There are a variety of treatment options that can include an array of different therapeutic methods that are available for an individual seeking treatment for an eating disorder. The principals of dialectical behavior therapy (DBT) are based on those of cognitive behavioral therapy (CBT). The CBT method works to help an individual learn how his or her feelings, thoughts, and behaviors influence each other. DBT is more keenly focused on the social and emotional aspects, as it helps individuals learn to cope with extreme, unstable and/ or harmful behaviors. Dialectical behavior therapy has evolved into an evidence based psychotherapy approach that is utilized as treatment for an assortment of mental health conditions. 

Eating Disorders

Eating disorders are serious mental illnesses that are characterized by persistent, damaging eating behaviors. They can have grave affects on one’s emotions, health, and capacity to adequately function in important areas of one’s life. There are a number of different manifestations of eating disorders. The various types are listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) under the Disorder Class: Feeding and Eating Disorders. The three most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder. If left untreated, eating disorders can result in severe short and long-term consequences. While eating disorders are life-long conditions, with treatment, ample support, and steadfast commitment, an individual can learn the tools and skills needed to go on to live a successful, meaningful, and healthy life. 

Dialectical Behavior Therapy

Psychologist Marsha Linehan developed dialectical behavior therapy in the late 1980s. It was initially developed as a means to help treat individuals with borderline personality disorder (BPD) and/ or with chronic suicidal ideations. As time has progressed it has become evident that DBT can be helpful in treating individuals with other mental health conditions and/ or mood disorders. Research has shown that DBT can be advantageous when integrated into one’s treatment plan for mental disorders such as depression, substance use disorder, post-traumatic stress disorder (PTSD), and eating disorders. 

DBT can benefit an individual diagnosed with an eating disorder by helping to foster self-management skills, lower stress, reduce anxiety, and learn to control destructive eating behaviors. The goals of DBT are to help a client learn to establish healthy coping mechanisms that can be applied to environments that would have otherwise provoked engaging in destructive eating behaviors and/ or patterns. It helps clients learn how to reduce emotional reactivity and improve their interactions with others. DBT promotes acceptance and teaches skills to enable an individual to live in the moment and cope with emotional triggers that may otherwise perpetuate eating disorder symptoms and behaviors. 

How Does It Work?

DBT includes a combination of individual therapy sessions, group therapy sessions as well as coaching support. Every individual is different and will require some form of customized treatment plan when it comes to eating disorders. Therefore, the individual therapy sessions are essential in creating a forum for the client to work on his or her own nuanced issues with one-on-one guidance from his or her clinician. Creating personalized behavioral plans and goals surrounding mindful eating are established in individual therapy sessions. These sessions are beneficial in empowering a client as they help to establish and nurture self-compassion, increase one’s sense of self-worth, and develop a positive self-image. 

Group therapy sessions enable a client to practice the skills learned in individual therapy sessions. They can offer a safe environment to connect with other individuals experiencing similar life challenges. Furthermore, they allow individuals in recovery to engage in healthy interpersonal connections, while simultaneously cultivating a support network. Individuals have an opportunity to share their experience as it relates to their personal recovery process as well as offer support and insights to others in the group. Group therapy sessions also teach individuals important self-management life skills while creating an opportunity for the individuals to implement these skills in a group setting (i.e. mindful eating in a group environment). 

While group therapy sessions and individual therapy sessions can provide enormous support, it is not uncommon for a client to experience moments of distress between sessions. During those moments between individual therapy sessions and group therapy sessions, DBT offers coaching guidance. Clients can request clarification for and discuss how to implement certain management skills and/ or self-soothing techniques. If a client is struggling and/ or is in crisis he or she can reach out to and speak with his or her clinician for support over the phone, at any time. The coaching component of DBT is extremely helpful for an individual, as he or she knows that support is available during times of need.