suicide Prevention Lifeline (988) or (1-800-273-8255)
  2. The Crisis Text Line (text HOME to 741741)
  3. The National Alliance on Mental Illness HelpLine (1-800-950-NAMI (6264))
  4. SAMHSA’s National Helpline (1-800-662-HELP (4357))
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DBT Skills at Charlie Health 

Deciding to start dialectical behavior therapy (DBT) or any other type of therapy takes courage. Charlie Health’s team of compassionate mental health professionals are here to listen to your needs, answer your questions, and match you with an appropriate care plan. Learn more today

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