Dialectical Behavior Therapy: Applications and Effectiveness

Dialectical behavior therapy (DBT) helps people handle their feelings better and build stronger relationships. It’s a mix of cognitive-behavioral therapy and a specific philosophy.¹ Marsha Linehan created DBT in the 1970s. It’s great for folks with borderline personality disorder (BPD), or issues with drugs, eating, and feeling depressed.²

The main parts of DBT are one-on-one talks, group meetings, and sessions where therapists share ideas. These treatments happen every week.² Lots of studies prove DBT helps cut down on trying to harm themselves, making emotions more under control, and getting better along with others for those with BPD.² There are also hopes it could work well for the elderly with issues like drug abuse, overeating, and sadness.

Key Takeaways

• Dialectical Behavior Therapy (DBT) is a comprehensive, evidence-based treatment that combines cognitive-behavioral techniques with a dialectical philosophy.
• DBT has proven to be especially effective in treating individuals with borderline personality disorder, as well as those struggling with substance use disorders, eating disorders, and depression.
• Multiple randomized controlled trials have demonstrated the efficacy of DBT for reducing suicidal and self-harm behaviors, improving emotional regulation, and enhancing social functioning.
• Emerging research indicates promising results for using DBT to treat substance use disorders, binge eating, and depression in elderly patients.
• The standard DBT treatment package includes weekly individual therapy sessions, group skills training, and therapist consultation team meetings.

What is Dialectical Behavior Therapy (DBT)?

Dialectical behavior therapy, or DBT, is a type of talking therapy. It’s based on cognitive behavioral therapy (CBT) but has its own methods. DBT helps people who feel emotions very strongly. It teaches them skills to control their feelings and have better relationships with others. The “dialectical” part means therapists use a mix of accepting and changing to aid patients.

Cognitive Behavioral Therapy (CBT) Adaptation

DBT’s heart lies in merging opposites through dialectics. Therapists in DBT work to accept a patient’s emotions and reality. Yet, they also teach ways to change unhelpful behaviors or thoughts. This balanced method combines both acceptance and change, key elements for those struggling with their emotions.

Dialectical Approach: Combining Acceptance and Change

In the 1970s, Marsha Linehan, an American psychologist, crafted DBT.¹ She made it for people coping with borderline personality disorder (BPD) and self-harm. Linehan used a mix of acceptance and CBT skills, finding it suited her patient’s unique needs.

Conditions Treated with Dialectical Behavior Therapy

DBT is used for people who struggle with big emotions and regulating them.¹ It focuses on helping with emotion control. This is key because it helps reduce harmful behaviors linked to strong negative feelings.

Borderline Personality Disorder (BPD)

For women with BPD, DBT has strong support in studies.² Tests have shown it works well in lowering suicidal actions and self-harm, boosting how they do with others, and improving emotion control in people with BPD.³

Substance Use Disorders (SUDs)

DBT also helps those with both BPD and SUDs.² It’s been shown to cut down drug use and help people keep up with their treatment. This is especially true for opiate users with BPD.

Binge-Eating Disorder

Early looks into DBT for binge-eating are promising.² People in these DBT programs do better controlling their eating, feel better about their bodies, and manage their anger more effectively.

Depression in Elderly Patients

An adjusted DBT also helps older people with depression and personality disorders.² It was found to be more effective than just using medicine alone. Even after 6 months, these benefits held strong.

Dialectical Behavior Therapy for Borderline Personality Disorder

DBT shows it can greatly reduce harmful behaviors in those with borderline personality disorder. This includes making less suicide attempts and hurting themselves less. DBT is better than other methods at lowering ongoing anger and helping people make friends and function better.⁴

It’s not just about stopping self-harm. DBT helps people get better at handling their feelings and fitting in with others. This means they might understand their emotions more and learn how to deal with strong feelings better.⁴

Research shows DBT works well outside of research labs, too. Outpatient centers and hospitals have used it, showing it can work beyond studies. This means DBT can help in everyday mental health care settings.³

Dialectical Behavior Therapy: Applications and Effectiveness

Dialectical behavior therapy, or DBT, offers a solid way to treat several mental health issues with real evidence.² It has helped a lot with borderline personality disorder (BPD). But, it’s also doing well with substance use, binge-eating, and depression in older folks.² DBT works by teaching patients how to deal with their emotions better, improve how they get along with others, and lower self-harm and thoughts of suicide.² Its special mix of accepting one’s current state while striving for changes is a key reason why it’s so effective.¹

DBT does a great job at cutting down harmful actions in people with BPD when we compare it to regular treatment methods.² Those who try DBT have fewer suicide tries, need less time in the hospital, and have lower risks of harming themselves again than those using other methods.² It helps women with BPD and substance issues a lot too, reducing their drug use and helping them stay away from opiates.² Studies from several places around the world show that DBT lowers self-harm, rash actions, and alcohol use more than usual treatments.²

There’s early info that DBT might also work well for binge-eating and other food-related troubles.² When it comes to older adults with depression, adding DBT to their meds makes more people overcome their sadness.²

Dialectical Behavior Therapy for Substance Use Disorders

Research shows that DBT helps those with borderline personality disorder and substance use. It reduces drug use and dropout rates more than other methods.⁵ During 12 months of DBT, patients used drugs less, and this continued later.⁵

Reduced Drug Use and Treatment Dropout

A study looked at DBT with opiate-dependent women who have BPD. Both DBT and control groups got opiate replacement. However, the DBT group stayed off opiates more at the 16-month check.⁵

Sustained Abstinence from Opiates

Other studies, including some outside the U.S., found DBT’s benefits. They saw less alcohol use and fewer risky behaviors like gambling and reckless driving.⁶ This shows DBT could be a big help with many substance use issues.

