Dialectical Behavior Therapy (DBT) is a modified form of Cognitive Behavioral Therapy for those with severe psychosocial disorders. Recent work at the University of Washington suggests its effectiveness with chemical dependency, in particular, and some addiction specialists are incorporating DBT into rehab treatment plans. This form of therapy concentrates on skill development, coping strategies, and an individual’s strengths. Through a focus on positive reinforcement, Dialectical Behavior Therapy can decrease the number of self-destructive episodes an individual might experience, as well as their severity. The basic assumption of DBT is that people are doing the best they can but are lacking the skills necessary to function appropriately in any given environment.
How DBT Works:
There are basically four components of DBT:
- Individual therapy, where the client records issues that come up during the week on diary cards and discusses them with a therapist. During these sessions, the therapy focuses on developing or improving skills that will diminish self-destructive behaviors, sabotage to therapy, and improve overall quality of life.
- Group therapy, with once weekly sessions that last for up to two and a half hours, focusing on the use of four specific skills: mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance.
- Therapist Consultation Team, which includes therapists who are using Dialectical Behavior Therapy and provides weekly support for the therapist.
- Phone Coaching, designed to help incorporate skills into an individual’s daily life. The coaching sessions are generally brief.
Mindfulness is the foundation for the other skills taught in DBT, because it helps individuals accept the powerful emotions they may feel when exposed to difficult situations. Buddhist practice informs the mindfulness exercises used in DBT, though the version used does not contain religious concepts. DBT helps develop the capacity to be present, to pay attention without judgment, and helps individuals develop perspective on their emotional states.
Because the use of Dialectical Behavior Therapy in substance abuse is relatively new, it is not yet considered an evidence-based therapy. However, the increased use of DBT in the treatment of chemical dependency will likely yield statistical evidence to prove or discount its effectiveness.