At Corner Canyon Counseling, we know our patients have myriad needs. Not everyone will benefit from one specific treatment modality. For those living with Borderline Personality Disorder (BPD), psychotherapy such as dialectical behavior therapy has proven to be an effective approach.
No longer reserved just for patients with BPD, Dialectical Behavior Therapy (DBT) is applied in treatment plans to help promote mindfulness, improve emotional regulation, and reduce the frequency of suicidal ideation.
What Dialectical Behavioral Therapy Treats
Developed in the 1970s, DBT is now used to treat the following mental health conditions:
- Anxiety
- Borderline Personality Disorder
- Depression
- Eating disorders
- Post-traumatic stress disorder
- Self-harm behavior
- Suicidal behavior
Dialectical therapy is based on cognitive behavioral therapy, which is the process of learning to understand how our thoughts affect our emotional state and our behavior. The word dialectical means combining opposites. Through both group and individual therapy, patients are taught to recognize reality and learn how to change it. Skills are taught and implemented for learning how to manage feeling overwhelmed. It’s a process of combining two opposites: acceptance and change.
THE STAGES OF DIALECTICAL BEHAVIOR THERAPY
Stage 1: Addresses and treats the most destructive behaviors first, such as suicidal ideation or self-harm.
Stage 2: Addresses emotional regulation, distress tolerance, and interpersonal effectiveness.
Stage 3: Addresses how to improve self-esteem and relationships with others.
Stage 4: Addresses how to increase joy, quality of life, and relationship connection.
What Patients Learn in Dialectical Behavior Therapy
In DBT, there are some acronyms that represent the tools patients learn to help them modify behavior. One such acronym is ACCEPTS. It’s believed that by increasing mindfulness (being present here and now), increasing the ability to tolerate stress, and increasing one’s ability to regulate emotions creates a strong foundation for growth.
ACCEPTS
- Activities: Focus on something you need to/can do (cook, clean, exercise, watch a show).
- Contributing: Find a way to help someone/contribute to your community.
- Comparisons: Compare this feeling to a different one you have experienced before. Compare how other people cope with this feeling compared to you.
- (opposite) Emotions: Immerse yourself in an emotional experience (read a book, watch a show, listen to music).
- Pushing Away: Push away or remove yourself from the situation mentally and/or physically.
- (other) Thoughts: Indulge thoughts unrelated to what you’re experiencing. Count, repeat song lyrics, do a crossword puzzle.
- (other) Sensations: Identify what your senses are experiencing. Change what you’re experiencing by going outside, drinking cold water, or listening to music.
Another common acronym in Dialectical Behavior Therapy is DEAR MAN. This skill set teaches DBT patients to be better at asking for what they need in order to function successfully day-to-day, as well as how to set boundaries to protect their mental and emotional health.
DEAR MAN
- Describe the current situation and what your specific reactions are.
- Express how you feel about the current situation.
- Assert yourself by saying yes or no to what others are proposing.
- Reinforce positive responses offered by others, or explain why their response isn’t helping.
- (stay) Mindful of the end goal, regardless of what you’re currently experiencing.
- Appear Confident with body language and manner of speaking.
- Negotiate to get the end result you prefer in the situation.
As DBT has evolved, an emphasis has been put on helping patients accept themselves as they are while working toward implementing necessary changes.
Benefits of Dialectical Behavior Therapy
When a patient is committed to working with their therapist to invoke change, the benefits of DBT can include fewer instances of wanting to act on self-harm impulses and engage in substance abuse. This psychotherapy can also reduce symptoms of depression, and lead to fewer days spent as an inpatient to treat mental health disorders.
It’s recommended that patients participate in Dialectical Behavior Therapy for at least six months in order to see positive results. Changing how we view our thoughts and emotions won’t happen overnight, and sometimes the therapy takes longer to be effective. It’s important to stay committed to your mental health journey and discuss your options with your healthcare provider if you think something isn’t helping as you’d anticipated.
DBT can be supplemented with medication, such as antidepressants, anti-anxiety prescriptions, or other antipsychotics. Contact Corner Canyon Counseling if you’d like to learn more about DBT, or other treatment modalities offered by our staff.