Dialectical behavior therapy, or DBT, is used for individuals struggling with emotion instability. DBT was originally developed to treat people with borderline personality disorder, but can also be effective in treating people struggling with substance dependence, criminals who commit violent crimes and people with traumatic brain injuries. The National Institute of Mental Health indicates that certain brain mechanisms underlying the impulsivity, mood instability and negative emotions are responsible for these maladaptive behaviors.
Brain Trauma Connection
According to The Bridge of Central Massachusetts, a private, nonprofit human service agency, brain-related trauma or discrepancies increase a person's vulnerability to intolerance of emotions and subsequent rejections by outsiders. The National Institute of Mental Health further explains that the portion of the brain known as the amygdala, which normally regulates arousal and emotions, may be involved in the disruption of normal emotional responses due to injury. Ongoing studies to further pinpoint possible brain injuries associated with mood regulation may reveal how DBT intervention can improve outcomes in a range of brain traumas.
DBT Functions
DBT is delivered through a multi-treatment approach utilizing individual therapy, coaching and a team structure. Additionally, managing crises and structuring the environment for the client is significant to this treatment. The primary function of DBT is to offer the individual motivation for change. Behavioral Tech, LLC indicates that the therapy meets additional criteria of enhancing not only the individual's capabilities, but also the therapist's, and generalizes these to the structured environment. The team approach allows for the therapist to maintain motivation in facilitating treatment while also providing the client a forum for ongoing structure in a group setting.
DBT Stages
The DBT Self Help website notes that DBT occurs in stages. The primary stage is stabilization of the client and achieving behavioral control to reduce suicidal or self-harming behaviors. Stage two and three involve regulation of emotional experience and teaching the client a state of normal happiness versus desperation. The final stage is a mechanism for the client that may not reach a sense of fulfillment in the prior stages to further explore the experiences needed to find emotional freedom. Certain skill sets are taught throughout the stages utilizing reinforcement of positive behaviors, relapse prevention plans and repetition.
Skill Sets
DBT may involve homework to continue the learning process. Skill sets emphasizing crisis management, also called distress tolerance, focus on teaching self-soothing through use of the senses, acceptance and relaxation. Emotion regulation skills include maintaining physical health through nutrition, exercise and abstinence from drugs. Interpersonal effectiveness is another skill set involving forming healthy relationship connections through increasing self-respect, giving and receiving validation, and use of reinforcement.
