DBT was developed by Marsha Linehan of Seattle, WA in the early 1990’s. Research indicates it is highly effective in helping people who experience a variety of symptoms and behaviors associated with depression and other mood disorders such as Bipolar Disorder, among others. As a type of Cognitive Behavioral Therapy, DBT emphasizes Dialectics and Mindfulness, DBT’s central component.
There are two essential parts of the treatment:
1) An individual therapy component in which the therapist and client discuss issues relating to daily life that come up during the week. During the individual therapy, the therapist and client work towards improving personal interaction skill use. Often, skills group is discussed and obstacles to acting skillfully are addressed.
2) In skills-based group therapy, which meets once a week for two hours, one learns to use specific skills that are broken down into four modules: core mindfulness skills, emotion regulation skills, interpersonal effectiveness skills and distress tolerance skills.
The essential part of all skills taught in skills group are the core Mindfulness skills. Mindfulness is awareness of one’s thoughts, actions or motivations. Mindfulness is held to engender insight and Wisdom.
Interpersonal response patterns taught in DBT skills training are very similar to those taught in many assertiveness and interpersonal problem-solving classes.
They include effective strategies for:
1) asking for what you need, 2) saying “no”, and 3) coping with interpersonal conflict.
Distress tolerance skills constitute a natural development from mindfulness skills. Many current approaches to mental health treatment focus on changing distressing events and circumstances. They have paid little attention to accepting, finding meaning for, and tolerating distress. Dialectical Behavioral Therapy emphasizes learning to bear pain skillfully.
Skills have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.
Dialectical behavioral therapy skills for emotion regulation include:
- Identifying and labeling emotions
- Identifying obstacles to changing emotions
- Reducing vulnerability to emotion mind
- Increasing positive emotional events
- Increasing mindfulness to current emotions
- Taking opposite action
- Applying distress tolerance techniques