Dialectical Behavior Therapy (DBT) is a form of psychotherapy that’s particularly effective in treating conditions marked by difficulties in emotion regulation. Instead of viewing certain mental health challenges as mere disorders, DBT zeroes in on emotional dysregulation as a core issue that fuels ineffective behavioral patterns. At its heart, DBT therapy is about understanding and managing emotions. It provides individuals with crucial tools to recognize, understand, label, and regulate their emotional responses, especially in challenging interpersonal situations that often trigger negative or painful feelings.
A key component of DBT is the weekly individual therapy session, where patients actively participate by completing a diary card. This self-monitoring tool, often available as a convenient app, is designed to track specific treatment targets related to mood, behavior, and skill application. Patients regularly identify and rate the intensity of emotions they experience, such as fear, shame, sadness, and anger, even including experiences like pain or thoughts of suicide. This diary card serves as a valuable starting point for in-depth discussions about emotional experiences during therapy sessions. Furthermore, the diary card includes a checklist of DBT skills – a practical reminder for patients to utilize these tools in their daily lives. Patients note how frequently they engage in positive coping mechanisms, ranging from self-soothing techniques and radical acceptance to strategies for reducing vulnerability to emotional distress and acting in ways that are opposite to their emotional urges.
The information meticulously recorded on the diary card plays a crucial role in guiding the therapist in structuring each therapy session. Unsurprisingly, any reported life-threatening behaviors or self-harming actions take immediate precedence. Once the behavioral targets for a session are identified, the therapist guides the patient through a process of behavioral analysis. This involves carefully examining the chain of events leading up to a specific problem situation encountered by the patient. The analysis delves into potential underlying beliefs or attitudes that might be subtly reinforcing the problematic behavior. The therapist and patient collaboratively discuss the consequences of the patient’s actions and explore more skillful and effective ways to navigate emotional and life challenges in the future.
Given the intensive nature of DBT, it’s recognized as a demanding therapy to deliver, even for seasoned professionals. To ensure the highest quality of care, DBT therapists typically operate within a consultation team. Regular team meetings are an integral part of the DBT approach, providing therapists with ongoing support and guidance. The recommendations and insights generated from these team consultations are then thoughtfully integrated into individual therapy sessions, enriching the treatment process.
While research has consistently demonstrated significant progress within the first year of DBT treatment, particularly in the crucial area of controlling self-harmful behaviors, it’s important to understand that DBT is often a longer-term commitment. Many individuals may benefit from and require therapy spanning several years to achieve sustained well-being and effectively manage emotion dysregulation.
