DBT therapy is considered the most effective approach to treating patients with BPD (Borderline Personality Disorder).
From English Dialectical Behavior Therapy, it is a first-line structured therapy for people with high emotional dysregulation, self-injurious behavior and suicidal behavior, characteristics of TPL.
A variation on traditional Cognitive Behavioral Therapy (CBT) with elements of acceptance and mindfulness, Dialect behavioural therapy in London has also been shown to be effective in treating other disorders. These include bipolar mood disorder, eating disorders, substance use and other addictions, post-traumatic stress disorder (PTSD), depression and ADHD (Attention Deficit Hyperactivity Disorder).
The main objective of DBT (Dialectical Behavioral Therapy) is for the patient to learn to regulate extreme emotion and impulses, reducing dysfunctional behaviors dependent on the mood state. He also learns to trust and validate his own experiences, emotions, thoughts and behaviors.
Dialectical Behavior Therapy ( DBT )) is a psychotherapeutic technique developed by the American psychologist, Dr. Marsha Linehan, which uses Cognitive Behavioral Therapy (CBT) concepts and strategies and emotional and social skills training. During her years of personal and work experience.With the improvement of the technique, Dr. Lineham was able to observe and publish numerous studies that prove that training the skills taught in DBT help individuals to manage their symptoms and improve the quality of life and their interpersonal relationships. Widespread in the United Kingdom, DBT aims to promote interpersonal effectiveness, emotional regulation, stress tolerance and self-control. Through the validation of emotions and the use of activities such as behavior analysis, meditation and the application of mindfulness, the therapist uses strategies in order to lessen the negative effects of stress and promote the need for change.
It is worth remembering that not every psychotherapeutic technique is appropriate for all disorders, nor for all people. A meticulous professional evaluation at the beginning of the treatment is fundamental, as well as the establishment of a relationship of trust between the therapist and the client. Together, the two will be able to identify goals for the treatment, thus increasing the chance of therapeutic success.
Combined Techniques
Dialectical Behavioral Therapy was developed in the 1970s by American psychologist, teacher and writer Marsha Linehan.
A PhD in Social and Experimental Personality Psychology, she carries the scars of burns and cuts on her arms as evidence of her own overcoming of the disease, which almost led her to death by suicide.
DBT combines behavioral therapy techniques, dialectical philosophy, and reality-acceptance principles derived from Zen Buddhism (of which Marsha is a practitioner and teacher).
Differential
As a differential compared to other cognitive-behavioral programs, DBT is an intervention based on therapeutic principles and not on a treatment manual.
It is based on a hierarchy of therapeutic goals established based on their importance: solving suicidal and parasuicidal behaviors; change behaviors that interfere with the course of therapy; eliminate behaviors that affect quality of life; and develop the behavioral skills that help achieve well-being.
This structure enables a flexible approach depending on the needs of each patient. In addition, it makes reference to the change in the focus of the intervention.
Interventions
DBT encompasses individual treatment, skills training (individual or group), inter-session coaching, and team consulting for therapists.
Individual therapy tends to be directive and based in the here and now, seeking to address the patient’s adaptive problems. Priority attention is given to suicidal and self-destructive behaviors and then to behaviors that interfere with therapy itself. Then come issues related to the patient’s quality of life and its improvement.
In the final phase of DBT, attention is given to intervening in psychological trauma and promoting self-respect. For some patients, it is necessary to find a deeper meaning for their existence. In these cases, therapy contemplates addressing issues such as living a life with meaning and spiritual aspects, particularly the feeling of belonging to the universe.
Modules
In skills or competence training, organized in modules and that can be done in a group, the patient is taught and practices a series of skills in which he has difficulty in his daily life .
For low self-efficacy, there is the Mindfulness Module, or mindfulness practices, which instructs in the skills of observing, describing and participating without judgment, seeking effectiveness, using a DBT concept called wise mind.
For emotional vulnerability, the Emotional Regulation Module helps to recognize, name and understand emotions, as well as modify emotional responses and manage extreme emotions.
As for impulsive behaviors, the DBT Distress Tolerance Module teaches crisis tolerance and survival skills.
Finally, for problems in relationships, the Interpersonal Effectiveness Module teaches the patient how to achieve their goals in relationships, maintaining self-respect, as well as cultivating relationships that are healthy and ending those that are not.
How does Dialectical Behavior Therapy (DBT) work?
DBT was originally developed to be applied in group therapy, supported by individual therapy. Participants attend two weekly sessions, one in a group for social skills training and another individual session, where the skills learned are discussed in more depth in relation to the individual’s private life. However, few groups are available in Brazil and therapists who work with the technique try to use flexibility to offer effective treatment.
In this way, at Núcleo Interface, individual sessions alternate between skills training and individual therapy, with the main objective of offering space to learn new strategies to deal with uncontrolled emotions.
Skills to be developed:
- Interpersonal effectiveness (dealing appropriately with others)
- Emotional regulation (dealing with strong emotions)
- Stress tolerance (practicing being more stress tolerant)
