Dialectical Behavior Therapy (DBT) came to light in the late 1980s with its focus on acceptance and targeting behavioral change.
With this type of therapy, recipients receive counseling to help direct their thought patterns toward developing new behaviors. These desired behaviors are generally in a response to upsetting triggers, such as being confronted about something. For example, instead of reacting out of anger toward someone who has upset you, through DBT, you can learn how to communicate your feelings to others in a healthy and effective way. Similarly, when you are facing a trigger that makes you want to reach for a drink or use again, you can step back from the situation and address it in a calmer manner — perhaps replacing the negative behavior of using with a positive one, like prayer or exercise.
How Does It Work?
DBT can help when people are regularly aroused and upset by certain stimuli, often things they are emotionally invested in or attached to. These people often get upset to an inappropriate level, and they may take a while to calm back down. DBT can change this by teaching addicts to accept what is outside their control and fix what is. This process is accomplished slowly.
When relapse occurs, it is viewed as an opportunity to learn why it happened in order to prevent a repeat episode, rather than a chance for the addict to dwell on it or feel guilty.
DBT focuses on strengthening self-esteem and breaking down destructive thought patterns. For example, an addict may think, “If I relapse, there’s no hope for me.” This kind of self-defeating prophecy will only hinder one’s journey in recovery. In all actuality, relapse happens 40 to 60 percent of the time, according to the National Institute on Drug Abuse. Many of those who relapse go on to pursue treatment again and enter sustained recovery.
DBT also often involves group interactions with others in treatment. Verbal exchanges are made while role-playing to attempt to engage the addict in situations that may normally upset him and give him to opportunity to react in healthier ways.
DBT typically includes:
- Individual counseling
- Skills groups
- Conjunctive treatment approaches among multiple care providers
- Continual backup care, including phone calls and regular check-ins between sessions
Should I Try It?
Most substance abusers are good candidates for DBT, because they all need to learn how to cope with triggers and avoid relapse. DBT can assist in changing the behaviors that have led them down this path in the past.
People who are struggling with other issues on top of substance abuse can benefit a great deal from DBT. This includes those with co-occurring mental illness. According to the National Alliance on Mental Illness, approximately 53 percent of drug addicts and 37 percent of alcoholics have one or more serious mental health disorders. One Psychiatry study on the efficacy of DBT as a treatment for binge eating disorders was impressive, with 86 percent of patients ceasing all bingeing by the completion of 20 weeks of treatment.
Is It a Successful Method of Treatment?
Research shows that DBT is actually a highly effective form of Cognitive Behavioral Therapy. In one study, DBT produced a greater likelihood of substance abuse abstinence than standard treatment after one year of treatment, according to the University of Washington.
Medication is often a big part of detox and substance abuse treatment. Sometimes pharmaceuticals are needed to ease the discomfort of withdrawal, while other times they’re necessary to treat comorbid disorders or symptoms that develop during treatment, such as depression. In fact, an American Journal of Geriatric Psychiatry study notes when depressed patients were treated with only medication therapy, 47 percent of them were in remission after treatment, but among those treated with both medication and DBT, 71 percent were in remission.
During care, DBT alongside various other treatment methods. It is not an everyday method of therapy, such as support group meetings might be. Rather, this method of treatment may require weekly meetings with peers to practice the techniques and new behavioral strategies you’ve learned. In addition, you’ll meet with your therapist just as often to keep attuning yourself to the new behaviors and emotional responses you desire.
DBT is often used to treat people with borderline personality disorder, which can be one of the most difficult conditions to treat. The National Institute of Mental Health notes DBT’s ability to decrease the rate of attempted suicide by 50 percent among BPD patients.
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