Dialectical Behavioral Therapy
Originally developed as a treatment for people with borderline personality disorder, Dialectical Behavioral Therapy (DBT) now finds a home in many treatment settings. DBT focuses first on stabilizing people if they demonstrate self-harming or other dangerous behaviors, then works into self-control, managing emotions, and learning to experience positive feelings.
At Everlast Recovery Centers, we use DBT in group and individual therapies. Almost everyone will benefit from learning the self-management techniques and coping skills that DBT teaches. From sub-acute detox to residential therapy, these skills only become more valuable.
What is Cognitive-Behavioral Therapy?
DBT grew out of a need for therapy to treat people who engaged in chronic self-harming or suicidal behaviors. People who initially benefitted from DBT included those who have a borderline personality disorder, characterized by extreme instability in their emotions and relationships.
DBT includes the following goals:
In the most intensive steps of the program, clients participate in group and individual therapy. Almost everyone can benefit from working on their emotional control and relationship skills, making DBT an essential tool for clients at Everlast.
How Does Dialectical Behavioral Therapy Work?
Traditional DBT proceeds in steps as the client becomes more stable. DBT takes an extended amount of time and involves an intense working relationship between the therapist and the client. Therapists base DBT on four key areas:
Those who partake in DBT learn mindfulness techniques, such as awareness of the present moment and giving space to out-of-control thoughts and emotions. Some therapists recommend that during times of intense stress, people focus on The Big Five: your five senses and all the things you can sense with them at that moment. Mindfulness gives people a tool to center, focus, and process strong feelings before acting on them.
Many of us do not respond with our best behavior when things go wrong, but some people have a lower tolerance for distress and problems than others. Learning to tolerate and cope with distress makes people more capable of avoiding emotional overreactions. Immediate practical techniques include distracting or self-soothing when distressed. In the long term, considering the consequences of overreacting to distress can help people avoid making poor decisions in the moment.
In DBT, people learn how to have more stable, healthy, balanced relationships. Since the therapy began treating people with severe instabilities in their relationships with others, it now teaches ways to interact better with people. Lessons include effective communication, sharing feelings without becoming too emotional, healthy boundaries, and good listening skills.
Many of us struggle to label our emotions or find the words to talk about them. DBT teaches skills to recognize an emotional response, name it, and work on changing it. Emotions may be overwhelming, and it may feel like all of them attack at the same time. However, by learning to know emotions by name and how to tackle each one, people develop emotional stability.
Dialectical Behavioral Therapy and Addiction
Low tolerance for distress can contribute to addiction and also help to feed it. People who lack the skills to cope with stress might seek out drugs or alcohol when they feel distressed. Because substance abuse temporarily takes away the feeling of distress, this becomes the go-to strategy for coping with life’s problems.
As with distress tolerance, people who have trouble regulating their emotions might find that drugs or alcohol help them temporarily eliminate those feelings. Many people lack the skill to regulate their emotions, leading to constant feelings of being overwhelmed. This also makes recovery more difficult, as all of these emotions will come back in sobriety unless dealt with in treatment.
People with substance use disorders can benefit from all the skills that DBT teaches. Learning these skills can be a critical part of relapse prevention. By learning how to regulate emotions and tolerate stress, those in recovery are less likely to relapse when challenges in life arise.
Other tools taught in DBT, including mindfulness and interpersonal effectiveness, are other crucial parts of the recovery process. Mindfulness helps people handle intense emotions and can further play into distress tolerance. Relationships in recovery help clients build a strong system of people who will support them during and after treatment. Rebuilding any relationships that were damaged in addiction takes works, but the tools learned in DBT can help.
Dialectical Behavioral Therapy in Residential Treatment
DBT has been modified many times since its initial development. No longer only a treatment for suicidal women, it has adapted to treat many different populations, including those in substance abuse treatment.
Learning the skills taught in DBT takes time and practice. It is meant to be a long-term treatment with steps that take clients from a crisis state to one where happiness and long-lasting sobriety are achievable. While the residential program at
Everlast may not allot all the time needed for DBT, our clients can still learn valuable skills to take with them after leaving our care.
Since both group and individual therapy form critical parts of DBT treatment, the residential setting at Everlast provides an ideal environment. Time spent in residential treatment, away from drugs and alcohol, gives our clients the time to practice the skills that will help them achieve long-term sobriety.