Dialectical Behaviour Therapy – DBT for BPD and Mental Health Problems
Dialectical Behavior Therapy (DBT) is a type of CBT (cognitive behavioral treatment) that was initially developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It has been over the time recognized as the gold standard psychological treatment for this population.
It is also effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.
Although, DBT is the brainchild of Dr. Marsha Linehan, a clinical psychologist from Seattle, many others have contributed and the development of the treatment continues.
DBT has four sets of behavioural skills.
- Mindfulness – the practice of being fully aware at the current moment
- Distress Tolerance: tolerating pain in difficult situations, not change it
- Interpersonal Effectiveness: How to maintain self-respect
- Emotion Regulation: how to control emotions when you want to control them.
General Characteristics of DBT
DBT help the patient identify his or her strengths and build on them.
Cognitive-based – This type of therapy helps people find about their thoughts, beliefs, and assumptions that make life harder for them.
Collaborative: It requires constant attention to relationships between clients and staff. In DBT people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them.
Specially formatted cards for tracking therapy interfering behaviors that distract or hinder a patient’s progress. Diary cards can be filled out daily, 2-3 times a day, or once per week.
Limitations of DBT
There are a few criticisms and limitations, if using DBT for treatment of depression and allied illnesses.
- Much of the available research on the efficacy of DBT included small sample sizes and focused on a specific sector of the mental health population. Critics argue more research should be done to determine whether DBT works well for those with varied or complex mental health concerns.
- DBT uses a detailed manual and requires solid training to implement. In many of the research studies where DBT was found to be effective. This does not necessarily indicate a weakness in the model itself but underscores the intensive amount of training required to deliver the services as designed. Therefore, expanding the availability of comprehensive training could be useful for community mental health organizations.