Dialectic Behavioral Therapy
Dialectical behavior therapy (DBT) is a therapy designed to help people suffering from mood disorders as well as those who need to change patterns of behavior that are not helpful, such as self-harm, suicidal ideation, substance abuse, and addictions.
This approach works towards helping people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviors to help avoid undesired reactions. DBT assumes that people are doing their best but lack the skills needed to succeed, or are influenced by positive reinforcement or negative reinforcement that interferes with their ability to function appropriately.
DBT is a modified form of cognitive behavioral therapy (CBT), that was developed in the late 1980s by Marsha M. Linehan, a psychology researcher at the University of Washington, to treat people with Borderline Personality Disorder (BPD) and chronically suicidal individuals. Research on its effectiveness in treating other conditions has been fruitful; DBT is now used in a variety of psychological treatments including treatment for traumatic brain injuries (TBI), eating disorders, and mood disorders. Research indicates that DBT might have some effect on patients who present varied symptoms and behaviors associated with spectrum mood disorders, including self-injury. Recent work also suggests its effectiveness with sexual abuse survivors and chemical dependency.
DBT combines standard cognitive behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice. DBT is the first therapy that has been experimentally demonstrated to be generally effective in treating BPD. The first randomized clinical trial of DBT showed reduced rates of suicidal gestures, psychiatric hospitalizations, and treatment drop-outs when compared to treatment as usual. A meta-analysis found that DBT reached moderate effects in individuals with borderline personality disorder.
Nic Showalter, M.A., CAC-III, is an experienced and skilled practitioner of Dialectic Behavioral Therapy (DBT), while he does not provide a full DBT program through his practice, he incorporates the concepts and skills in his individual treatment of mood disorders, addictions, substance abuse, anxiety, and behavioral modification. He also utilizes DBT skills in his training and groups, when conducted.