Dialectical Behavior Therapy, or DBT, is a form of talk therapy. It helps individuals who experience a lot of emotions or behaviour issues that are challenging to manage. Initially, Dr. Marsha Linehan developed DBT as a treatment method for borderline personality disorder (BPD). Since then, it has been applied to numerous people to help them get out of post-traumatic stress, drug or alcohol problems, ADHD difficulties, eating problems, and many other disorders.
DBT focuses on two major concepts. The first one is that of acceptance – learning to accept your feelings and thoughts as being real and valid. The second one is learning new skills and dealing with those feelings in a better way. DBT is not a therapy that solely involves discussion of thoughts and emotions. It encompasses a comprehensive program comprising four sections. This entire program is referred to as comprehensive adherent DBT.
In this article, we will describe each component of DBT, its purpose, and the average time required to achieve tangible results. But before exploring them, let’s quickly discuss how DBT is different from other talk therapies.
What Makes DBT Different from Other Talk Therapies?
Numerous types of talk therapy help individuals by enabling them to discuss their past or present issues. DBT partially does that. However, it also provides clear steps and tools for learning. DBT teaches four core sets of skills, also known as skill modules, including mindfulness, emotion regulation, crisis survival, and interpersonal effectiveness. It also provides phone support and a team of professional therapy experts who will offer you additional help when you need it.
DBT makes a difference in many ways. It is not only a personal conversation. It is an entire scheme that helps you exercise new skills every week and provides assistance in between sessions. It has been found that individuals achieve their optimal outcomes when they possess the complete components of the DBT program.
What is Included in a Complete DBT Program?
There are four components of comprehensive DBT. All of the parts are essential. Note that when there is only one or two parts, it is not full DBT. It is more or less what you like to call DBT-informed Therapy, or DBT tools, but not the Complete program. A typical DBT program is designed in the following manner:
● Weekly One-on-One Therapy
Each week, you have a one-hour session with a therapist who is DBT-trained. During these sessions, you and the therapist will select an area to work on and will start with a few behaviors at a time. For instance, consider employing a coping skill when you’re feeling intense anger, and you might hurt yourself. In such cases, setting a goal to use that skill in specific situations could be beneficial.
Every single day, you mark on them whether you practised the skill or whether you had urges using a simple form known as a diary card. It is also a form that follows your mood and provokes self-harming urges or acting out. You use your diary card to guide every session. The therapist will ask, How was your diary card this week? This way, you will be able to see your improvement.
Your session cannot be full DBT unless you are using a diary card, setting objectives, and monitoring behaviors every week.
● Weekly Skills Group
You have skills group sessions of two to three hours per week. This group is more like a class than a typical group discussion. The skills teacher, a trained professional, leads the class.
The four areas of skills taught during the six months in the class are the following:
Mindfulness: The discovery of how to pay attention to your thoughts and your feelings without judging them.
Emotion regulation: To learn how to calm down powerful emotions such as anger or sadness.
Distress Tolerance: How to manage short-term challenges in a crisis without worsening the situation.
Interpersonal Effectiveness: How to tell others what you want, have boundaries, and maintain respect in relationships.
You are given simple homework to complete at home and exercises to work on during the session. After six months, you master and train all skills so that you can apply them in your everyday life. It is not full DBT when you learn only a part of the skills or when you miss a significant part of the classes.
● Phone Coaching
Life is not on hold waiting for your counselling session. You will have tough times at home, in the workplace, or amongst friends. Phone coaching will allow you to give a call or send a text message to a DBT therapist outside of session times
Full DBT phone coaching offers crisis support when you feel overwhelmed or unsafe. If you forget something or have a complex situation at the moment, you can call the after-hours DBT therapist to get support in choosing what skills to apply in real-life situations.
In other talk therapies, not all therapists will give you the option to call as much as you want or whenever you want; full DBT will always have a component of phone availability.
● Consultation with a Team of Therapists
Counsellors also require a team. Your DBT therapist meets with other DBT therapists every week. During this session, they discuss the DBT therapy but not individual clients. They focus on maintaining loyalty to the DBT model, learning from each other, and preventing burnout.
When your therapist is not in a consultation team, they are not doing full or adherent DBT.
What is the Duration of DBT?
The typical length of a complete DBT program is a year. But you will see changes a lot faster. The simple timeline is the following:
Months 1-3: Safety and Procurement of the Basics
During the initial three months, you focus on mindfulness and learning to accept distress. These help you survive during crises and observe your feelings without reacting. Every week, you come together during your one-on-one and skills classes.
Toward the end of the third month, you should start feeling that you can take a time-out when you are irritated. You start making a decision about a skill rather than acting hastily.
Months 4-6: Emotion Regulation and Interpersonal Skills
During months four to six, you are taught the habits of emotion regulation and interpersonal effectiveness. You work on learning to calm intense emotions and change direction towards healthier alternatives for expressing your needs to the people related to you. At this stage, you tend to get actual results in improved ways of handling relationships and stress.
A lot of clients report feeling more stable. They experience less dramatic fits or meltdowns. They can realizethat they engage in fewer disputes with the people they love and can resolve minor conflicts without becoming overwhelmed.
Months 7-12: Strengthening Skills and Purpose-Driven Living
During the last months of a year-long program, you are fine-tuning and looking ahead. You and your therapist can establish fresh targets for hopes and goals.
As much as necessary, you maintain diary cards and phone coaching. After twelve months, many individuals report significant changes. They experience fewer crises. This makes them feel in more control of their lives. They naturally employ DBT skills and also assist others in doing so.
What to do after one year?
After a year, some people may choose to reduce their sessions to once a month or even just coaching. Others get on as usual but still desire the total backing.
The program is flexible, allowing you to call weekly and then adjust your involvement to suit your new life.
Who needs Full DBT, and who does not?
Full DBT is most suitable in cases where individuals think strongly of committing suicide or experience severe panic attacks, or take drugs or alcohol in ways that provoke health hazards.
Those who experience emotions strong enough to take numerous days to recuperate and take away their happiness or have relationship issues due to careless action and constant contention benefit greatly from CBT.
Indications that DBT is Working in Your Life
Simple indicators that you have become better include a decrease in the number of times you feel you cannot cope, at least once a week, and you have had to use one of your skills to calm down. Additionally, you can now talk to your friends or family without feeling too overwhelmed. You also complete your diary card most days and bring it to therapy. You become more optimistic and more focused on avoiding harm to yourself.
In North Vancouver, the Boomerang Counselling Centre offers Dialectical Behaviour Therapy (DBT) to individuals seeking to enhance their connections and relationships and learn new methods to manage emotions. They impart the fundamental DBT skills of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
Read More About: 6 Main Points of Dialectical Behavior Therapy (DBT)
Conclusion
Dialectical Behavior Therapy is a comprehensive program that teaches you to develop a life you believe is worth living. It is a combination of weekly one-to-one treatment, group skills, phone coaching, and therapist consultation teams. The best results are obtained when all four parts can work in collaboration.
In the first 3 to 6 months, most clients begin to improve, and major changes are sometimes evident within the 12th months. Full DBT will benefit you when you are in severe emotional distress, when you are struggling with self-harm urges, and/or have harmful behaviours that you would like to change. It equips you with the abilities, encouragement, and hope for a calmer and more balanced future.
Keep in mind that not every Therapy is identical. When you want to see lasting change and confirmed outcomes, you will need to seek a DBT program that adheres to all four sections. You can learn to love yourself, discontinue the patterns that can be injurious to you, and live well through commitment and practice.
