Dialectical Behavior Therapy Overview

0:00 this talk is an overview of dialectical behavior therapy also known as DBT let's start by outlining what DBT is DBT is a form of therapy designed for people who struggle with emotional disregulation especially those who suffer from chronic suicidality and self-injurious behavior it was initially developed to treat people with borderline personality disorder but is effective for numerous diagnoses involving emotional disregulation DBT uses cognitive behavioral and mindfulness strategies with the ultimate goal of helping patients to build a life worth living an important underlying theory is the biosocial theory which posits that emotional disregulation results due to both biological and social forces that

0:45 is due to both nature and nurture vulnerability to emotional disregulation is thought to be heritable and this vulnerability can be exploited if a person is exposed to a chronically invalidating environment during their early upbringing emot disregulation and chronic invalidation subsequently lead to the development of maladaptive ways of coping for example anger outbursts violence or self harm with this understanding in mind DBT involves shaping and reinforcing more adaptive and healthy behaviors while also providing the validating environment that the person lacked in their early development by the way the dialectical part of dialectical behavior therapy refers to the process of synthesizing opposing ideas for example the ideas of

1:31 acceptance and change this particular dialectic arises often in DBT as the patient is encouraged to accept themsel while simultaneously attempting to change maladaptive behaviors logistically DBT involves three different components group skills training individual therapy and 24-hour phone coaching the phone coaching is particularly important to DBT as it helps the patient to take the new skills they've learned in therapy into the real world as you can imagine this is quite an intensive treatment process and can involve multiple days per week of therapy also the patients receiving DBT can be very sick and emotionally taxing for therapists to work with as such a comprehensive DBT program involves a team of providers formerly known as a

2:18 therapist consultation team who can support each other in problem solving for difficult scenarios as well as providing emotional support these are the basics of DBT let's next outline the skills taught in DBT the skills taught in DBT fit into four categories distress tolerance interpersonal Effectiveness mindfulness and emotion regulation you can remember these skill categories with the pneumonic of the DBT Diamond dime is an acronym for the four categories and you can visualize each category as being a point on a diamond let's move on to discuss each of these skill categories in a bit more depth distress tolerance means improving your ability to cope with overwhelming emotions and painful events the skills learned in this

3:04 category include distraction and self- soothing techniques as well as the practice of radical acceptance radical acceptance is a core skill in DBT it involves acknowledging your present situation without judging the events or criticizing yourself interpersonal Effectiveness means improving your ability to communicate and nurture relationships while simultaneously making sure your own needs are met these skills include General Social skills as well as training in assertiveness and effective listening mindfulness means improving your ability to experience the present moment non-judgmentally without ruminating on the past or worrying about the future this involves two groups of skills the what skills which help you to observe the content of your thoughts and emotions and the house skills which help

3:51 you practice mindfulness in your daily life finally emotion regulation involves improving your ability to observe emotions clearly and not rea to them in harmful or destructive ways this includes improving your ability to recognize your emotions reducing your vulnerability to being controlled by your emotions and engaging in a practice called opposite action which means doing the opposite of what your emotions are urging you to do these are the core skills taught in DBT and that's the end of this talk DBT can be a very powerful treatment for people who are deeply suffering I hope this overview gives you an appreciation for the hard work of both the providers and and the patients going through this treatment thank you