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Two Parts of Dialectical Behavior Therapy

Dialectical Behavior Therapy was researched and developed by Marsha Linehan, PhD., in 1991, and is a type of therapy which stands out from other traditional types of psychotherapy because it was developed especially to treat people with Borderline Personality Disorder.

Dialectical Behavior Therapy is based upon the theory that the psychosocial treatment of Borderline Personality Disorder is just as important as traditional psychotherapy. A structure of treatment goals forms the basis Dialectical Behavior Therapy: (1) the reducing of parasuicidal behaviors; (2) the reducing of behaviors which interfere with the relationship between client and therapist; and (3) the reducing of those behaviors which directly impact upon the client’s quality of life. Studies have shown that Dialectical Behavior Therapy is effective in achieving these treatment goals.

Marsha Linehan’s basic theory behind Dialectical Behavior Therapy is that some people, because of invalidating environments during their early developmental upbringing, and due to biological factors as yet unknown, react abnormally to emotional stimulation. Their level of arousal goes up much more quickly, peaks at a higher level, and takes more time to return to baseline.

As a result of this abnormal reaction to emotional stimulation, theorizes Linehan, people with Borderline Personality Disorder experience crisis-strewn lives and extreme emotional lability, or emotions that shift very quickly. Dialectical Behavior Therapy is a method that teaches skills that will help the person with this disorder to handle the rapid mood changes more effectively.

Dialectical Behavior Therapy consists of two parts: individual Psychotherapy sessions once a week, and weekly 2.5-hour group therapy sessions.

The first part of Dialectical Behavior Therapy consists of one-per-week individual psycho-therapy sessions in which a particular problematic behavior or event from the past week is explored – beginning with the chain of events leading up to it, going through possible alternative solutions that might have been used, and examining how more useful solutions to the problem can be used in the future.

Both between and during these individual psychotherapy sessions, adaptive behaviors are taught and reinforced, especially as they occur within the therapeutic relationship. The emphasis of Dialectical Behavior Therapy is on managing emotions rather than crisis intervention.

The second part of Dialectical Behavior Therapy involves weekly 2.5-hour group therapy sessions in which interpersonal skills, distress tolerance skills, emotion regulation, and core mindfulness skills are taught.

The techniques used in Dialectical Behavior Therapy are extensive and varied, addressing essentially every aspect of therapy, and they 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, and confrontation is balanced by understanding. The client is helped to understand his/her problem behaviors and then helped to deal with situations more effectively by learning necessary skills to do so and to deal with any problems that he/she may have in applying them in his/her natural environment.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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