Dialectic Behavioural Therapy
Dialectic Behavioural Therapy (DBT) was developed from Cognitive Behavioural Therapy (CBT).
The dialectical approach to understanding and treatment of human problems is therefore non-dogmatic, open and has a systemic and transactional orientation.
Model: highly structured treatment (a manual). Dialectical Behaviour Therapy is based on a bio-social theory of borderline personality disorder.
The approach: influenced by Behaviourist and Cognitive theory.
Focus: The dialectical viewpoint underlies the entire structure of therapy, the key dialectic being “acceptance” on the one hand and “change” on the other; to encourage people to gain insight into their behaviour, and provide motivation to change it.
Clients learn problem-solving techniques for dealing with stressful events, including ways of improving social skills and of controlling anger and other emotions; strong emphasis placed on problem solving, and possesses elements of behavioural modification.
Generalisation outside therapy is not assumed but encouraged directly.
Advice and support available between sessions and the client is encouraged and helped to take responsibility for dealing with life's challenges.
Technique: DBT combines standard cognitive-behavioural techniques for emotion regulation and reality-testing with concepts of mindful awareness, distress tolerance, and acceptance largely derived from Buddhist meditative practice.
Dialectic behaviour therapy applies identifying and labelling emotions; identifying obstacles to changing emotions; reducing vulnerability to emotion mind; increasing positive emotional events; increasing mindfulness to current emotions; taking opposite action; applying distress tolerance techniques.
There are four modules focusing in turn on four groups of skills:
Core mindfulness skills
Interpersonal effectiveness skills
Emotion modulation skills
Distress tolerance skills
The techniques are underpinned by a dialectical philosophy that recommends a balanced, flexible and systemic approach to the work of therapy.
Techniques for achieving change are balanced by techniques of acceptance; problem solving is surrounded by validation; confrontation is balanced by understanding.
“Dialectical thinking” refers to a form of argument in which an assertion is first made about a particular issue (the “thesis”), the opposing position is then formulated (the “antithesis”) and finally a “synthesis” is sought between the two extremes, embodying the valuable features of each position and resolving any contradictions between the two. It is an alternative to intense, polarized emotions; clients are encouraged to recognize multiple viewpoints and bring them “into dialogue”.
Mindfulness is a method for becoming aware of one's actual, realistic experience in the moment, the capacity to be non-judgemental, pay attention emotions and all senses and being aware of them, and separating the present moment from fears about the future or rumination about events about the past.
Interpersonal effectiveness includes effective strategies for asking for what one needs, saying no, and coping with interpersonal conflict; the application of these skills to specific situations; focuses on situations where the objective is to change something (e.g., requesting that someone do something) or to resist changes someone else is trying to make (e.g., saying no).
Distress tolerance skills constitute a natural development from mindfulness skills; the ability to accept, in a non-evaluative and non-judgemental fashion, both oneself and the current situation; acceptance of reality is not approval of reality. Distress tolerance behaviours are concerned with tolerating and surviving crises and with accepting life as it is in the moment.
Four sets of crisis survival strategies are as follow:
* improving the moment, and
* thinking of pros and cons.
Acceptance skills include radical acceptance, turning the mind toward acceptance, and willingness versus wilfulness.
“Invalidating Environment” refers essentially to a situation in which the personal experiences and responses of the growing child are disqualified or “invalidated” by the significant others in her life; is characterised by a tendency to place a high value on self-control and self-reliance.
It is recommended for people with personality disorder, mood disorders, self-harm episodes, and eating disorders. The method is successful.
If you require help and advice Counselling and Psychotherapy may be provided via Skype and FaceTime in the comfort of your home, office or any place of your choice.