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Dialectical Behaviour Therapy

What is DBT and Why it Saves Lives.

By Will Sutherland

We all struggle from time to time with our mental health and relationships. However, some people experience these struggles so severely and frequently, that it fundamentally affects their wellbeing and safety. Dialectical Behaviour Therapy (DBT) was developed to assist those experiencing extreme difficulty in relationships, decision-making and emotion regulation. Although DBT is best known for assisting those with borderline personality disorder, it has also been consistently effective for those with Generalized Anxiety Disorder, Clinical Depression and those engaging in self-harm and suicidality1. DBT is a broad system of therapeutic treatments that significantly reduce the rates of suicidality and hospital admissions2. One of the most important components of the treatments is the group skills training3. The Three Seas Group is now conducting a 12-week DBT Group Skills Training Program for adolescents and adults. The program will cover the four key components of DBT: mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness.

Firstly the program begins with mindfulness techniques. This involves a process called Wisemind4, where participants learn to integrate their emotional self, logical self and intuition. This allows them to act more efficiently and to be more present in their experiences. Participants also learn to engage more fully in their lives by being mindful of what they are doing and how effective their choices are at reaching desired outcomes.

Secondly, participants learn to tolerate distress. First participants learn to acknowledge that pain is a part of life and second, to chose tolerant behaviours instead of impulsive behaviours. These techniques are for daily life and crisis situations. One notable technique is TIP4, which works to address physiological symptoms. The technique suggests plunging your face into icy water (Temperature), engaging in Intense exercise or slowing down your breathing (Paced)(see below), to reduce autonomic arousal that leads to distress.

The third component is emotional regulation. Participants will learn how important emotions are to our actions and our relationships. Then they learn to identify their emotions and helpful techniques to manage more challenging emotions. Our emotions motivate us to act, however sometimes those emotions lead to unhelpful habitual reactions. The Opposite Action Technique4 teaches participants to identify an alternate behaviour to the one their emotion encourages. If a participant is angry and they feel like acting destructively, they can instead consider choosing a kind or constructive response.

The fourth component is interpersonal effectiveness. This involves strengthening existing relationships, ending toxic relationships and creating new healthy ones. Interpersonal Effectiveness teaches participants techniques to develop relationships where their needs are met. These involve improving interpersonal communication, negotiation and mindfulness during conflict. One of these strategies is the DEARMAN technique4 (see below).

The Three Seas Group DBT program is run in a classroom format, where practical and effective skills are taught through psycho-education. If you have any questions or would like to find out about our next in-take please call our Client Connect Team on 9809 1000.

TIP

Temperature – using cold or ice water.

Intense Exercise

Paced breathing – slowing the inhale and exhale.

See here for further information on TIP: https://dbt.tools/distress_tolerance/tip.php

DEARMAN

Describe the situation

Express yourself 

Assert yourself

Reinforce (reward) the other person

Remain Mindful of triggers and emotions

Appear confident and open

Negotiate 

See here for further information on DEARMAN:  https://dbt.tools/interpersonal_effectiveness/dear-man.php

  1.  McCauley E, Berk MS, Asarnow JR, et al. Efficacy of Dialectical Behavior Therapy for Adolescents at High Risk for Suicide: A Randomized Clinical Trial. JAMA Psychiatry. 2018;75(8):777–785. doi:10.1001/jamapsychiatry.2018.1109
  2. Behavioral Tech. (2021). What is dialectical behavior therapy (DBT)? Behavioral Tech – Training, Continuing Education in Dialectical Behavior Therapy (DBT). https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/
  3. Mehlum, L. (2021, 2021/02/01/). Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder. Current Opinion in Psychology, 37, 89-93. https://doi.org/https://doi.org/10.1016/j.copsyc.2020.08.017

Linehan, M. (n.d.). Home. Dialectical Behavior Therapy (DBT) Tools. https://dbt.tools/index.php

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