Dialectical Behavioral Therapy (DBT) is an approach to cognitive behavioral treatment. It is appropriate for clients who have tried other types of treatment and have not seen much improvement with those models. It has also successfully been used with clients who are suicidal. DBT focuses on bringing two dialectical (opposite) concepts together during the therapy process.
The dialectical concepts that DBT focuses on are acceptance and problem-solving strategies. Clients in DBT work with a certified practitioner, who provides them with support and acceptance during the process. Clients develop techniques for improving their well-being and achieving their personal goals.
DBT was developed in the 1970s by Marsha Linehan. She had been working mainly with two types of clients who were experiencing mental health issues: those with chronic suicidal thoughts and people with borderline personality disorder. Linehan used standard cognitive behavioral therapy (CBT) and adapted its practices to develop DBT.
Three Frameworks of DBT Theory
Three main theoretical frameworks work together to form the foundation for DBT. These are a behavioral science model used by healthcare professionals to diagnose and discuss chronic mental health issues, mindfulness as it is applied by Zen Buddhists and dialectics.
1. Behavioral Science Model
The behavioral science model tries to explain how borderline personality disorder develops in some people. It suggests that some people are born with more emotional vulnerability than others. These “feelers” may have more intense negative responses to a situation than others who don’t possess the emotional vulnerability.
2. Zen Buddhism Mindfulness Techniques
Mindfulness techniques taught in DBT are used to anchor clients to the present. Clients learn to pay attention to what is going on inside of them (their thoughts, feelings, physical sensations, and impulses) and what is happening outside of them (which can be described by their sense of sight, smell, hearing, and touch). The goal is to teach clients to calmly evaluate a situation, their surroundings, the facts as they know them, and focus only on one thing at a time without judgment.
Dialectics are used by therapists to encourage their clients to look at an issue from two different points of view. It is based on the idea that everything is made up of opposites. To clarify, dialectics makes three basic inferences:
• Everything is connected.
• Change is continuous and unavoidable.
• Opposites can be combined to form a closer semblance of the truth.