With so many addiction therapy options available to those looking for help, it’s vital to understand what each method entails. Knowing more about each method will help you make the best decisions about your treatment and care during your journey. Lacking this knowledge could mean participating in therapies that lack any significant benefit. One therapy option often offered through our Los Angeles addiction treatment programs is dialectical behavior therapy.
What is Dialectical Behavior Therapy, and How Does it Work?
Dialectical behavior therapy is a type of cognitive-behavioral therapy that emphasizes how you interact in your relationships. Unlike mainstream therapy that tries to identify why you’re doing something, cognitive-behavioral therapies like DBT aim to look at your thoughts and actions in the present moment.
Dialectical means “integration of opposites.” The strategies taught in DBT help the therapist and the patient to let go of their extreme positions on situations. DBT keeps therapy in balance so that patients can achieve their goals.
The main point that dialectical behavior therapy teaches is how to live in the moment. Patients in DBT learn how to cope with grief and stress, regulate their emotions and improve their relationships. People dealing with such mental health conditions as borderline personality disorder tend to have sudden bursts of emotion that are stronger than someone in a normal state of mind. DBT aims to help people control these surges by using several techniques.
Principles of Dialectical Behavior Therapy
The theory of “dialectics” follows three main principles:
- Everything is connected
- Change is unavoidable
- Opposites can be integrated to form a closer approximation of the truth
In DBT, patients are encouraged to look at their therapists as allies instead of enemies. During treatment, therapists practice “validation,” or looking at the patients’ views as acceptable and valid, even if that isn’t necessarily the case. This is why they also help patients identify negative behaviors to show them an alternative way of living life.
The Focuses of Dialectical Behavior Therapy
Dialectical behavior therapy helps clients work through painful emotions while also teaching them how to maintain positive, healthy relationships. It includes four major areas of focus to help clients to learn the skills they need to live a sober life after treatment. These areas are as follows:
This area helps to teach the individual how to be more present and accept the current moment. When you’re mindful, you can better control your emotions and in turn have better relationships.
DBT teaches six mindfulness skills that are divided into “what” and “how.” The “what” skills teach you what you’re focusing on at the moment, like your emotions and thoughts or your awareness. These skills are what a person does when practicing mindfulness.
The “what” skills are:
- Describe – Put what you’ve observed into words
- Observe – Pay attention to the present moment
- Participate – Get fully involved in your present activity
On the other hand, the “how” skills teach you how to be more mindful. The “how” skills are:
- Effectively – Doing what works
- Nonjudgmentally – Describing the facts of what’s happening
- One-mindfully – Focusing on one thing at a time
Dealing with the loss of a loved one, a sudden career change, or divorce can be difficult. Focusing on distress tolerance helps the client increase their threshold for negative emotions and working through them instead of trying to escape. Instead of turning to destructive behavior, you can practice distress tolerance to accept and deal with stress when it’s happening. Distress tolerance teaches you how to deal with stress in four ways: self-soothing, distracting, improving the moment, and thinking of the pros and cons of not tolerating distress.
Some acceptance skills taught with distress tolerance are willingness versus willfulness, radical acceptance, and turning the mind toward acceptance. Distress tolerance will help the client have a better long-term outlook on life.
This area teaches a client how to handle any intense emotions they might feel. They can learn to accept, manage, and change these emotions for the better to work towards a more positive outcome. In emotional regulation, you’ll learn how to pinpoint and properly label your emotions, avoid giving in to emotional urges, be mindful of your emotions, and increase emotions that have positive effects. By learning how to control your feelings, you can figure out how to positively react to intense situations.
The area of interpersonal effectiveness focuses on teaching the client how to be a more effective communicator. This means learning communication skills that allow an individual to be assertive, respectful, and an overall healthier individual to have a relationship with.
Interpersonal effectiveness will also teach you how to listen more effectively and deal with difficult people. By being more effective in your interpersonal relationships, you can communicate your needs to others and navigate conflict in a healthy way.
