II. Definitions
- Dialectical Behavior Therapy (DBT)
- Subtype of Cognitive Behavioral Therapy (CBT) which focuses on emotion acceptance and behavior change
- Teaches emotional regulation, distress tolerance, interpersonal relationship building and mindful decision making
III. Indications
-
Borderline Personality Disorder
- Original indication for Dialectical Behavior Therapy
- Broad range of mental health conditions with emotional dysregulation
- Intense emotions
- Self-destructive behavior
- Difficult relationships
- Other mental health conditions
IV. Background
- Clinicians should consider teaching focused DBT techniques at clinic visits (e.g. a 5 minute MindfulnessExercise)
V. Management Mindfulness
- Goals
- Focus on the present moment (instead of future fears or past worries)
- Accept difficult emotions
- Dispose of unhelpful thoughts
- Techniques
- See Mindfulness (e.g. box breathing)
- Wise mind balances the logical/rational mind with the emotional mind
VI. Management: Distress Tolerance
- Goals
- Intense emotion management (e.g. anger, sadness, anxiety)
- Techniques
- Distraction techniques
- Live in the moment (e.g. Mindfulness techniques)
- Self soothing techniques to experience relaxation and comfort (e.g. five senses to explore places of relaxation)
- Radical acceptance of reality and setbacks without perseverating over what may have been instead
- Embrace the privelege to decide what gives life meaning
VII. Management: Emotional Regulation
- Goals
- Develop skills to cope with overwhelming situations
- Avoid self harm
- Techniques
- Perform the opposite actions related to negative emotions
- Anger: Perform a kind task
- Unmotivated: Exercise or perform an activity
- Positive self-talk
- Although I sometimes fail, I also sometimes succeed
- Perform the opposite actions related to negative emotions
VIII. Management: Interpersonal Effectiveness
- Goals
- Maintain healthy relationships with improved communication and boundary setting
- Techniques (Mnemonic: DEAR MAN)
- Describe
- Review the facts of a negative event with the person involved (e.g. failed commitment)
- Express
- Share the emotion of how this negative event made you feel (e.g. ignored, sad, lonely)
- Assert
- Ask for your want (and decline what you don't want)
- Reinforce
- Explain the positive effects on the relationship of met needs
- Mindful
- Summarize goals and needs
- Appear
- Be confident when expressing what you need
- Negotiate
- Find solutions that meet your own needs, as well as the needs of everyone involved
- Describe
IX. Resources
- Dialectical Behavior Therapy
- Simple DBT Skills Diary Card (free)
- DBT Coach