Talk therapy is a broad term that includes many more specific types of mental health intervention. One of the most common forms of talk therapy is cognitive behavioral therapy (CBT). A form of therapy that grew out of CBT is dialectical behavioral therapy (DBT), which is an evidence-based and highly effective intervention that we offer at Palms Behavioral Health in Harlingen, Texas.
How DBT is Different From CBT
CBT generally focuses on helping people to identify errors in their thinking and new ways to think about things. DBT does not label any thoughts as invalid or wrong but instead acknowledges the idea that two seemingly opposed ideas (dialectics) can be simultaneously true, thus leading to a more moderate, middle path that balances acceptance and change. For example:
- A person can be doing their very best to cope with a mental health disorder and also can learn more ways to manage their mental illness.
- Two people in a relationship can love each other very much and also become annoyed with each other’s behavior at times.
- A person can want to recover from mental illness and also find it difficult to give up old coping skills they have relied upon in the past.
Although CBT and DBT are both present-focused, CBT may also include some discussion of a person’s past and how it contributed to how they think or behave today. DBT is more centered around a client’s current emotions and skills for emotional regulation.
CBT also does not have a precise protocol or timeline. It can look different for every patient, depending on their specific issues. DBT, on the other hand, doesn’t change as much from one person to the next. There are four stages and three components that DBT nearly always includes and it rarely includes additional pieces:
- A skills training group: This group may offer themed modules and look like a classroom setting, with one or more leaders to teach participants the behavioral skills they need. It often takes at least six months and more often, about a year to complete all of the group sessions, which are generally 1.5 to 2.5 hours long.
- Individual therapy: One participant and one therapist focus on the more specific issues the person is having and practice applying the skills they are learning in the group. Sessions are often 50-60 minutes long and occur once per week.
- On-call coaching: When a participant is struggling outside of their group or individual sessions, they can use this option to work through difficulties they are experiencing.
Individual therapy and skills training groups often involve homework that participants complete between sessions. The homework often involves patients documenting their emotions and actions and practicing the skills they have already learned.
Skills that DBT Teaches
DBT helps to enhance a person’s skills in four main areas:
- Mindfulness: Cultivating awareness of the present moment, observing without judgment, and focusing on one thing at a time.
- Distress tolerance: Learning to cope with painful or challenging situations that arise in life.
- Interpersonal effectiveness: Communicating needs and setting boundaries respectfully, managing conflict, and saying no when necessary.
- Emotional regulation: Understanding and managing emotions by identifying obstacles and engaging in positive experiences that promote emotional well-being.
What DBT Can Treat
DBT was developed to treat borderline personality disorder and is still the preferred treatment method for this condition. It can also help treat other mental illnesses, particularly ones that involve:
- Intense emotions
- Relationship difficulties
- Self-harm
- Self-sabotage
- The patient feels like everything they do is wrong
- Addictive-like behaviors
- Constant shame
Some examples of conditions this might include are substance use disorders, bipolar disorder, depression, eating disorders, and attention deficit-hyperactivity disorder (ADHD)
Benefits of DBT
DBT results can vary from person to person, depending on the severity of their condition. Research has found that people who complete DBT often:
- Have reduced self-harm behaviors
- Experience a decrease in suicidal thoughts
- Have lower rates of hospitalization
- Experience improved social functioning
The more engaged a person is with DBT, the more likely they are to experience a high level of benefit. This includes things like completing assigned homework, participating in group discussions, and attending individual therapy sessions consistently.
At Palms Behavioral Health, we treat adolescents, adults, and seniors who require inpatient or outpatient care to manage mental health disorders. We use evidence-based, trauma-informed practices, to develop an individualized care plan for each patient we serve in our programs.