Dialectical Behavior Therapy Components
Dialectical Behavior Therapy in Los Angeles is broken into the following components:
- Skills training – This training occurs during group sessions and will help the client strengthen the skills they’re learning in previous sessions. This means learning to live in the moment, work through painful events and emotions, and creating healthy boundaries in relationships.
- Individual therapy – One-on-one sessions help a client become more motivated both during and after treatment. Here, they learn how to apply the skills they’re learning to everyday scenarios. Self-harming and suicidal behaviors are addressed first, followed by post-traumatic stress responses and ones that may interfere with therapy. The counselor will work on the patient’s self-respect, self-image and social skills in individual therapy.
- Independence – As the client learns independence, they learn to be their own advocate and case manager. They learn how to talk about their emotions in a way that lets them receive the support and help they need from others. They also learn how to properly problem-solve on their own.
- Support system – This component helps the client build the support system they need both during and after treatment. This can include therapists, family members, friends, and peers from treatment.
- Collaborative: Counselors and patients are constantly working together in DBT. People in DBT are encouraged to work out their relationships with their friends and loved ones.
- Cognitive-based: As a form of cognitive-behavioral therapy, DBT helps pinpoint emotions, behaviors, and thoughts that are negatively affecting our relationships.
- Phone coaching: This is a helpful option for clients who need extra support or feel overwhelmed. Your DBT counselor will help you apply the skills you’ve learned to real-world situations.
DBT Homework and Exercises
Homework and exercises in DBT can include role-playing and written assignments. Each DBT module is usually assigned a different kind of exercise or homework assignment that pertains to said module.
A common exercise for practicing interpersonal effectiveness is learning the acronym GIVE, which helps the patient communicate and maintain relationships:
- Gentle – Don’t threaten, judge or attack. Use appropriate language when speaking.
- Interested – Act interested in what’s being said. Don’t interrupt the person to speak.
- Validate – Acknowledge the person’s situation as well as their thoughts and feelings.
- Easy manner – Stay lighthearted and smile throughout your conversation.
For emotional regulation, you might learn the acronym PLEASE, which helps people have healthier bodies and overall healthier emotions:
- Physical illness (treat) – If you’re sick, get treatment.
- Eating (balanced) – Make sure you are satisfied after you eat.
- Avoid mood-altering drugs – These drugs can make your moods unpredictable.
- Sleep (balanced) – Sleep an average of eight hours a night.
- Exercise – Exercise will release endorphins and improve your body image.
A popular distress tolerance homework assignment is doing the opposite of what you’re feeling and putting your body in charge. Get up and walk around if you feel like sitting, and go outside if you feel like staying inside.
The Difference Between Dialectical Behavioral Therapy (DBT) and Cognitive Behavioral Therapy (CBT)
While DBT is a branch of cognitive-behavioral therapy and they both have a few similar basic principles, the two are slightly different and focus on different things. DBT concentrates on a person’s interactions in different environments and relationships, and it involves individual, group and phone coaching sessions. On the other hand, CBT uses structured, one-on-one sessions that center on a person’s overall thoughts, feelings, and behaviors in the moment. Counselors who practice DBT feel that some people react to relationships more intensely than the average person does.
Who Should Try Dialectical Behavior Therapy?
People who have difficulty regulating their emotions and show self-destructive behaviors are prime candidates for DBT. DBT is especially helpful in treating people with borderline personality disorder, which is what it was originally designed for.
DBT also helps people with the following conditions:
- Eating disorders
- Post-traumatic stress disorder
- Anxiety disorder
- Substance use disorders
- Major depressive disorder
At LA Detox, we can speak with you about all of our different therapy options, including DBT, and help you figure out which one is right for you.
Begin with Dialectical Behavior Therapy Today at LA Detox
Do you believe DBT could help you in your journey towards sobriety? Learn how Dialectical Behavior Therapy and other addiction therapy programs in Los Angeles can help you during treatment today. Contact us, and we will help you recover.