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What Are The Four Areas of DBT?

Dialectical behavior therapy (DBT) is type of psychotherapy (talk therapy) based off of the cognitive behavioral therapy (CBT) approach. DBT further emphasizes the psychosocial aspects of treatment. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to more effectively treat individuals diagnosed with borderline personality disorder (BPD). Since it was developed, research has found it to be not only highly effective in treating individual with BPD, but also a successful treatment method for individuals experiencing other mental health illnesses (e.g. eating disorders, post-traumatic stress disorder, generalized anxiety disorder, depression, substance use disorder, etc.). The purpose of DBT is to provide clients with new skills to manage painful emotions and reduce conflicts in relationships. The therapeutic approach consists of three different therapy settings, including weekly individual psychotherapy sessions, weekly group DBT skills therapy sessions, and phone consultation to provide additional support between the weekly individual and groups sessions (when needed). DBT is made up of four distinct modules, with roughly six weeks specifically allocated to focus on each area. The entire dialectical behavior therapy process usually takes around six months to complete. 

  1. Core Mindfulness: Focusing Skills

This module focuses on teaching an individual how to focus their mind and attention. Through learning and practicing the DBT mindfulness skills, individuals are able to focus on the present and tend to what is exactly happening in any given moment. Skills during this module help individuals learn and practice slowing down to focus on mindfully acknowledging and experiencing emotions without reacting impulsively and/ or destructively. It teaches individuals to avoid taking things personally, glean a better understanding of their emotions, become active listen listeners and learn to sit with emotions instead of pushing them away. 

  1. Distress Tolerance: Crisis Survival Skills

The purpose of the distress tolerance module is to help individuals learn tools and techniques to get through challenging times when emotions are elevated. Rather than becoming overwhelmed by or hiding from difficult emotions, it teaches individuals four sets of crisis survival skill to assist in finding meaning in, accepting and tolerating distress, some of which include self-soothing, distracting, and thinking of pros and cons. Learning these skills help an individual learn to acknowledge, process, and integrate emotions and situations in a non-evaluative and nonjudgmental fashion. 

  1. Emotion Regulation: De-escalation Skills

This module teaches important skills surrounding emotional regulation, as well as providing education regarding the function of emotions. It helps individuals learn to both experience strong emotions while simultaneously reducing the intensity of the emotions without acting on them. In this module individuals will learn a variety of helpful skills including, but not limited to: properly identifying and labeling emotions, increasing positive emotional events, increasing mindfulness to current emotions, identifying obstacles to changing emotions, and applying distress tolerance techniques. 

  1. Interpersonal Effectiveness: Social Skills

This module teaches skills to help individuals learn how to effectively and authentically communicate with others. These skills involve helping individuals identify and understand their own needs in a relationship. Further, these skills help an individual learn various tools to help in facilitating and engaging in healthy relationships with others that enable one’s needs to be met. This includes advocating for one’s needs and communicating in way that is assertive, maintains self-respect, and strengthens relationships. 

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