Therapy is a great place to make new goals and heal from the past. Therapists often gently challenge their clients to make positive changes, and this partnership may lead to a new level of insight that leads to true healing.

Sometimes people need healing before they can begin to make positive changes. In some cases, a person may have gone to several treatment programs, tried many therapists, and may still struggle to succeed. This can lead to a sense of hopelessness and avoidance. Individuals who have tried other methods but still feel overwhelmed by emotions and unhealthy behaviors may find success with Dialectical Behavior Therapy (DBT)

Female counselor with patient

The DBT Model

DBT was developed in the 1980s by psychologist Marsha Linehan, based on her work with patients who had borderline personality disorder. Linehan and her team of researchers found that some clients just did not heal from traditional approaches to therapy. Through careful research and application, she modified a well-known and proven treatment, Cognitive Behavioral Therapy, in order to reach them and help them to heal.1

Identifying and Changing Unhealthy Behaviors

Dialectical Behavior Therapy involves learning new ways to build a life worth living. DBT functions in stages. Therapists first work closely with clients to help them build self-soothing skills to make emotions more manageable before working on their behavior changes and life goals. DBT is highly supportive and works with the client in a non-judgmental manner that understands how hard change can be, yet still challenges the client to reach his or her higher goals.

In DBT sessions, individuals partner with their therapists to identify the thoughts and assumptions that lead to poor behaviors in a non-judgmental environment. That’s similar to the steps taken in Cognitive Behavioral Therapy sessions. DBT practitioners help clients accept their own thoughts and feelings so that they may make changes from a calm and confident frame of mind.2

Meditation techniques play a big role in the efficacy of Dialectical Behavior Therapy, as participants are encouraged to notice mood changes or disruptive signals. Meditation techniques allow clients name and understand the changes they feel. Rather than being overwhelmed, they learn to accept the changes in a calm and understanding state. This can be a remarkable change for people who have been ruled by reactions.3

DBT also helps patients to build social skills, so they can engage with other people in relationships based on understanding, rather than hostility. Group work is a part of the DBT model. Group work helps clients learn and practice emotional regulation and skills in understanding the emotions of others.

“I also gave DBT a try,” writes Diana, in her HeroesInRecovery story. “ I still practice DBT today, and credit it for making my life less stressful…DBT taught me how to experience and embrace life using all my senses. I remember riding in the car with a friend one afternoon, watching sunlight stream through the window. I felt it on my skin as I had a thousand times before. But this time was different. I was fully present in the moment. I felt a new kind of sunlight radiate through me, warming my heart. I still have some obstacles to overcome. My life is not perfect and will never be, and that’s okay because I am happier than I have ever been.”

DBT Specifics

Dialectical Behavior Therapy can be time-consuming, as patients who participate might be required to:

  • Attend private sessions several times per week
  • Participate in group skill-building sessions at least once per week
  • Complete intensive homework assignments
  • Keep journal entries each day

Dialectical Behavior Therapy can be completed on an outpatient basis, but it works very well during residential treatment, especially if the client desires rapid, healthy improvement. Group work and intensive personal counseling help each client build new approaches to emotion management, friendships, and work.

Developing Healthy Relationships

DBT is designed to help individuals build healthier relationships, communicate more effectively, and overcome conflicts with less stress and strain. Because DBT is such an intensive and rewarding type of treatment, it is vital for potential clients to choose a practitioner who is fully trained in DBT and works within a DBT treatment team

The Dialectical Behavior Therapy National Certification and Accreditation Association states that there is no specific credential a provider must have in order to provide this therapy, but voluntary accreditation does help providers demonstrate a profound commitment to this kind of care. Families might be wise to ensure that their providers have this certification.4

Healing with DBT

While DBT was originally created to help people with personality disorders, the Substance Abuse and Mental Health Services Administration suggests that it’s an appropriate therapy to provide to people who have a variety of mental health concerns, including:

  • Suicidal thoughts
  • Psychological adjustment difficulties
  • Drug addictions
  • Eating disorders

These are very different concerns, and not surprisingly, the length of time these people might need in order to heal can also vary dramatically. Some might need only a few weeks of sessions. Others might need months or even years.5

Studies demonstrate that people who participate in DBT tend to experience a profound level of healing. For example, in a study in the American Journal on Addictions, researchers found that people who had borderline personality disorders and addictions healed at a superior rate when given DBT, when compared to people who got treatment without DBT.6 Those given DBT were able to achieve greater reductions in drug use, and they were able to make greater gains in social skills when compared to their peers. This just shows how much value a DBT program might provide to a family in need.

Combining DBT with Other Therapies

While Dialectical Behavior Therapy might be just right for some people, there are others who may benefit from a different form of treatment. For example, some people with addictions explode and shut down in standard treatment programs because they haven’t made the internal decision to get sober. People like this might benefit from Motivational Enhancement Therapy rather than DBT, so they can develop the urge to really get sober and participate in therapy.

Some people also transition out of DBT into more standard Cognitive Behavioral Therapy programs. They might need the affirmations of DBT in the early part of recovery, but as they heal, they might be more prepared to participate in therapy sessions that move a little faster and involve a little more confrontation. Typical CBT sessions might work best for people like this.

Family therapy might also play a role in recovery for people in treatment.Families are often devastated by the impact of addiction and mental illness, and each family member might benefit from learning new coping skills. Family therapy sessions can uncover that trauma, and they might allow the family to develop new habits that are just a little more helpful.

Medication management might also aid the healing process for some people with addictions or mental illnesses. The aid of proven medications can sometimes help improve mental health, and medication therapymay sometimes allow people to feel just a little more control over their emotions and reactions.

At Black Bear Lodge, we utilize a number of therapies to help our patients, and our practitioners are adept at utilizing Dialectical Behavior Therapy to help patients in need. In our residential treatment facility, we provide counseling sessions and group work, and our around-the-clock staff coverage ensures that patients always have someone to talk to, should the need arise. If you’d like to know more about our model, please call and our admissions coordinators will be happy to help.

1 An Overview of Dialectical Behavior Therapy. Psych Central. N.p., 17 July 2016. Web. Accessed 18 Sept 2017.

2 What is Dialectical Behavior Therapy? Behavior Tech. Web. Accessed 18 Sept 2017.

3 Choi-Kain, Lois W., Ellen F. Finch, Sara R. Masland, James A. Jenkins, and Brandon T. Unruh. 2017. What Works in the Treatment of Borderline Personality Disorder. Current Behavioral Neuroscience Reports 4 (1): 21-30.Web. Accessed 18 Sept 2017.

4 Dialectical Behavior Therapy National Certification and Accreditation Association. Frequently Asked Questions. Web. Accessed 18 Sept 2017.

5 Substance Abuse and Mental Health Services Administration. National Registry of Evidence-Based Programs and Practices. Web. Accessed 18 Sept 2017.

6 Linehan, M, Schmidt, H., Dimeff, L., Craft, J, Kanter, J, Comtois, K. Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence. American Journal of  Addiction. 1999. 8(4):279-92. Web. Accessed 18 Sept 2017.