Dialectical Behavior Therapy (DBT) Defined
Effective DBT Therapy for Borderline Personality Disorder
Jul 5, 2009
Many mental health agencies and private clinicians utilize Dialectical Behavior Therapy to treat Borderline Personality Disorder and other conditions. Here are some of the hallmarks of DBT.
Dialectical Behavior Therapy Must Focus on Dialectics
Dialectical Behavior Therapy must address the issue of dialectics, and have a both/and perspective rather than an either/or perspective. Here are examples of the both/and perspective:
- The DBT philosophy is that clients are doing the best they can and they need to be more effective (rather than the client is either functional or dysfunctional.)
- Another underlying Dialectical Behavior Therapy philosophy is that, clients haven’t caused all their problems and they need to solve them anyway (rather than either the client is responsible or not.)
- The therapist is warm and understanding while at the same time challenging the client when necessary. (Rather than either the therapist is nice or mean.)
All of these are examples of dialectics: two opposites that are both true. Helping the person with Borderline Personality Disorder balance the opposites are a hallmark of DBT.
Making Dialectical Behavior Therapy Effective Requires Client Action
Clients and therapists are seen as collaborators. The therapist is willing to work hard and be fully dedicated to helping. In return there are certain expectations of the client in DBT.
- Commitment is an essential part of DBT. Homework will be given regularly. The client won't get better just by coming to appointments, it will require work.
- While the client’s thoughts, feelings and actions are certainly understandable and understood by the therapist, certain boundaries are drawn in therapy because certain behaviors, such as self-harm and lack of participation, are not productive.
- Progress is charted in writing on diary cards by clients.
- There is a partnership between client and therapist, both must be willing participants in the work. Honesty about the impact of client and therapist upon each other occurs in the form of a continual, mutual assessment of the process of therapy.
- Clients are expected to participate in analyzing their vulnerabilities, triggers and causes that lead to problem behaviors.
Some Goals of Dialectical Behavior Therapy
These points below are essential for the work to be considered Dialectical Behavior Therapy.
- DBT focuses on helping clients build a life worth living.
- DBT focuses on reducing and eliminating behaviors that are harmful or that interfere with therapy, both on the part of clients and therapists.
- DBT teaches specific skills that are also practiced in the sessions. These skills are intentionally applied to life. Clinicians also use these skills themselves in the therapy.
- The skills that are taught fall into four areas: mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness.
DBT Includes Individual and Group Sessions
- Clients can expect to have some telephone “coaching” with the therapist in between sessions as clients work on new skills.
- Group sessions are often held in addition to individual sessions. Skills are taught in group sessions but are also reviewed and utilized in the individual sessions.
DBT can be a very worthwhile treatment experience. Therapists may work just as hard as the clients at it and a very satisfying relationship could result. Most people can benefit from the skills taught, as they are excellent life skills to have. Dialectical Behavior Therapy is worth a try, particularly for those with Borderline Personality Disorder.
Readers may also be interested in: Causes of Borderline Personality Disorder
This article is for general information only and is not a substitute for personal mental health care. Anyone with troubling symptoms or questions should consult a qualified mental health professional in person.
Sources:
- Moonshine Consulting, Dr. Cathy Moonshine, and Barry Kiehn and Michaela Swales, An Overview of Dialectical Behaviour therapy in the Treatment of Borderline Personality Disorder, published on priory.com
 |
