HOW DOES DBT WORK?
The principles of Dialectical Behavior Therapy
Dialectical Behavior Therapy is an evidence-based treatment that works to balance the tension between acceptance and change, two seemingly incompatible tendencies.
DBT is informed by the philosophical concept of “dialectics,” the integration of opposites or, as some philosophers have described it, the “union of opposites.” In the context of psychotherapy, DBT helps clients simultaneously accept their situation while working tochange it by moving past rigid patterns of thinking.
Marsha M. Linehan PhD, a world renowned psychologist and author, developed DBT
starting in the late 1970s, when she was treating chronically suicidal individuals.
Back then, Linehan realized that the traditional cognitive-behavioral interventions aimed
at helping these patients were too focused on changing emotions and behaviors.
Consequently, patients often shut down emotionally, abandoned treatment, or became
angry with their therapists because they felt invalidated. However, interventions that
focused solely on validation or self-acceptance also fell short, undermining the pressing
need for patients to change their behavior, and therefore their life experience. In
response, Linehan created the treatment plan now known as DBT, which emphasizes
finding the proper balance between change and validation in working with clients.
“The spirit of a dialectical point of view is never to accept a proposition as a final truth or indisputable fact,” according to a 2008 study co-authored by Linehan. “In the search for the validity or truth contained within each contradictory position, new meanings emerge.… The patient and therapist regularly ask, ‘What haven’t we considered?’ or ‘What is the synthesis between these two positions.’” Linehan writes that DBT treats the whole patient, not a discreet disease or disorder. The interrelated elements that make up that whole are constantly in flux.
Our therapists, all of whom are extensively trained in DBT, will assess whether clients need comprehensive DBT that is compliant with the Linehan model or an alternate treatment we offer called the Emotion Fitness Program (EFP), which draws from some of DBT concepts as well as other types of treatment.
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