Dialectical Behavior Therapy: How It Works | Techniques and Skills
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Dialectical Behavior Therapy: How It Works

Though Dialectical Behavior Therapy (DBT) is still considered a relatively new treatment method in the psychiatric world, having only been developed in the ‘80s and ‘90s, it has proven to be an incredibly effective method of addressing substance abuse.

The Palm Beach Institute offers DBT in our addiction treatment programs, but for those unfamiliar with the therapeutic style, here is a quick guide on what to expect:

What Is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (also called Dialectical Behavioral Therapy) is an evidence-based therapeutic practice used to help substance abusers who are suicidal or those with borderline personality disorder, post-traumatic stress disorder, and other psychiatric disorders.

DBT was developed by Marsha M. Linehan, PhD, who realized people who were suicidal may not have the appropriate coping mechanisms necessary to process their personal life problems. If therapists were too hurtful in their criticism for their clients to change their ways, rather than having the patient buck up and do so, it would make matters worse.

Thus, the principles of Dialectical Behavior Therapy were formed: give clients constructive criticism that both accepts the person as they are while also simultaneously encouraging them to improve their lives. These opposing goals form a “dialect,” both confronting their behavior while affirming their mental state. This helps clients feel validated for their emotions and beliefs, but also be able to come to an understanding that they need to change their thought processes in order to improve their lives.

How Does Dialectical Behavior Therapy Work?

Dialectical Behavior Therapy assumes that the client is doing the best that he or she can, but that he or she also needs to learn new behavior, similar to components taught in Cognitive Behavioral Therapy.

DBT’s goals are to give clients motivation to change by setting achievable goals, teach life skills to use both during and after treatment, restructuring their environment to be void of triggers and temptation, providing relapse prevention education, and building healthy behaviors and social connections.

Once the client begins to be receptive to DBT, then four modules can be put into action:

Mindfulness: Clients are taught to focus on the present instead of the past or future and to accept internal and external happenings as they come without placing judgment on the experience or emotion. This allows clients to be aware of their self and surroundings before they come to accept them as they are.

Distress Tolerance:  Clients are taught relapse prevention techniques by developing skills on how to cope with situations that overwhelm them, make them anxious or depressed, or possibly trigger them into using/drinking again. DBT helps them gain the confidence and the knowledge to persevere through difficult events while also accepting that if a lapse does occur, it is not the end of the world either.

Interpersonal Effectiveness: Clients are taught how to set limits and learn to spot toxic behavior in themselves and in their relationships. DBT aims to reduce emotional vulnerability in the clients so that they may have the strength to build self-esteem and build healthy, positive relationships with people who care about their wellbeing.

Emotion Regulation: Clients are taught how to prevent themselves from acting on dangerous or self-harming impulses by learning how to identify, regulate, and experience their emotions in a rational manner. Clients are aware of the consequences of using drugs or drinking excessively so that they may remind themselves of their priorities to avoid reckless behavior.

Setting time-limited abstinent pledges is a major example of how Dialectical Behavior Therapy gives clients goals they can achieve. This can mean staying abstinent for one week or one day, 20 days or 20 minutes, whichever is a feasible goal for the client to achieve based on the status of their addiction and recovery.

Is Dialectical Behavior Therapy Effective?

Many studies have proven Dialectical Behavior Therapy to be very effective among clients who have a substance use disorder and are prone to suicide and self-harm.

One unique aspect of Dialectical Behavior Therapy is how the method approaches and addresses the event of a relapse. Regarded as “failing well,” relapses are used as learning experiences for the client, who will analyze what led to the relapse with their therapist.

This is to avoid the abstinence violation effect, where people who relapsed will give into self-hating thoughts and perpetuate their addiction further. For example, they might think, “I’m so stupid, always screwing up my life, so I might as well keep taking drugs and die.”

By acting quickly and teaching the person how relapses indicate how the therapy can improve, clients can approach their sobriety in a new light. Also note that many DBT skills training may involve a series of individual and group therapy sessions, lasting about 1 to 2.5 hours long and may span over 24 weeks. DBT understands that it takes time for people to change their thought processes and learn healthy behavior, but when given the patience and time to go about dialectical behavior therapy properly, clients are given an opportunity for success.

Need Addiction Treatment? Go to the Palm Beach Institute

The Palm Beach Institute offers Dialectical Behavior Therapy (DBT) to our clients, especially if they have a history of self-harm and/or borderline personality disorder.  At our facility, we are committed to providing all of our clients with a safe, nonjudgmental environment to allow them to grow and have the strength to begin a new life of sobriety.

If you or a loved one is struggling with substance abuse, it may be necessary to seek more drug and alcohol treatment. Come to the Palm Beach Institute, where we treat you like family, provide a supportive community, and work hard to teach inherent life skills to practice in recovery. Call our 24-hour helpline at (855) 960-5456 and start living sober today.

 

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