Dialectical Behaviour Therapy (DBT) Ontario

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What is Dialectical Behaviour Therapy?

Dialectical behaviour therapy (DBT) is a type of ‘talking therapy’ and is a modified version of cognitive behaviour therapy (CBT). It was originally adapted to treat borderline personality disorder (BPD), but is now used effectively to manage a range of additional mental health conditions, including substance use disorder, post-traumatic stress disorder (PTSD), depression and some eating disorders.

The term ‘dialectical’ means ‘working with opposites’ and DBT provides a framework for making sense of contradictory things. Working with a therapist, individuals learn to hold two seemingly opposite perspectives at once – accepting the way they are, while also acknowledging the need for change. Accepting ourselves and working towards changing our behaviour might feel contradictory, but DBT teaches that is it possible to achieve both of these goals simultaneously.

The main aim of DBT is to promote healthy balance and avoid the all-or-nothing styles of thinking common in individuals with personality disorders and other mental health issues typically resulting from intense emotions.

What are the strategies used in DBT?

DBT focuses on providing therapeutic skills in four key areas to help individuals recover, change their behaviour, move towards a more meaningful and fulfilling life, and reach their personal goals. The therapist introduces two sets of acceptance-oriented skills and two sets of change-oriented skills:

Acceptance-oriented skills

Core mindfulness

Improves the ability to accept ‘what is’, slow down and be fully present in the current moment. This helps with staying calm and avoiding engagement with automatic negative thought patterns and impulsive behaviours.

Distress tolerance

Increases tolerance of intense/negative emotions, rather than using harmful coping strategies to escape from them (for example, using alcohol or drugs to numb them). Healthy coping strategies are introduced and practised, including distraction, self-soothing and improving the moment.

Change-oriented skills

Emotional regulation

Helps recognise, navigate and change intense emotions that are causing issues and creating problems. This can include challenging unhelpful thoughts and finding new healthy ways to deal with distress that do not cause harm to the individual or those around them.

Interpersonal effectiveness

Improves communication/interaction with others – learning to be more assertive, maintaining self-respect and respect for others, developing good listening skills and staying positive – strengthening relationships.

What are the key goals of DBT?

The ultimate goals of dialectical behaviour therapy are to significantly reduce impulsivity, interpersonal challenges, emotional reactivity, self-harm, and suicidal behaviour.

These goals are achieved by helping individuals to:

  • stay in the present moment
  • understand and accept difficult feelings
  • learn a range of skills to cope with stress and regulate/manage feelings
  • improve their relationships with others
  • become able to make positive changes in their lives.

When is DBT used?

While DBT was originally developed to help treat borderline personality disorder, it is now an evidence-based treatment that can be used effectively to treat individuals experiencing a range of other mental health conditions, including:

  • attention-deficit/hyperactivity disorder (ADHD)
  • bipolar disorder
  • depression (including treatment-resistant major depression and chronic depression)
  • eating disorders (including bulimia and binge eating)
  • generalised anxiety disorder (GAD)
  • post-traumatic stress disorder (PTSD)
  • self-harming
  • suicidal thoughts and/or behaviour
  • substance use disorder.

DBT is mainly used to help those who have difficulties with emotional regulation and/or are exhibiting self-destructive behaviours. It is a helpful therapy for those considered high-risk and tough-to-treat, particularly those who present with multiple diagnoses.

It is typically delivered in three therapeutic settings:

  • Individual therapy
  • Group therapy skills training
  • Phone/video coaching.

Is DBT an effective therapy?

In controlled trials, DBT has consistently been found to be effective for treating individuals from different backgrounds in terms of age, gender, race/ethnicity and sexual orientation.

DBT works because it successfully increases an individual’s ability to use practical coping skills, especially when experiencing, expressing, and regulating intense emotions.

DBT is most effective for individuals who are:

  • committed to making positive changes in themselves
  • ready to work hard at therapy, including homework assignments
  • wanting to focus on their present and future, rather than their past
  • willing and able to attend DBT group therapy sessions as well as one-on-one.

Which is better, DBT or CBT?

DBT and CBT are both ‘talking therapies’ used to help individuals manage problems by changing their thought patterns and behaviours. DBT applies core CBT principles of understanding how thoughts, feelings and behaviours influence each other, but places more focus on acceptance and relationships with others.

When comparing DBT with CBT, it’s not simply a case of one being more effective than the other, as each has its appropriate use.

DBT was developed because CBT wasn’t working well for some people. It was found that those suffering from mental health issues resulting from intense emotions were more likely to quit CBT therapy where ‘change’ was the sole focus.

As DBT places an additional focus on ‘acceptance’, through mindfulness and distress tolerance techniques, it can be more effective for certain types of people.

Dialectical Behaviour Therapy at Centres for Health and Healing

At Centres for Health and Healing, we specialise in personalised mental health treatment, using research-based, highly effective programs. Our client-focused, holistic programs offer a perfect balance of therapeutic techniques and treatment approaches to ensure deep transformational healing and successful long-term recovery.

There are different types of talking therapy accessible in our programs, including DBT, which can be delivered through group, family and individual sessions.

Many of our clients respond particularly well to DBT, particularly those who present with multiple diagnoses.

If you think you or a loved one might benefit from DBT, it is important to talk with a mental health professional or healthcare provider trained in the approach. Please call us free today for further information and guidance. We are here to help.

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