Promising Results for Alcohol and Drug Use

DBT for Eating Disorders and Depression

DBT, or Dialectical Behavior Therapy, seems to help not just with depression but also eating disorders. Specifically, it’s useful for binge-eating disorder. People under DBT treatment do better than others in controlling binge-eating, improving how they see their bodies, and handling their eating worries.⁷ Yet, we still need to understand if these improvements last in the long run.

Improvements in Binge-Eating and Body Image

DBT is showing results for those battling eating disorders. It deals with the uncontrolled emotions that can lead to eating problems such as purging, restricting, and binge-eating.⁷ Most research on DBT so far has been focused on bulimia nervosa and binge-eating disorder. It has noted a drop in binge-eating instances.⁷ While there’s not much data on the use of DBT for anorexia nervosa, there is some. For instance, it has led to a 33% drop in symptoms for those with both anorexia and borderline personality disorder after a DBT program.⁷

Remission from Depression in Elderly Patients

A version of DBT adapted for the elderly is also proving its worth. This version targets depression in older patients with a personality disorder. Those under this adapted DBT see more relief from depression than those only on medication, and this effect lasts at least 6 months.⁸ These results highlight DBT’s potential to help older adults struggling with both depression and personality disorders.

DBT Treatment Components

The DBT treatment has several important parts. Patients get one-on-one therapy each week for about an hour. In these sessions, the focus is on how to use DBT skills in their lives.⁹

There’s also a group skills training session once a week. This group meeting lasts from 1.5 to 2.5 hours. Here, people can learn and practice things like mindfulness and managing emotions together.⁹

The last part is the therapist team. DBT therapists meet up every week, spending 1 to 2 hours together. They share advice, help with tricky cases, and make sure they’re using the DBT approach well.⁹

Finding a Dialectical Behavior Therapy Therapist

To start looking for a DBT therapist, ask your healthcare team for suggestions. This could be your general doctor, a psychiatrist, or a therapist.¹ They might know DBT specialists in your area.

Another way is checking online. Visit websites like the “Find a Psychologist” tool by the American Psychological Association.¹ This helps find DBT therapists nearby.

Questions to Ask Potential DBT Therapists

It’s key to quiz a DBT therapist on their background and skills.¹ Ask if they’re certified in DBT, attend consultations, and their rules on reaching out between sessions via phone or email.

Empirical Support for Dialectical Behavior Therapy

Randomized Controlled Trials (RCTs)

Many studies have looked at whether dialectical behavior therapy works. These studies, known as randomized controlled trials, show that DBT is very good at helping people. It helps reduce thoughts of suicide, self-harm, and makes people better at handling their emotions. This is especially true for those with borderline personality disorder (BPD).²

Efficacy for Specific Patient Populations

Research doesn’t just support DBT for BPD. It also shows potential for treating other issues. These include substance use disorders, binge-eating, and depression in older adults.² Though there’s less evidence for these groups, studies indicate that DBT could help with a variety of mental health issues. These might involve problems with managing emotions and acting quickly.¹⁰¹¹

Critical Elements of Dialectical Behavior Therapy

For a treatment to be real DBT, it must meet certain key points. It should achieve five main goals: get the patient motivated, boost their skills, help them use these skills in real life, set a helpful surrounding, and get the therapist to perform well.²

Biosocial Theory and Emotion Focus

DBT stands out due to its biosocial theory. This view says emotional struggles come from being biologically sensitive and growing up in an environment that doesn’t support emotions. DBT uniquely focuses on managing emotions, making it different from other therapies.¹²¹³

Dialectical Philosophy

DBT is marked by its dialectical philosophy, poising that balance between acceptance and change is key. This balanced approach helps people with difficulty regulating their emotions.¹²

Mindfulness and Acceptance Interventions

DBT uses mindfulness and acceptance practices, which are not common in other therapies. These techniques teach patients to deal with their emotions without trying to alter them rapidly.¹²¹³

DBT Training and Implementation

Teaching dialectical behavior therapy (DBT) well needs special courses and sticking to the model. DBT therapists go through a lot of training. This often means a 2-year study to get the skills and know-how.² They also join a DBT consultation team. This is to keep learning, get support, and make sure they stick to the treatment plan.¹⁴

Dialectical Behavior Therapy (DBT) is seen as the best way to help people with Borderline Personality Disorder (BPD).¹⁴ Studies have proven that DBT helps cut down on suicide attempts, time spent in the hospital, and improves other areas.¹⁴ Making sure people are well-trained in DBT is key to it helping as many people as possible.

Looking at DBT used in public mental health care, it really works.¹⁴ Research shows that people who work in communities can learn DBT well too.¹⁴ But, keeping the programs going has been hard, and steps must be taken to make sure training stays on track.¹⁴

Source Links

1. https://my.clevelandclinic.org/health/treatments/22838-dialectical-behavior-therapy-dbt
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/
3. https://www.verywellmind.com/dialectical-behavior-therapy-1067402
4. https://www.verywellmind.com/dialectical-behavior-therapy-dbt-for-bpd-425454
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2797106/
6. https://americanaddictioncenters.org/therapy-treatment/dialectical-behavioral-therapy
7. https://withinhealth.com/learn/articles/dialectical-behavior-therapy
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522082/
9. https://depts.washington.edu/uwbrtc/about-us/dialectical-behavior-therapy/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638174/
11. https://psychotherapy.psychiatryonline.org/doi/10.1176/appi.psychotherapy.2015.69.2.111
12. https://frtc.ltd/dbt-explained-a-deep-dive-into-dialectical-behavior-therapy
13. https://www.medicalnewstoday.com/articles/everything-to-know-about-dialectical-behavioral-therapy
14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835762/