How DBT Therapy Works to Change Problematic Behaviors

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How does dialectical behavior therapy, or DBT therapy, work?

DBT provides both grounding and coping skills to deal with external and internal conflicts.

DBT helps people be content in the present moment, improves parent-child interactions, assists with navigating conflict with other people, lets people tolerate when life doesn't go as one wishes, and provides guidance as to how to understand and relax emotions.

When one receives DBT, one can overcome interpersonal challenges, and accept change.

DBT helps people reduce emotional extremes. It teaches helpful skills and through that changes unhelpful thought patterns.

Here we will discuss DBT treatment stages and targets, DBT therapy benefits, the major skills learned, DBT therapy techniques, and how DBT is different from cognitive behavior therapy, or CBT.

Keep reading to learn about how DBT therapy works!

Coping Skills Therapists in Colorado

Kimberly Nefflen, LPCC

Kimberly Nefflen, LPCC

Colorado Springs, Colorado
(719) 602-1342
Dr. Michelle Palmieri, DSW, LSW

Dr. Michelle Palmieri, DSW, LSW

Colorado Springs, Colorado
(719) 602-1342
Maria Roncalli, LPC

Maria Roncalli, LPC

Colorado Springs, Colorado
(719) 203-7021
Olivia Woodring, LPCC, NCC

Olivia Woodring, LPCC, NCC

Colorado
(719) 345-2424
Kristen Yamaoka-Los, LPC

Kristen Yamaoka-Los, LPC

Colorado Springs, Colorado
(719) 481-3518
Sarah Munk, LPC

Sarah Munk, LPC

Colorado
(719) 345-2424
Katie (Kate) Castillo, MS, LPCC

Katie (Kate) Castillo, MS, LPCC

Colorado Springs, Colorado
(719) 345-2424
Sherry Rice, LPCC, ADDC

Sherry Rice, LPCC, ADDC

Colorado
(719) 452-4374
Barbra Styles, LPC, LAC

Barbra Styles, LPC, LAC

Colorado Springs, Colorado
(719) 345-2424
Margot Bean, LCSW

Margot Bean, LCSW

Colorado Springs, Colorado
(719) 345-2424

DBT Treatment Stages & Targets

There is a pre-treatment stage when people set their therapy goals.

Then, in the first official stage, a mental health professional helps a client move from feeling like they have no control to having control.

During stage two clients work on experiencing their emotions in full. In stage three, clients develop self-reliance and build healthy lifestyles.

Stage four, if people choose to explore it, consists of moving from incompleteness to connecting with a greater purpose.

Now, there are four DBT therapy treatment targets.

The first is to decrease life-threatening behaviors. These include self-injurious behaviors, suicide attempts, suicidal thoughts, and suicidal threats.

The next target is to decrease therapy-interfering behaviors that could include being quiet in session or being late to or missing sessions entirely.

The third target is to decrease behaviors that interfere with one's quality of life.

Those may be excessive worry over life's demands, relationship conflict, trouble at work or school, physical aggression, and/or electronic dependence.

The last target is to increase one's coping skills. This means being able to fully enjoy the present moment, accepting one's self, tolerating and understanding difficult emotions, and communicating with and relating to other people. 

DBT Therapy Benefits

DBT can be used to treat mood disorders, such as depression, post-traumatic stress disorder bipolar disorder, and anxiety.

It can help people with eating disorders as well. DBT is a comprehensive treatment that's been proven to decrease impulsive behaviors, anger, chaotic relationships, mood instability, and self-injury.

DBT has helped people deal with painful and conflicting emotions, and understand their relationships and personal boundaries.

DBT teaches clients how to accept as well as change their feelings. Many DBT participants have left therapy with new and healthy motivations and interests to increase their quality of life.

Major Skills Learned in DBT

Aside from the benefits outlined above, people will consistently be exposed to four major coping skills.

One of these is mindfulness. Mindfulness focuses on being in the present moment and teaches clients signs of problematic emotions and behavioral patterns.

Through mindfulness, people improve their self-awareness and identify impulsive thoughts and behaviors.

Another coping skill is emotional regulation. This is used to protect one's self from emotional extremes by creating soothing and pleasant experiences.

There is interpersonal effectiveness. This teaches people how to appropriately interact with other people, and allows them to feel supported by peers.

Interpersonal effectiveness encourages the practice of sharing ideas, and the communication of needs and wants with others.

Clients will learn about asking someone else for help, feeling comfortable around others, and developing healthy boundaries.

The last major skill learned in DBT therapy is distress tolerance. Coming away from distress tolerance, clients will know how to appropriately react to stressors.

Although people will acknowledge painful emotions, they will be able to deal with them in healthy ways, as opposed to dangerous ones like hurting themselves. 

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DBT Techniques

People can receive DBT therapy through individual psychotherapy.

When this is done, the clinician uses diary cards to guide the client in each session.

A clinician may also use a behavioral chain analysis, which identifies links that led to problematic behavior and its consequences.

The links in a behavioral chain analysis include thoughts, feelings, behaviors, and external events.

A therapist might use a solution analysis as well. This is done to figure out good intervention points to stop the maladaptive behavior from repeating itself.

Outside of therapy, a client may be able to call their therapist to receive coaching on how to use a skill, or if they are in a difficult situation and do not know which skill to utilize.

When in individual therapy, a client needs to commit to trying new behaviors.

As a complement to individual therapy, a client may enroll in skills training.

It happens in a group format. They are full of psychoeducation and teach the above-mentioned skills: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance.

There are also therapist consultation teams, which are there for clinicians to increase their motivation to deliver effective DBT therapy treatment.

DBT vs CBT

DBT focuses on emotional and social functioning, while CBT teaches how to change thoughts, feelings, and behaviors.

DBT is a form of CBT. DBT encourages a view of situations that is holistic and teaches people to view circumstances in multiple dimensions.

Marsha Linehan, Ph.D. designed the DBT approach in the 1980s. Linehan wanted to find a therapeutic solution for those who have bipolar disorder.

She found that people with other forms of mental illness could benefit as well.

Therapists have used DBT in many forms since its advent to help clients.

Conclusion

There is a lot to know about how DBT therapy works! It is a form of CBT, although the two forms of therapy have their differences.

There are multiple ways to deliver DBT, from group to individual sessions led by trained therapists who will work together with you to get what you need out of your sessions.

The sessions teach clients skills which they can practice each day.

People benefit from DBT by finding they have better relationships with not just other people but themselves and can live in the moment more often.

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July 17th, 2024

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