Dialectical Behaviour Therapy

What is Dialectical Behaviour Therapy?

Dialectical Behaviour Therapy (DBT) is a therapeutic approach that combines elements of Cognitive Behavioural Therapy (CBT) with mindfulness practices. It was developed by Marsha M. Linehan to help individuals with borderline personality disorder (BPD), but it has been adapted to treat a wide range of mental health conditions which include mood disorder, self-destructive behaviours, and difficulties with emotion regulation.

How does IH Psychotherapy utilize Dialectical Behaviour Therapy?

At our practice, DBT is used to help clients build skills for managing emotions and behaviours and to enhance their capabilities for self-acceptance and effective interpersonal relationships. The goal is to reduce clients’ self-destructive behaviour patterns and to help them live more fulfilling lives.

What are the key tenets of Dialectical Behaviour Therapy?

1. Dialectics: DBT emphasizes finding a balance between acceptance and change. It recognizes that individuals may be doing the best they can while also acknowledging the need for growth and transformation.

2. Mindfulness: DBT incorporates mindfulness practices to develop awareness, acceptance, and non-judgmental observation of thoughts, emotions, and sensations in the present moment.

3. Emotion Regulation: This component focuses on helping individuals identify, understand, and manage their emotions effectively, including techniques to reduce emotional vulnerability and increase emotional resilience.

4. Distress Tolerance: In DBT, individuals learn strategies for tolerating distressing situations without engaging in self-destructive or maladaptive behaviours. It teaches skills to withstand emotional pain and delay impulsive responses.

5. Interpersonal Effectiveness: This component aims to improve interpersonal skills, enhance assertiveness, set boundaries, and maintain healthy relationships. It focuses on effective communication, problem-solving, and navigating social interactions.

What issues does Dialectical Behaviour Therapy address?

DBT is primarily used to treat conditions such as borderline personality disorder (BPD), suicidal tendencies, substance use disorders, eating disorders, mood disorders, and post-traumatic stress disorder (PTSD).

What does research show about the effectiveness of Dialectical Behaviour Therapy?

Research on DBT has demonstrated its effectiveness, particularly in the treatment of borderline personality disorder. Studies have shown that DBT can reduce suicidality, and self-harm behaviors (McMain et al., 2009), improve emotion regulation, enhance interpersonal functioning (Linehan et al., 2006; McMain et al., 2012), and reduce self-injurious behaviours (Stiglmayr et al., 2014). It has also been found to be effective in treating other mental health conditions (Clarkin et al., 2007), although further research is continuously conducted to establish its efficacy across different populations and contexts.

It’s important to note that research outcomes may vary across different populations and issues, and further research is ongoing to explore the effectiveness of DBT in different contexts. It’s always advisable to consult a trained professional and consider multiple sources of evidence to make informed decisions about therapy approaches. 

References

Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multi-wave study. American Journal of Psychiatry, 164(9), 922-928. https://doi.org/10.1176/ajp.2007.164.6.922

Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindeboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behaviour therapy vs therapy by experts for suicidal behaviours and borderline personality disorder. Archives of General Psychiatry, 64(12), 1401. https://doi.org/10.1001/archpsyc.63.7.757

McMain, S. F., Guimond, T., Streiner, D. L., Cardish, R. J., & Links, P. S. (2012). Dialectical behaviour therapy compared with general psychiatric management for borderline personality disorder: Clinical outcomes and functioning over a 2-year follow-up. American Journal of Psychiatry, 169(6), 650-651. https://doi.org/10.1176/appi.ajp.2012.11091416

McMain, S. F., Links, P. S., Gnam, W. H., Guimond, T., Cardish, R. J., Korman, L., & Streiner, D. L. (2009). A randomized trial of dialectical behaviour therapy versus general psychiatric management for borderline personality disorder. American Journal of Psychiatry, 166(12), 1365-1374. https://doi.org/10.1176/appi.ajp.2009.09010039

Stiglmayr, C., Stecher-Mohr, J., Wagner, T., Meiβner, J., Spretz, D., Steffens, C., Roepke, S., Fydrich, T., Salbach-Andrae, H., Schulze, J., & Renneberg, B. (2014). Effectiveness of dialectical behaviour therapy in routine outpatient care: The Berline Borderline Study. Borderline Personality Disorder and Emotional Dysregulation, 1(20). https://doi.org/10.1186/2051-6673-1-20

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