Introduction to DBT

Welcome to DBT MENA!

Training to become a DBT Therapist is life changing for both the therapist and the client. Becoming a DBT Practitioner is not easy, it requires a willingness to learn, take on challenges, face client’s problems and constantly learn and develop skills to help save lives. 

Dialectical Behavior Therapy (DBT) is a type of psychotherapy focusing on emotional regulation, acceptance, and validation. The basis of DBT relies on standard behavioral and cognitive therapy techniques to create a “life worth living” for the client, which is the ultimate goal of DBT.

The word ‘Dialectical’ is related to the synthesis or integration of opposites. In DBT, the most fundamental dialectic is that of acceptance and change. Validating the client yet providing the tools for them to improve their lives is particularly a unique feature of DBT. The word “Behavioral” in DBT refers to the behavioral approach implemented within the therapy. Thus, the situations and target behaviors which are relevant to the clients’ goals are assessed to orchestrate solutions for their struggles.

 A short, insightful video describing the dialectic nature of DBT, with clients sharing their personal experiences on how this evidence-based therapy has positively impacted their lives. 
Reference: 2016, “Dialectical Behavior Therapy (DBT).” YouTube, YouTube https://www.youtube.com/watch?v=KJA53l91LSk&t=3s  

History of DBT

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DBT was originally developed in the 1980s by Marsha Linehan as a therapy for women with chronic suicidality. It is driven by clinical experiences based on the application of behavioral principles and social learning theory. The National Institute of Mental Health provided research funding. It had become clear that the treatment was effective for those with behaviors most commonly associated with Borderline Personality Disorder. DBT then gained fame as an effective treatment for Borderline Personality Disorder.

Linehan previously faced struggles in implementing purely change-oriented strategies in her therapy. This led her to attempt to balance between leading the patient to apply change while leading the patient to accept everything in their lives. Acceptance-oriented strategies focused on Mindfulness skills and Distress Tolerance Skills, and change-oriented strategies focused on Interpersonal Effectiveness Skills and Emotion Regulation Skills. In 1991, the first randomized controlled study (RCT) was conducted, and positive benefits were observed for highly suicidal clients. 

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Benefits of DBT

DBT’s effectiveness is bolstered by a wealth of evidence and support from numerous studies. Its comprehensive nature sets it apart from other treatments, making it a pivotal factor in its evidence-based success and the array of benefits it offers.

  • DBT is an evidence-based treatment and has been supported by a plethora of randomized controlled studies (RCTs).  
  • DBT is principle-based, which allows for creativity and allows it to be a therapy focused on change. 
  • One of the benefits of a principle-based treatment is that it can be versatile enough to accommodate the specific situations, cultures, and contexts of the persons it serves.
  • In DBT, dialectical strategies help both the therapist and the client get unstuck from extreme positions.
  • DBT stands out with its comprehensive approach, unlike many other psychotherapies. It integrates Individual psychotherapy, DBT Skills training, in-the-moment phone coaching, and DBT Consultation Teams, with each component serving a distinct and vital function in the therapeutic process.
  • The skills training component equips clients with new skills to enhance their behavioral repertoire and apply what they learn in therapy to their daily lives, fostering generalization to their environments. 
  • DBT’s phone coaching aids clients in using DBT skills to effectively cope with difficult situations in their everyday lives. It aids in commitment to change. 
  • DBT Consultation team is essential to help therapists monitor their fidelity to the treatment, develop their skills and sustain their motivation. It acts as therapy for the therapist. 

Decrease in Suicide Attempts

50% fewer suicide attempts in patients in DBT versus other therapy modes.

Linehan et al, 2006; Two-year randomized controlled trial and follow-up of Dialectical Behavior Therapy vs therapy by experts for suicidal behaviors and borderline personality disorder

Reducing the number of hospitalizations

A 6-month DBT program has been shown to be effective in reducing hospital stays by 70%

Prendergast & McCausland, 2007; Dialectic Behavior Therapy: A 12-Month Collaborative Program in a Local Community Setting

Reducing self-harm

At 12 months after DBT therapy, 51.2% of adolescents were not self-harming.

McCauley et al, 2018; Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial

Effectiveness of DBT Adaptations

  • DBT Prolonged Exposure: Rates of diagnostic remission from PTSD ranged from 71-80% among DBT PE treatment completers and 58-60% among all clients assigned to receive the DBT PE protocol (Harned et al., 2012) 
  • DBT Substance Use: Harned and colleagues (2008) found that 87.5% of those with substance dependence who received DBT achieved full remission for at least 4 weeks, as compared to only 33.3% of those who received comparison treatment by experts. (Harned et al., 2008) 
  • DBT Eating Disorders: Evidence supporting the effectiveness of DBT found that 56% of people with binge-eating disorder completely stop binge eating after DBT. (Safer & Robinson, 2010)  and, 27% of people with bulimia nervosa completely stop binge eating and purging after DBT. (Chen et al., 2016)