Dialectical Behavior Therapy

What Skills Are Taught in DBT?

What skills are taught in DBT?

DBT teaches a variety of skills that are grouped into the following four categories:

  1. Mindfulness: Increasing your awareness of your experience; learning to control (i.e. focus, and refocus, and refocus, and refocus...) your attention; Integrating feelings, facts, goals, and values to make wiser decisions.
  2. Distress Tolerance:
    • Crisis Survival: Increasing your ability to tolerate difficult (even extreme) emotions without making things more painful; getting through a crisis without making it worse.
    • Reality Acceptance: Embracing reality just as it is in the moment so that you can respond to things more skillfully.
  3. Emotion Regulation: Understanding your emotions; observing your emotions; reducing emotional dysregulation by improving self-care, increasing the frequency of pleasant emotions in your life, building self-efficacy, and being prepared t be skillful in difficult situations; reducing emotional suffering by maximizing your capacity for mood-independent behavior.
  4. Interpersonal Effectiveness: Increasing your ability to maintain safe, healthy, and balanced interpersonal relationships.

Patients in DBT also learn problem-solving skills. DBT places a strong emphasis on learning to solve the problems in your life as a way to build a sustainable life worth living. The above skills may at times be solutions to problems, while at other times they may simply facilitate finding solutions. For example, it may be hard to find the best way to handle a problem in your life if you feel overwhelmed with anxiety or depression. Learning to regulate or tolerate your emotions may make it easier to find a solution by heling you think more clearly or act less impulsively; and learning to regulate or tolerate your emotions may also be the solution in some situations.

DBT for Adolescents

DBT for adolescents (often abbreviated DBT-A) teaches the same skills as those taught to adults. Additionally, DBT-A patients are taught "Walking the Middle Path" skills.

These skills are aimed at developing:

  • Flexible patterns of thinking
  • Skills for self-validation and validating others
  • Effective problem-solving skills

DBT-A also includes working with the family of an adolescent to develop more balanced patterns of interaction, better communication among family members, and contingencies that increase effective and skillful behaviors. Family sessions are often aimed at finding a "middle path" between conflicting perspectives or extreme options, such as:

  • Normalizing pathological behavior vs. pathologizing normative behavior
  • Excessive leniency vs Authoritarian control
  • Fostering dependence vs. Forcing autonomy