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dbt help Archives - Suzanne Wallach

What Are The Limitations Of DBT?

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Dialectical behavior therapy (DBT) is an evidence-based, rigidly structured form of psychotherapy. It was developed by psychologist Marsha M. Linehan in the late 1980s as a means to better treat individuals diagnosed with borderline personality disorder (BPD), suffering from chronic suicidal ideation. DBT combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills. It is carried out in three therapeutic settings, including weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills training group therapy sessions, and access to twenty-four-hour support between sessions via phone coaching. Dialectical behavior therapy focuses on teaching skills in four primary areas, which are known as the four modules of DBT. Each module highlights distinct and specific skills that build upon each other and are individually and collectively integral to the success of DBT. Nevertheless, as is true with any mental health intervention, DBT has its fair share of limitations, some of which include:

  • May be ineffective in treating trauma: According to the U.S. Department of Veterans Affairs, due to the fact that DBT does not necessarily involve any form of trauma processing, it is not and should not be considered a stand-alone treatment for trauma.
  • The format and duration of DBT may be a deterrent: The different layers of treatment required for DBT including the amount of time allocated to each of the four modules, the three different therapeutic settings, etc. may be perceived by some as overwhelming and discouraging. As a result, some individuals that could benefit greatly from dialectical behavior therapy view it as overly complex to the point that they are unwilling to try the treatment.
  • DBT is religiously integrated: The foundation of DBT is rooted in mindfulness practice based on Zen Buddhist teachings, therefore some clients (e.g., conservative or orthodox Jews, Christians, Muslims, etc.) may object to certain facets of DBT that are derived from eastern religious philosophies.
  • Large-scale research is lacking: Critics argue that additional research is required to determine if DBT works for those with varied or complex mental health concerns, as most of the available research on the efficacy of DBT includes small sample sizes and focuses on a specific sector of the mental health population.
  • The availability of comprehensive training for providers is insufficient: DBT relies on a detailed manual and demands an intensive amount of training to deliver the services as designed. In many of the research studies where DBT was found to be effective, the providers implementing the DBT treatment were doctoral-level students or higher, which the minimizes the availability of providers.

Treatment In Calabasas

Calabasas is a city in California. It is a well-known suburb of Los Angeles, located west of the San Fernando Valley and north of the Santa Monica Mountains. Over the past decade, the city of Calabasas has grown in its reputation for luxury as well as for privacy which makes it a hidden gem for residential living for society’s elite, and one of the most desirable destinations in Los Angeles County. It is also home to a plethora of highly qualified mental health clinicians providing an array of therapeutic services and treatment options.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

Can DBT Help With Anxiety?

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Anxiety is the body’s natural response to stress. Anxiety will manifest differently in different people. The feelings of anxiety can range from mild to severe. While fleeting anxiety is unavoidable, it is not healthy for an individual to experience persistent and debilitating symptoms of anxiety. An individual may be struggling with an anxiety disorder when pervasive anxiety interferes with his or her ability to function in daily life. The National Alliance on Mental Illness (NAMI) asserts: “Anxiety disorders are a group of related conditions, each having unique symptoms. However, all anxiety disorders have one thing in common: persistent, excessive fear or worry in situations that are not threatening.” There are currently five distinct types of anxiety disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). They include the following: generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and social anxiety disorder (social phobia). According to the American Psychiatric Association, close to thirty percent of adults in America struggle with an anxiety disorder at some point in their lives. 

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy treatment that was originally developed by Marsha M. Linehan, in the late 1980s to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Since its inception, dialectical behavior therapy has been and remains the gold standard method of treatment for individuals diagnosed with BPD, and its efficacy has also expanded to other ailments. DBT is based on the cognitive behavioral therapy (CBT) approach that relies on talk therapy and emphasizes the psychosocial aspects of treatment. It utilizes a multifaceted approach that consists of weekly individual psychotherapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching between sessions. DBT strives to help individuals learn to identify triggers outside of themselves and pair those triggers with healthy responses and coping mechanisms. This is accomplished through focusing on and cultivating therapeutic skills in four main areas, known as the four modules, which are: 

  • Core mindfulness: focuses on improving an individual’s ability to accept and be present in the current moment
  1. Distress tolerance: focuses on increasing an individual’s ability to tolerate pain that may arise from difficult situations, as opposed to trying to change and/ or escape it
  2. Interpersonal effectiveness: focuses on teaching techniques that enable a person to communicate with others in a way that is assertive, maintains self-respect, and simultaneously strengthens relationships
  3. Emotion regulation: focuses on decreasing emotional impulsivity by shifting intense emotion without reacting instinctively to them

An individual that suffers from debilitating anxiety will benefit most from a customized treatment plan. DBT offers both the ability to provide personalized therapeutic support through the individual therapy sessions, as well as peer support in DBT skills training group therapy sessions. Through DBT an individual can learn an array of effective coping mechanisms and anxiety management strategies that can help to prevent, reduce, and even become more resilient towards anxiety.

The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.

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