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Two of the most common types of psychotherapy you’ll see mentioned by drug rehab centers are cognitive behavioral therapy and dialectical behavioral therapy. What is dialectical behavioral therapy, and how does it differ from CBT? DBT is a therapy that helps people who have overwhelming emotions find more happiness and regain control over their lives. It’s different from CBT in many ways.
What is Dialectical Behavioral Therapy?
DBT is a type of psychotherapy that branched off from cognitive behavioral therapy to specifically address the self-harm problems of people who have borderline personality disorder. Additional research has found DBT is effective in treating many other mental health disorders, including substance use disorder, PTSD, eating disorders, bipolar disorder, and depressive disorders.
DBT treatment consists of four stages:
Other fundamental components of DBT are mindfulness, biosocial theory, and dialectical philosophy. Mindfulness, the act of observing the present moment without judgment, is an evidence-based technique known to reduce rumination and minimize emotional reactivity. You want to learn how to respond instead of react to negative experiences. Reaction is impulsive and emotionally driven. Responding comes from a calmer place and has occurred after thinking of the best way to handle a situation.
Biosocial theory states that people who are born with emotional vulnerability — being more sensitive to emotional stimuli — are more likely to resort to self-harm behaviors when they grow up in an invalidating environment. In other words, if you felt dismissed, ignored, or punished for emotional responses as a child, this may have been interpreted as invalidation and led to self-harm behaviors.
Most parents don’t intend to invalidate their children and do the best they can in raising them. If you’re a parent of a child who has an addiction or another self-harm problem, don’t get caught up in the guilt of any parenting mistakes you think you’ve made. One of the things clients learn in DBT is people do the best they can with what they know. It also teaches clients that problems may not always be their fault, but it’s still their responsibility to resolve them.
Dialectical philosophy involves acknowledging that you must accept your situation to successfully change it because life is composed of opposing forces. When a person tries to change, their desire for acceptance, which is the opposing force, increases. Consequently, approaches that ignore acceptance and focus on changing behavior can fail to produce lasting results. Only seeking acceptance of the situation is also a problem because it doesn’t change unhelpful behaviors or circumstances.
History of DBT
Dr. Marsha Linehan and her colleagues developed this psychotherapy in the 1980s to find a way of making CBT work better for clients who have borderline personality disorder. They discovered that validation was one of the key components missing from an effective approach in helping clients manage BPD and make positive changes in their lives. Acceptance and change seem contradictory, but the results have shown that the two used together in balance are powerful for positive change and happiness. Without validation included in the therapist’s approach, clients tended to experience distress at the thought of change and were less likely to cooperate with their therapist.
Linehan has personal experience with mental health struggles and was dedicated to discovering a solution for her clients who couldn’t be effectively helped by the available strategies at the time. Behaviorism was a popular model, but patients with BPD didn’t respond well to it because it made them feel as if they were to blame. Mixing humanism into her approach to show understanding and validation addressed the need for acceptance and validation that behaviorism lacked.
At the time of developing DBT, Linehan was going through Zen training and learned helpful principles and strategies that she incorporated into this new therapy approach. While trying different approaches on consenting clients, Linehan’s team observed through a one-way mirror and took meticulous notes, so they could figure out what works and what doesn’t.
DBT for Mental Health
Some people get the impression that DBT is just for those who have severe mental health struggles. However, it can be used in counseling people with milder mental health conditions too. This psychotherapy is effective for both adolescents and adults as well as both genders. People who have depression and anxiety have been able to feel happier, calmer, and more in control of their lives with DBT. After DBT, they have confidence in achieving goals and handling emotions in a healthy manner.
DBT can improve your mental health in many ways, including:
DBT for Addiction and Co-Occurring Disorder
Studies have shown DBT is effective in treating addiction and co-occurring disorders. When you receiving DBT for addiction, your treatment plan will include strategies geared at substance use problems. You’ll learn about dialectical abstinence, which prepares you to handle a potential relapse better than you might have otherwise. No therapist wants their patient to relapse, but it does happen. Dialectical abstinence helps you avoid beating yourself up and falling deeper into a negative cycle if a relapse were to occur. You will know what to do to bounce back quickly.
When you go through DBT for substance use and co-occurring disorders, your treatment plan will include group skills training, individual therapy, and phone coaching. DBT therapists have a consultation group for helping them handle the emotional demands of providing psychotherapy. When therapists make time for their own self-care, they will be of the greatest help to their clients.
Group Therapy and DBT in Addiction Treatment
During DBT group skills training, you’ll learn about emotion regulation, distress tolerance, mindfulness, interpersonal effectiveness, and other skills for overcoming substance use problems. DBT group therapy also involves roleplaying, in which you practice the new techniques you’ve learned for responding to common life situations. You’ll also be given homework assignments to absorb and implement what you’re learning.
Another benefit of group therapy is you gain ideas and insights from others going through similar struggles. It also regularly reminds you that you’re not alone. People find comfort in knowing they’re not the only ones who experience obstacles and setbacks. Seeing your peers improve gives you motivation and encouragement to also improve. DBT groups are kept small to ensure each person receives the care they need.
How long group therapy lasts depends on the rehab facility. Programs may last around 6–12 months. A group therapy session can take 2 hours. This might seem long, but changing the human brain takes time, consistency and dedication. Many professionals say a year of quality treatment is important for lasting recovery. It gives your brain time to solidify its new mode of operation.
What is Dialectical Behavioral Therapy Recommended For?
Anyone who thinks they would benefit from DBT is encouraged to look into this option. Mission Harbor Behavioral Health can incorporate it into your personalized treatment plan. If you’ve received cognitive behavioral therapy but feel as if you need something more, DBT is great to try. CBT is more goal-oriented than DBT, whereas DBT focuses on acceptance, connection, and healthy emotion regulation. The two can work powerfully together in a person’s mental health treatment journey.
Mission Harbor can help you or a loved one who’s struggling with addiction, co-occurring disorders, or another mental health problem. Our facility offers DBT and other evidence-based treatments. After an initial discussion and assessment, we’ll let you know what type of treatment plan is recommended for your unique situation. Contact us today to schedule an appointment or ask any questions you may have.
The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.
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