Therapy 101: Dialectical Behavior Therapy

If you’ve ever looked into getting therapy, then it’s likely that you’ve heard a lot of different terms thrown around to describe it. There are many different therapy techniques and modalities out there. This blog post is part of a series that is meant to explain some of the more common forms of therapy you’re likely to encounter as you look into potential therapists. 

What is DBT?

DBT stands for dialectical behavioral therapy. It’s quickly becoming a very common form of therapy used by many clinicians and has many clinical studies to back up its effectiveness. Dialectical refers to the idea of reconciling two opposing thoughts, such as knowing someone has harmed you while also acknowledging they are not a bad person. 

This form of therapy was originally designed to help individuals with borderline personality disorder. BPD often comes with intense emotions and risky, usually self-destructive behavior as a result of emotional dysregulation. DBT is meant to help individuals tolerate distress more effectively and thus regulate their emotions more successfully. This in turn helps to reduce harmful behavior, such as self-harm and suicide attempts.

When followed strictly, DBT uses a combination of one-on-one therapy with a client and a trained therapist and group skills sessions. There is also a “light” form of DBT that removes the group skills sessions and involves only the one-on-one therapy.

Can DBT be Used for Other Purposes?

DBT has been shown to be effective in treating eating disorders (especially binge eating and bulimia), bipolar disorder, PTSD, and schizophrenia. It can also be used with those who have major depressive disorder, generalized anxiety disorder, and other similar mental illnesses. 

How Does It Work?

Dialectical behavioral therapy approaches clients’ problems with the idea that there is some sort of skills deficit that is making it difficult for clients to cope with their emotions and things that go on. Harmful behaviors stem from high levels of distress as a result of this. Through this idea, DBT focuses on skills building and also on increasing distress tolerance in clients. 

There are four basic skills that therapists work with clients on: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. 

Therapists will use a variety of activities and help teach clients different ways they can work on these skills outside of the session. 

In more traditional DBT there are four stages that therapy proceeds in. It starts with helping to stabilize the client if they’re in crisis and allowing them to feel safe. The second stage focuses on exploring emotional pain. In the third stage, clients work on setting SMART goals and maintaining healthy behaviors. Finally, in the fourth stage, clients look at the big picture and work towards achieving them. 

How do I Find a Therapist?

There are many ways to find a DBT therapist. Right here at Compassionate Counseling Company we have clinicians who integrate DBT into their sessions (Niah, Kelly, Jessica, and Emily). However, if you’re looking for the more traditional form of DBT, then the DBT-Linehan Board of Certification is the best place to find one. If you plan to use insurance, make sure the provider is covered under your plan! You can use your insurance company’s provider search to check. 

Resources:

https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt

https://dialecticalbehaviortherapy.com/

https://eddinscounseling.com/dbt-101-dialectical-behavior-therapy

https://www.mcleanhospital.org/essential/dbt

https://www.verywellmind.com/dialectical-behavior-therapy-1067402

Post-Traumatic Stress Disorder Can Affect Anyone

May was Mental Health Awareness Month and on our socials, we shared information about different mental health topics throughout last month. These blog posts are part of a series where we expand on those topics and offer more information. 

Post-traumatic stress disorder, more commonly known as PTSD, is a mental health disorder that develops as a response to a traumatic event. Currently, we’re not sure what exactly causes PTSD, as most people who experience trauma do not develop PTSD. We do know that people who were assigned female at birth are much more likely to develop PTSD than those who were assigned male at birth. We also have current statistics for PTSD: 3.6% of the US adult population has PTSD with 37% of those with PTSD having severe symptoms. It usually develops within months of the traumatic event and symptoms can last months, years, or even be life-long. Treatment is critical for helping to manage these systems. 

Traumatic events that have been linked to development of PTSD are: sexual assault, abuse, witnessing a death, combat/war, terrorist attacks, being in an accident, and even experiencing the trauma of a loved one second hand. 

Often, the symptoms are broken down into four main categories: re-experiencing, avoidance, cognitive/mood, and arousal. 

Re-experiencing:

  • Recurring, intrusive thoughts about the event
  • Flashbacks
  • Bad dreams
  • Intrusive memories
  • Avoidance:
    • Avoiding the place where it happened
    • Avoiding people who remind you of the event
    • Avoiding objects or other things that remind you of the event
  • Cognitive/Mood:
    • Memory problems related to the event
    • Negative self-image or thoughts
    • Guilt or shame
    • Numbness or depression
    • Anxiety
    • Derealization
    • Dissociation
  • Arousal:
    • Hypervigilance
    • Easily startled
    • Difficulty concentrating
    • Sleep disturbances
    • Irritability

Children have also been diagnosed with PTSD and we often see them develop it in response to many of the same situations that adults do. However, they can show some different symptoms such as:

  • Regression (for example, a toilet-trained child suddenly wetting the bed)
  • Unusual and sudden clinginess (usually to a parent or another trusted adult)
  • Re-enacting the traumatic events through play

Early diagnosis and treatment is critical for the best possible outcome for an individual with PTSD. This can help with reducing the severity of symptoms or even eliminating some of them entirely. Treatment can help the individual get back to a healthy level of everyday functioning and help them manage symptoms such as nightmares, flashbacks, and many of the other distressing symptoms of PTSD.

Treatments generally include medications, such as SSRIs, and therapy. Therapy usually consists of some form of CBT (like exposure therapy and recognitive structuring) and EMDR. Learning self-management techniques is also critical to successful therapy, such as the ability to self-soothe and use mindfulness strategies. 

PTSD can co-occur with other disorders like depression, OCD, panic disorder, and substance use disorder. Often, treating these disorders co-currently is the best way to see improvement, as PTSD improves with the treatment of OCD, for example, and OCD improves with the treatment of PTSD.

Want help with PTSD? Look at our list of clinicians and contact us to book an appointment.

Resources:

https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd#part_6135

https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

https://www.samhsa.gov/mental-health/post-traumatic-stress-disorder