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Dialectical behavior therapy (DBT), a comprehensive cognitive behavioral treatment, aims to treat individuals who see little or no improvement with other models of therapy. This treatment focuses on problem solving and acceptance-based strategies within a framework of dialectical methods. The term dialectical refers to the processes that synthesize opposite concepts such as change and acceptance.
Certified practitioners of DBT offer acceptance and support to people in therapy, many of whom have conditions described as "difficult to treat," as they work to develop techniques in order to achieve goals, greater overall mental and emotional well-being, and lasting positive change.
DBT, which can be used in a variety of mental health settings, incorporates the following five components:
Capability enhancement: DBT provides opportunities for the development of existing skills. In treatment, four basic skill sets are taught: Emotion regulation, mindfulness, interpersonal effectiveness, and distress tolerance.
Generalization: DBT therapists use various techniques to encourage the transfer of learned skills across all settings. People in therapy may learn to apply what they have learned at home, at school, at work, and in the community. For example, a therapist might ask the person in treatment to talk with a partner about a conflict while using emotion regulation skills before and after the discussion.
Motivational enhancement: DBT implements individualized behavioral treatment plans in order to facilitate the reduction of problematic behaviors that might negatively affect quality of life. For example, therapists might utilize self-monitoring tracking sheets so individual sessions can be adapted to address the most severe issues first.
Capability and motivational enhancement of therapists: Because DBT is often provided to people who experience chronic, severe, and intense mental health issues, therapists receive a great deal of supervision and support to prevent things like vicarious traumatization or burnout. For example, treatment-team meetings are held frequently to give therapists a space to provide and receive support, training, and clinical guidance.
Structuring of the environment: A goal of therapy is often to ensure positive, adaptive behaviors are reinforced across all environmental settings. For example, if an individual participates in multiple treatment programs within one agency, the therapist might make sure each program was set up to reinforce all the positive skills and behaviors learned.