What is dialectical behavior therapy (DBT)?
Dialectical Behavior Therapy (DBT) is especially suitable for people who are frequently overwhelmed by intense emotions. It can lead to impulsive behavior and unstable relationships with others. DBT is therefore aimed at gaining more control over your thoughts, emotions, and behavior. You learn skills to regulate emotions, to prevent impulsivity and (self-)destructive behavior, and to learn how to maintain relationships with others. As a result, you can develop more stability and a more positive self-image.
Techniques
The treatment uses various techniques. For example, together with your therapist, you analyze the events that led to self-destructive behavior. In addition, you practice mindfulness during and outside of sessions, emotional regulation, and interpersonal skills.
The therapy lasts an average of one year and consists of individual sessions, group therapy, homework assignments, and the possibility of telephone contact – even outside office hours.
Trauma-informed treatment and DBT
DBT is often combined with trauma-focused treatment, such as EMDR en imaginal exposure therapy. Usually, when there are problems in dealing with emotions as well as a posttraumatic stress disorder.
Melanie Harned developed a protocol in which DBT is combined with imaginal exposure (the so-called DBT-PE protocol). The premise is that trauma-focused treatment is started alongside DBT as early as possible, initially addressing the memories that cause flashbacks.
How did DGT originate?
Dialectical Behavior Therapy (DBT) was developed in the 1980s by Prof. Dr. Marsha Linehan. She saw that traditional behavior therapy was not helping people with borderline personality disorder (BPD) enough.
Linehan developed a new treatment method for coping with complex emotions and impulsive behaviors. She incorporated her own experiences with suicidality into this. In the 1990s, Dr. Wies van den Bosch introduced and implemented DBT in the Netherlands.Â
Dialectic
Dialectical behavior therapy combines behavioral therapy with meditation techniques and dialectics. Dialectics assumes that there can be multiple perspectives. Dialectics is a way of thinking in which opposites (for example, different opinions) are brought together.Â
How does DGT work?
DGT consists at least of:Â
- Weekly individual therapy with the practitioner
- Weekly group therapy
- Telephone consultation with the therapist
- Homework
And in addition, potentially trauma-focused treatment such as imaginal exposure or EMDR when you and your practitioner determine that unprocessed memories play a significant role in your symptoms.Â
Develop skills
- Attention skills
Awareness of emotions and thoughts. Without immediately judging them or acting on them (impulsively).Â
- Dealing with emotionsÂ
First you recognize when you are emotional. Then you become aware of what the emotions do to you.Â
- Crisis skillsÂ
Learning how to deal with intense emotions and crisis moments without reacting impulsively.Â
- Managing relationshipsÂ
Gain insight into how to maintain relationships. You learn to consider others as well as stand up for yourself.
What symptoms is DBT for?
DBT was originally developed for people struggling with chronic suicidality, in other words, people who repeatedly suffer from suicidal thoughts and suicidal behavior. This is frequently seen in people with borderline personality disorder (BPD).
Additionally, DBT is recommended when people have difficulty regulating emotions and suffer from impulsive and self-destructive behavior, such as self-harm. It can also work for problems that often go hand in hand with trauma, such as depression, anxiety, and substance abuse.
Where can I get dialectical behavior therapy?
Dialexis offers a overview of all DBT treatment teams offering DBT therapy.
You join a team and discuss with them who your individual therapist will be.Â
Where can I find more information about DGT?
Reading tips
- Building blocks for a meaningful life – Marsha Linehan.
- The DBT skills – Marsha M. Linehan, translation by L.M.C. (Wies) van den Bosch.
- DBT treatment for adolescents with borderline personality development in an outpatient treatment unit – J. Niessen, Journal of Child and Adolescent Psychotherapy
- Treating Trauma in Dialectical Behavior Therapy – Melanie S. Harned
Viewing recommendations
Book recommendation
Building blocks for a meaningful life – Marsha Linehan
Psychology Magazine article
Watch tip
What is DGT?
Short explanatory video about dialectical behavior therapy
In collaboration with
Ronald Roskam
Health Care Psychologist in training to become a Clinical Psychologist, VEN-certified EMDR therapist and supervisor, certified individual DBT therapist in training to become a trainer and supervisor, and VGCt Cognitive Behavioral Therapist.
