Therapy

Dialectical Behavioural Therapy

AIM:

The research is to find out where the therapy originated, including the name of the person who first introduced the therapy and a brief history if possible. Provide a short summary of any clinical research or scientific evidence that supports the validity of the therapy. List of conditions the therapy is best suited to treat. A summary of how the therapy works to assist the client. Contras or dangers associated with using the therapy. A bibliography listing the resources used to find the information, including websites and publications.

FINDINGS:

Dialectical behavior therapy (DBT) is a specific type of behavioral psychotherapy developed in the late 1980s by psychologist Marsha M. Linehan to help better treat borderline personality disorder. Since its development, it has also been used for the treatment of other kinds of mental health disorders.

Dialectical behaviour therapy (DBT) is a comprehensive, evidence-based treatment for borderline personality disorder (BPD). The patient populations for which DBT has the most empirical support include parasuicidal women with borderline personality disorder (BPD), but there have been promising findings for patients with BPD and substance use disorders (SUDs), persons who meet criteria for binge-eating disorder, and depressed elderly patients. Although DBT has many similarities with other cognitive-behavioural approaches, several critical and unique elements must be in place for the treatment to constitute DBT. Some of these elements include:

(a) Serving the five functions of treatment,

(b) The biosocial theory and focusing on emotions in treatment,

(c) A consistent dialectical philosophy,

(d) Mindfulness and acceptance-oriented interventions.

The 4 Modules of Dialectical Behaviour Therapy

1. Mindfulness

The essential part of all skills taught in skills group are the core mindfulness skills.

Observe, Describe, and Participate are the core mindfulness “what” skills. They answer the question, “What do I do to practice core mindfulness skills?”
Non-judgmentally, One-mindfully, and Effectively are the “how” skills and answer the question, “How do I practice core mindfulness skills?”

2. Interpersonal Effectiveness

The interpersonal response patterns –how you interact with the people around you and in your personal relationships — that are taught in DBT skills training share similarities to those taught in some assertiveness and interpersonal problem-solving classes. These skills include effective strategies for asking for what one needs, how to assertively say ‘no,’ and learning to cope with inevitable interpersonal conflict.

People with borderline personality disorder frequently possess good interpersonal skills. They experience problems, however, in the application of these skills in specific contexts — especially emotionally vulnerable or volatile situations. An individual may be able to describe effective behavioural sequences when discussing another person encountering a problematic situation, but may be completely incapable of generating or carrying out a similar set of behaviours when analysing their own personal situation.

This module focuses on situations where the objective is to change something (e.g., requesting someone to do something) or to resist changes someone else is trying to make (e.g., saying no). The skills taught are intended to maximize the chances that a person’s goals in a specific situation will be met, while at the same time not damaging either the relationship or the person’s self-respect.

3. Distress Tolerance

Most approaches to mental health treatment focus on changing distressing events and circumstances. They have paid little attention to accepting, finding meaning for, and tolerating distress. Religious and spiritual communities and leaders have generally tackled this task. Dialectical behaviour therapy emphasizes learning to bear pain skilfully.

Distress tolerance skills constitute a natural development from mindfulness skills. They have to do with the ability to accept, in a non-evaluative and nonjudgmental fashion, both oneself and the current situation. Although the stance advocated here is a nonjudgmental one, this does not mean that it is one of approval: acceptance of reality is not approval of reality.

Distress tolerance behaviours are concerned with tolerating and surviving crises and with accepting life as it is in the moment. Four sets of crisis survival strategies are taught: distracting, self-soothing, improving the moment, and thinking of pros and cons. Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus wilfulness.

4. Emotion Regulation

People with borderline personality disorder or who may be suicidal are typically emotionally intense and labile — frequently angry, intensely frustrated, depressed, and anxious. This suggests that people grappling with these concerns might benefit from help in learning to regulate their emotions.
Dialectical behaviour therapy skills for emotion regulation include:

*Learning to properly identify and label emotions § Identifying obstacles to changing emotions

* Reducing vulnerability to “emotion mind”

*
Increasing positive emotional events

* Increasing mindfulness to current emotions § Taking opposite action

* Applying distress tolerance techniques

CONCLUSIONS:

Contras and dangers, as far as I can see and have read it can take time for the therapy to work.