What is the “D” in DBT?

The “D” means “dialectical.” A dialectic is a synthesis or integration of two seemingly opposing or contradictory thoughts/emotions/opinions.  This type of psychotherapy promotes the balance of acceptance and change of our thoughts, feelings and behaviors in order to manage mental health struggles and change ineffective behaviors.  Check out DBT for dummies cheat sheet for more~!

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DBT Assumptions

DBT assumes that many of the problems exhibited by patients are caused by skills deficits. In particular, the failure to use effective behavior when it is needed is often a result of not knowing skillful behavior or when or how to use it.  The belief is that if no one has taught us how to effectively regulate our emotions or tolerate intense pain, why would we expect ourselves to be able to do so.  This is at the core of DBT.  Skills training groups provide us the opportunity to learn the skills/behaviors we may not have been taught in order to increase our resilience and decrease suffering. (https://www.psychiatrictimes.com/view/dialectical-behavior-therapy-skills-training-effective-intervention) 

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What is Taught in a DBT Skills Group

​​Problematic behaviors evolve as a way to cope with a situation or attempt to solve a problem. While these behaviors might provide temporary relief, they often are not effective in the long-term. DBT assumes that clients are doing the best they can, AND they need to learn new behaviors in all relevant contexts.​

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 The function of DBT Skills is to help enhance a client’s capabilities. There are four skills taught in DBT:​

• Mindfulness: the practice of being fully aware and present in this one moment​

• Distress Tolerance: how to tolerate pain in difficult situations, not change it​

• Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others​

• Emotion Regulation: how to change emotions that you want to change​

​Skills training is frequently taught in groups during weekly sessions, and the full skills curriculum runs for 24 weeks. Group leaders assign homework to help clients practice the skills in their everyday lives. Briefer schedules that teach only a subset of the skills have also been developed for particular populations and settings.