Sunday, December 11, 2011

Dialectical Behavior Therapy (DBT) for the Strength to Recover

Practice with Dialectical Behavior Therapy (DBT) helped one family member cope with bipolar symptoms. Just as with my younger daughter, these symptoms were not due to psychological problems, but to be successful and move forward with her life, and to be able to do what she needed to do to get better in spite of the symptoms, she had to essentially be stronger and more mentally healthy than a person without bipolar disorder. Eventually, this family member was no longer diagnosed with any mental health problem at all! (The same as my younger daughter!)

Although DBT is best done with both individual and group therapy with a therapist who specializes in the technique, my daughter used self-directed workbooks (included at the bottom) and assistance from her individual psychotherapist. Prior to starting the DBT, she had already been using the technique of Cognitive Behavior Therapy (CBT) to deal with the manifestation of anxiety.

We have a guest poster writing about DBT, Lindsey Webster. Ms. Webster has been a rehabilitation counselor for 15 years and owns the site Masters in Counseling. The site serves as a great resource for new students looking to find all the information they need about obtaining a Masters degree in Counseling. She has a Master's degree in Social Work.





The Benefits of Dialectical Behavior Therapy for Those with Anxiety Disorders 
by Lindsey Webster, MSW

In recent years, more research has been done to verify the benefits of combining dialectical behavior therapy (DBT) with cognitive behavior therapy (CBT) for those with anxiety disorders. There is a large amount of evidence to support the theory that using both CBT and DBT to treat anxiety disorders is a better approach than just using CBT alone.

Dialectical behavior therapy (DBT) was originally developed to treat people with borderline personality disorder. This type of therapy uses the concepts of acceptance and mindfulness to help give the patient a better understanding of their disorder in the present moment. The concept of mindfulness (or awareness) was taken from Buddhist meditative practices that have been used for thousands of years. .

Marsha Linehan, the psychology researcher who developed the dialectical behavior system of therapy, noted in her research that the chronically suicidal patients she studied required unconditional acceptance, because they had been raised in an environment which offered little acceptance. For this reason, therapists who use DBT want the patient to view them as an ally in all things. When the patient tells the therapist about their feelings and behaviors, the therapist accepts those feelings and behaviors while, at the same time, showing the patient a better way to view and handle the situations that create those unsettling emotions and actions. .

The goal of being mindful in DBT is aided by the patient noting and recording all issues that arise during the week in a diary. These issues are discussed during their next counseling session. Debilitating behaviors are listed in order of severity, with self-injurious and suicidal behaviors first, behaviors interfering with treatment second and quality of life issues third. A patient should work at improving the most austere behaviors first before improving less serious behaviors. .

There is also a group therapy component to DBT. The group meets to learn and discuss skills that are organized into four modules: core mindfulness skills, emotion regulation skills, interpersonal effectiveness skills and distress tolerance skills.

When combined with cognitive behavior therapy (the most common type of therapy used for the treatment of anxiety disorders), dialectical behavior therapy acts as additional support and teaches the patient to always be aware of their emotions and actions and to accept and tolerate stress. .

Both CBT and DBT provide patients who suffer from anxiety disorders an opportunity to talk about their disorder in an accepting environment. It is important to note that some studies have shown that talking about your anxiety (and trying to find reasons why and how you can overcome it) can be just as effective, if not more effective, as taking an anti-anxiety medication. For this reason, it is almost necessary that those who suffer from an anxiety disorder combine some form of cognitive behavior and/or dialectical behavior therapy with medicinal treatments. Using both counseling and medicine will ensure the best chance of improvement for the patient.

Lindsey Webster has been a rehabilitation counselor for 15 years and also owns the site Masters in Counseling. She likes to write about different topics related to counseling and careers.




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Last Updated: 28 December 2011

3 comments:

ɹǝƃƃolquǝʞoʇ said...

I've been through DBT. I recommend it to everyone.

Unknown said...

I am just beginning a DBT group and I have concerns about how effective it may be for me. I have been unable to respond to many other psychiatric techniques and I fear that, even with my most ardent efforts, DBT will join those other techniques as something that didn't work for me. Any advice for a novice with the fears I have?

Jeanie said...

Michael, I think that we will get out of DBT what we put into it. DBT is a lot of work while going through it. It requires a person to be very thoughtful, honest, and mindful. But as with developing any new habit or skill, if a person puts in the diligence for the time required, the person ends up with something which becomes second nature to them.

So, the advice I would have is to go in with an open mind, honesty, and the determination to do all the at-home work involved. It is not the type of therapy where the person goes in once a week and is the passive recipient of knowledge. No - this is a revelation and fundamental shift in thinking which can only come about by the person's own effort.

I hope this is encouraging, because the success is not so much in another person's efforts, but in your own. I think the trick is to apply the skills being learned, mindfully, and daily. DAILY. CONSTANTLY. Until it becomes a part of you.