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Hopewell Virtual Winter Summit

December 8, 2020

Dialectical Behavioral Therapy in Hopewell’s Residential Mental Health Community

Dialectical Behavior Therapy (DBT) is a type of behavioral therapy that was developed by Marsha Linehan in the 1980s. At that time, Dr. Linehan was working with severely depressed and suicidal patients, and she found some significant deficits in treatment for these patients.

Dr. Linehan had several personal experiences in treatment, and so she blended the wisdom she gained from her own history with traditional mindfulness techniques and the existing treatment models of the time to create a new therapeutic intervention, DBT.

What is Dialectical Behavior Therapy, and How Does it Help Residents of Hopewell’s Residential Mental Health Community?

Let us start by breaking down the first two words of its name.

“Dialectics” is a term that refers to the exploration of duality, or opposites. When working in dialectics, one acknowledges that each position is useful and contains its own wisdom, or truth (even if it is only a tiny bit). Dialectics also maintain that opposite tensions are interconnected and defined by one another. Thus, in DBT, we learn how to embrace opposites and seek balance between them. In this way, we learn fluidity and flexibility to enable change.

Dialectics help us to move away from “black and white” thinking, acknowledging that experiences are seldom ALL good or ALL bad, especially as it pertains to our thoughts, emotions, sensations, and actions. Instead, DBT strives to use terms like “more/less effective, more/less pleasant, more/less helpful,” etc., to describe our experiences. This also encourages folks to seek out the bit of wisdom and usefulness in all things, even if there is only a sliver to be found.

“Behavior” refers to how we respond to the world around us. Our behaviors are based on a multitude of factors, including our biology, environment, and our personal history of experiences. DBT focuses on identifying behaviors that are causing undue distress and suffering, so that one may begin to build more constructive ways of coping. By engaging in skill building techniques for mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, DBT provides a myriad of resources to enact behavioral change.

  • Mindfulness skills provide tools for inviting awareness into the present moment without judgment or criticism. One learns how to build a strong habit of mindfulness through intentional observation, focusing on just describing the facts, participating wholly, avoiding evaluations such as “bad” or “good”, being present in the moment, and doing what works effectively. This provides a foundation for all the other DBT skill sets.
  • Distress tolerance skills offer tools for managing crises without making the situation worse. Relaxation, distraction, and self-soothing techniques are implemented for managing our physiology when we are in a moment of distress. Through this DBT skill set, one learns how to regulate themselves more effectively and replace destructive coping strategies with ones that work more effectively and provide increased tolerance building overall.
  • Emotion regulation skills help build understanding of emotions, which includes creating an attitude of acceptance for all emotions, no matter how unpleasant they may be. When it comes to emotions, it is especially helpful to move away from classifying them as “good” or “bad,” as we cannot control our emotional responses to stimuli. In this way, DBT helps to reduce vulnerability to emotions and provides regulation skills when emotions threaten to overwhelm to a point of crisis.
  • Interpersonal effectiveness skills are essential for learning how to get needs met, maintain healthy relationships, increase self-respect, learn how to set and keep appropriate boundaries, and to communicate effectively.

Dialectical Behavior Therapy in Hopewell’s Residential Mental Health Community.

Each of the four tenets of DBT overlaps with one another. The full set builds a strong repertoire of skills that can be interchanged, combined, and personalized to ensure usefulness.

At Hopewell, we offer a DBT education group once per week, as well as an additional weekly DBT skill-building group. We also have clinical staff available to support residents with building personal skills, implementing DBT-based goals into their treatment planning, and provide families with tools they need to reinforce and support these healthy changes.

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