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Dialectical Behavior Therapy

In cognitive behavioral therapy sessions, which are often considered the gold standard for people who have addictions, participants are encouraged to go into battle with their thoughts, preferences and habits. They name the things that might be causing them some sort of distress, and they then work increasingly hard to ensure that those things are somehow changed or removed from the person’s life for good. It’s an intensive form of therapy, and it can bring people great results. But it’s not the right kind of therapy for everyone. In fact, some people benefit from a completely different from of therapy, known as dialectical behavior therapy (DBT). This form of treatment is just a bit gentler and a bit more accepting, and it might allow people to heal in ways they never thought were possible in the past.

Emphasis on Validation

therapistAll therapists attempt to connect with their clients and provide them with the kind of encouragement and support that can help them to heal. Those who use DBT, however, use a specific technique known as validation. Each statement the person makes is considered healthful and understandable, and the thoughts behind those behaviors aren’t challenged. In therapy, it’s acceptable for the client to say almost anything and feel almost anything, and the therapist might only respond with words of understanding and encouragement. Many people who access DBT have never received this level of understanding before, and they find therapy to be intensely rewarding as a result. They might feel so rewarded that they continue to attend therapy, where they might drop out of other treatment programs.

Increasing participation and ensuring that people don’t drop out of the treatment plans that can help them is vital, and it’s a difficult goal to achieve. Since DBT has the power to keep people engaged, it might be considered useful for almost anyone. For example, in a study in JAMA, researchers found that 59 percent of clients dropped out of standard treatment programs after only one visit, while only 25 percent of those getting DBT did the same. With each session, new lessons are learned and important growth takes place. DBT can make it happen.

Important Lessons

While just going to therapy could be considered vital for healing, as those who go to their therapy sessions tend to learn and change while those who don’t tend to stay the same, dialectical behavior therapy does more than simply push participation. In fact, in each DBT session, people are learning vital lessons regarding emotional control.

DBT sessions center on the theory that life will always provide challenges. During each and every day, people might be required to deal with:

  • Missed appointments
  • Nasty coworkers
  • Prickly family members
  • Money concerns

While the situations can’t ever be completely obliterated, a person’s response to those challenges could be the key to a calm and healthy life. Those who can simply notice a problem, and notice their distress regarding that problem, can then make a choice not to react. The situation is still in play, and the emotions that situation engenders are still considered valid, but the person can choose not to explode with anger, medicate with drugs or resort to self-harm in response to the trigger. The person can just take control and choose not to react.

treatmentSimilarly, there are times in which emotions can build in response to a trigger, and people can become remarkably upset and worried about the future and their place in the world. In the past, these people might have stayed upset and off-kilter for days in response to a trigger, and they may have experienced an intense amount of distress as a result. DBT sessions provide people with the tools they can use to soothe their minds when they’re distressed, so their responses can’t build and grow.

Dialectical behavior therapy sessions can also provide people with important lessons regarding interpersonal skills. They might need to brush up on their ability to reject a request, speak their minds or deal with rejection. They might also need to learn how to communicate their own thoughts and needs without hurting the feelings of others, or stepping on the needs that other people might have.

When put together, these lessons can have a deep impact on the way a person both views and navigates the world. For example, in a study in Archives of Psychiatric Nursing, those given DBT “unanimously” reported that the treatment was capable of saving their lives and making life more bearable. The skills these people learned in their supportive therapy sessions allowed them to deal with life’s struggles in a much more reasonable way.

Typical Structure

Since there’s much to learn in the dialectical behavior therapy model, it’s not surprising that the work tends to take place over a long period of time in many different treatment settings.

It’s not uncommon for people who have DBT to commit to:

  • Skills-based therapy
  • Intensive homework assignments

It’s a significant time commitment, but the lessons are all just a little different and a little customized, so it’s rare for people to pick up the same kinds of skills or cover the same kinds of topics in multiple sessions.

People who participate in DBT can also move through the therapy at their own pace without feeling as though they should rush or breeze through their lessons. They’re encouraged to participate at a level that works for them and progress as quickly or as slowly as they feel is appropriate. Pushing by a therapist, or encouraging a person to make leaps and take risks, isn’t considered appropriate in DBT.

Target Markets

treatment for middle-aged and elderly adultsOriginally, DBT was designed to assist people who have borderline personality disorder. People with this condition typically don’t succeed in standard therapy programs, as they might feel invalidated and pressured to perform when they’re placed in standard, goal-oriented treatment. A slower pace with a more accepting therapist might be the better choice for them, due to their underlying mental illness. Research suggests that DBT really does have the power to bring about big changes in people who have this specific mental illness. For example, in a study in the journal Behavior Research and Therapy, researchers found that 42 percent of those who had DBT as a treatment for borderline personality disorder got better as a result. In fact, the researchers suggest that this form of therapy is more effective than the other forms of treatment available. It just has the potential to make things better.As mental health professionals became aware of the changes dialectical behavior therapy could bring about in people with this specific mental illness, they began to wonder if the therapy might be useful for people who had other concerns. As a result, the treatment has been slightly tweaked and modified, and it’s been proven effective in helping all sorts of people with different types of mental illnesses. For example, some therapists have used the treatment to assist people who have bulimia nervosa. People with this disorder might also struggle with negative thought patterns, and they might blanch in the face of criticism from a therapist. In a study in The American Journal of Psychiatry, researchers found that DBT had the ability to amend binge/purge behavior in people with this condition, just showing how helpful it might be.The therapy has also been modified to meet the needs of adolescents, veterans and people of specific ethnic traditions. These people might need the same kinds of lessons, but the modifications take into account the age-related and culture-related issues that might impact both the care needed and the treatments desired.

Finding Help

At Axis, we provide our clients with a significant amount of therapy as they look for ways to deal with a mental illness, a substance abuse issue or both. Our counselors are adept at choosing the right therapy to help the client in need, and we’d like to tell you more about our treatment model. Please call us to find out about our therapists and our availability.

Further Reading