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Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy (CBT). It combines the behavior change techniques of CBT with therapies designed to help patients focus on two main components: change and acceptance (dialectics).
DBT is a type of cognitive behavioral therapy that focuses on the acceptance of a patient’s experience. It attempts to identify and change negative thinking patterns and behaviors and encourages positive outcomes. Therapists use four methods to administer DBT:
DBT is mainly used to treat people with:
DBT is especially effective at treating patients diagnosed with co-occurring disorders. It was initially developed in the 1970s for patients diagnosed with suicidal thoughts or borderline personality disorder, and it is still used to treat a variety of mood and personality disorders today. This makes it an excellent tool for any addiction treatment program that treats patients with a dual diagnosis.
CBT and DBT are both considered psychotherapy, or talk therapy.
CBT is structured, short-term, goal-oriented, and focused on the present. It begins with education about the disorder and how it affects the patient. Then you learn and practice skills to help make changes in your thoughts, feelings, and behaviors. The skills you learn to deal with present problems will help you deal with problems in the future.
DBT is based on CBT, but with a greater emphasis placed on emotions, mindfulness, and social aspects. Validation (accepting yourself) and relationships are cornerstones of DBT. It shows the patient that what they went through and are currently going through is real and teaches them how to accept their situation.
The patient will also work with their counselor and peer group extensively. In addition to CBT skills, they’ll learn skills for managing your emotions, building relationships, coping with distress, acceptance, and mindfulness.
Dialectical behavior therapy is a very useful method used in some substance abuse or addiction treatment programs. It targets behavior related to substance dependency and focuses on building the skills necessary to manage cravings, prevent relapse, and build relationships that will help you on your path to recovery.
The first stage focuses on decreasing reckless and dangerous behaviors. Patients also build skills to increase their attention, improve relationships, understand their emotions, and manage their distress.
People often shut off emotions when they become too difficult to manage. In this stage, patients practice experiencing emotions fully without using substances to escape them.
In this stage, the treatment shifts from focusing on extreme symptoms to more common problems such as relationships, work problems, life goals, and other emotional issues.
While the first three stages aim at reducing harmful or unwanted symptoms, step 4 focuses on building happiness. DBT accomplishes this by connecting with the world around you.
Dialectical behavior therapy for substance use disorders helps by focusing on the following behavioral targets:
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Chapman, Alexander L. “Dialectical Behavior Therapy: Current Indications And Unique Elements.” Psychiatry (Edgmont (Pa. : Township)) vol. 3,9 (2006): 62-8.
Goodman, Marianne et al. “Dialectical Behavior Therapy Alters Emotion Regulation And Amygdala Activity In Patients With Borderline Personality Disorder.” Journal of Psychiatric Research vol. 57 (2014): 108-16. doi:10.1016/j.jpsychires.2014.06.020