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Dialectical Behavioral Therapy (DBT)


"Dialectical Behavior Therapy (DBT) is a comprehensive multi-diagnostic, modularized behavioral intervention designed to treat individuals with severe mental disorders and out-of-control cognitive, emotional and behavioral patterns.  It has been commonly viewed as a treatment for individuals meeting criteria for Borderline Personality Disorder (BPD) with chronic and high-risk suicidality, substance dependence or other disorders.  However, over the years, data has emerged demonstrating that DBT is also effective for a wide range of other disorders and problems, most of which are associated with difficulties regulating emotions and associated cognitive and behavioral patterns.

As the name implies, dialectical philosophy is a critical underpinning of DBT.  Dialectics is a method of logic that identifies the contradictions (antithesis) in a person's position (thesis) and overcomes them by finding the synthesis.  Additionally, in DBT a client cannot be understood in isolation from his or her environment and the transactions that occur.  Rather, the therapist emphasizes the transaction between the person and their environment both in the development and maintenance of any disorders.  It is also assumed that there are multiple causes as opposed to a single factor affecting the client.  And, DBT uses a framework that balances the treatment strategies of acceptance and change - the central dialectical tension in DBT.  Therapists work to enhance the capability (skills) of their client as well as to develop the motivation to change.  Maintaining that balance between acceptance and change with clients is crucial for both keeping a client in treatment and ensuring they are making progress towards their goals of creating a life worth living.

DBT clearly articulates the functions of treatment that it addresses.  They are:

  1. to enhance an individual's capability by increasing skillful behavior,

  2. to improve and maintain a client's motivation to change and be engaged with treatment,

  3. to ensure generalization of change occurring through treatment,

  4. to enhance the motivation of therapists to deliver effective treatment, and

  5. to assist the individual in restructuring or changing his or her environment such that it supports and maintains progress and advancement towards goals."

"DBT-Lenihan Board of Certification"

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