The Benefits of Dialectical Behavior Therapy

If you have substance or mental health problems, a variety of methods may be used to help you recover. Most effective plans include some kind of psychotherapy. This therapy may come in a wide variety of forms. One option known to help many affected people is dialectical behavior therapy, or DBT. DBT differs from another common choice for therapy, cognitive behavioral therapy or CBT. It provides its own unique benefits, and may play a crucial role in your recovery.

At Emerald Isle Health & Recovery, we include DBT in our comprehensive slate of recovery services. Every day, we use this therapy as part of  our customized treatment plans for both substance and mental health issues. With our expert help, it is possible to gain relief from even severe mental health or addiction symptoms.

What Is DBT

DBT is a form of cognitive-behavioral mental health treatment. All treatments of this type seek to make positive changes in how you think and feel. This is the cognitive half of the equation. They also seek to make positive changes in how you act in everyday life. This is the behavioral half of the equation.

DBT is unique in that it is dialectical. This means that it is based on the interaction of potentially opposing forces or points of view. In the case of DBT, these two forces are acceptance and change. To make progress in the therapy, you must accept the nature of your current situation. In addition, you must be willing to change in ways that benefit your mental health. In this way, two opposite concepts are joined together to support your recovery.

A Brief History of DBT

Dialectical behavior therapy was founded by a psychologist named Marsha Linehan. Dr. Linehan was initially looking for ways to deal with the complex problems affecting suicidal women. She began by focusing on the behavioral change half of the cognitive-behavioral equation. With time and further research, she balanced out this emphasis on change with a focus on self-acceptance. Eventually, Dr. Linehan developed the full DBT model. She first applied this model to the treatment of borderline personality disorder.

Current Usage of DBT

Since then, the use of DBT has been expanded to the treatment of other serious mental health problems. The list of those problems includes:

  • PTSD, or posttraumatic stress disorder
  • Major depression
  • Binge eating and other eating disorders
  • Substance abuse and addiction, also known as stimulant use disorder

Importantly, DBT can also be used to treat dual diagnosis. This is the name for a substance use disorder combined with another mental health issue.

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DBT Models and Approaches

The Four DBT Components

The DBT therapy model is more complex and in-depth than some other therapy options. It has four main aspects or components, each of which plays an important role. The first of these components is skills training in a group setting. This training is designed to help you begin to take control over your day-to-day behavior. Over a period of several months, you receive a variety of weekly skills assignments. Each assignment focuses on a specific ability that will help support you when therapy ends.

The second DBT therapy component is one-on-one therapy. In weekly sessions, you build your individual working relationship with your therapist. You also receive guidance and help with personal motivation and practical applications of your DBT skills. In the typical program, you will go through one-on-one therapy and group skills training in the same period of time.

The third component of the DBT model is phone coaching. This approach gives you real-time access to your therapist in moments when you need help or guidance. By doing so, it provides an important layer of extra support for your recovery efforts.

The fourth DBT component is a therapist consultation team. This team does not focus on you as a recipient of treatment. Instead, it focuses on your therapist. Its aim is to make sure that your therapist receives adequate professional support and resources. This is important because DBT therapists often work with people severely affected by mental health issues. The work they do with their consultation teams helps them remain motivated and effective.

Skills Developed Through DBT

During your time in skills training, you will work on developing your behavioral abilities in four key areas. Two of these areas – distress tolerance and mindfulness –  are related to the acceptance portion of DBT. In distress tolerance, you learn to how to increase your ability to cope with painful emotions. The goal is not to change these emotions. Instead, you focus on improving your tolerance of them.

In mindfulness training, you learn how to pay close attention to your surroundings and circumstances. Again, you are not trying to change these things. You are simply trying to grow more aware of them.

The remaining two skills training areas – emotion regulation and interpersonal effectiveness –  are focused on behavioral change. Emotion regulation training helps you do two things:

  • Become less vulnerable to painful, destabilizing emotional states
  • Learn how to change emotional responses that harm your well-being

Interpersonal effectiveness training improves your ability to do several things, including:

  • Stating your wants and needs
  • Setting firms boundaries with other people
  • Remaining civil and respectful while interacting with others
DBT Therapy and Treatment

The DBT Therapy Hierarchy of Treatment

In DBT, your therapist will not try to tackle all of your problems at once. Instead, they will focus on the most important things first, then move on to additional focuses of treatment. The very first thing DBT seeks to resolve is involvement in behaviors that could threaten your life. Examples of these kinds of behaviors include:

  • Non-suicidal self-harm
  • Suicidal thinking
  • Talk of suicide
  • Suicidal planning
  • Actual suicide attempts

The next thing DBT focuses on is behavior that can disrupt the therapy itself. This can include things such as:

  • Not showing up for your treatment sessions
  • Showing up late
  • Failing to act in a cooperative way during treatment

The third area of focus is behavior that harms your quality of life. The fourth area is the gaining of helpful DBT skills that serve as replacements for damaging behaviors.

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Stages of DBT Recovery

DBT is progressive. This means that you improve in stages over time. People in the first stage are new to treatment. As a rule, their behaviors are damaging and not under their conscious control. This stage ends when you learn how to gain control over your harmful behaviors.

At the beginning of stage two, you have gained behavioral control. Still, you have not yet learned how to cope with the painful emotions motivating your past behavior. This stage ends when you learn how to face those emotions and integrate them into your overall life.

When stage three of your DBT therapy starts, you have learned how to control your behavior and integrate painful emotions. But you still need to learn how to put your new skills to use in everyday life. This stage ends when you have gained these kinds of real-world abilities.

Most people have completed DBT when the third stage of recovery ends. However, in some cases, the fourth stage of treatment is required. This stage is designed to help you find a deeper purpose that helps make your life more fulfilling.


In many ways, DBT is similar to cognitive behavioral therapy. In fact, DBT is largely based on CBT. However, there is an essential difference between the two therapies. Unlike CBT, DBT places special importance on accepting unpleasant thoughts, emotional states and behaviors. It treats all of these things as valid in their own way, even if they are harmful. The therapy then moves beyond acceptance to the active process of positive change.

DBT as a Cornerstone of Healthy Thinking

Dialectical behavior therapy has been shown to work for significant numbers of people. This is true, in part, because DBT therapy serves as a cornerstone of healthy thinking. It also plays the same role in fostering healthy emotional responses and behavior. The things you learn in DBT can help you achieve lasting stability and an enduring sense of well-being.

Learn More About DBT for Mental Health at Emerald Isle

Dialectical behavior therapy relies on the integration of opposites to support your well-being. These two opposites are acceptance and change. Initially, the therapy seeks to help you accept your current situation. It then helps you find ways to change thoughts, emotions and behaviors that cause you harm. DBT is unique in its emphasis on acceptance as a mode of healing.

During DBT, you will take part in a combination of group and individual therapy. Each approach provides its own benefits for your recovery. You will also have phone access to your therapist for help during moments of crisis. It takes a relatively long time to complete dialectical behavior therapy. This is true because the therapy works in gradual stages. Research shows that DBT is useful for treating substance problems and other separate forms of mental illness. It is also useful for treating combined substance problems and mental illness.

At Emerald Isle, dialectical behavior therapy is one of the many treatment options available to you. We include this therapy in a comprehensive approach to substance and mental health treatment. No matter how severe your condition, we can devise a treatment plan that makes the most of your recovery efforts. Call us today to learn more about our full slate of available treatment services.