In DBT, the overall goal is helping individuals create “a life worth living.” What makes a life worth living varies from person to person; however, it often consists of decreasing behavioral, emotional, and thinking patterns associated with problems in living, such as:
- Confusion about yourself: Not always knowing what you feel or why you get upset, numbing out
- Impulsivity: Acting without thinking it through
- Emotional instability: Fast, intense mood changes with little control; or steady negative emotional states
- Interpersonal problems: Patterns of difficulty keeping relationships steady, getting what you want, or keeping your self-respect; frantic efforts to avoid abandonment
Remember the notion of the core dialectic "acceptance and change" from day one of this DBT Spotlight Blog Series? Well, this is just one instance of when balancing acceptance and change comes into play - in order to create a life worth living, you must balance acceptance with an unwavering focus on changing problem behavior. Through this balance, DBT aims to help change the behavioral, emotional, and thinking patterns associated with problems in living.
This is done through learning and applying the four skills modules that are taught in DBT. Two of which are acceptance-based and two of which are change-based:
Two "acceptance" skill modules:
1. Mindfulness: These skills are intended to help one become fully present in each moment; and to aid in increasing the capacity to control one's attention. The goal of mindfulness practice is to reduce suffering and increase happiness. These are considered "core" skills, which are used in all other DBT skills. These skills are also used to reach "wise mind," an intuitive knowing.
2. Distress Tolerance: These skills are about distracting and surviving a crisis or distressing situation without making things worse. This involves a certain amount of acceptance of reality even if you do not agree with it, as well as willingness to try DBT skills.
Two "change" skill modules:
1. Emotional Regulation: These skills are about learning how to accurately identify emotions, knowing their function, and how they work. These skills help reduce vulnerability to unwanted emotions and cultivate healthy emotional expression.
2. Interpersonal Effectiveness: These skills are about getting your needs met in relationships, sustaining healthy relationships, and maintaining self-respect by teaching you how to ask for something you want and say "no" to something you don't want.
By increasing the use of these skills, you will decrease the behavioral, emotional, and thinking patterns associated with problems in living. These skills are typically learned and reinforced through:
Weekly individual therapy
- Client and therapist work together in order to understand what contributes to the problems in the client's life and what interferes with change.
- New and more effective skills are learned.
Skills training groups
- Lead by experienced DBT clinician(s), DBT skills are taught and practiced in a group setting.
Between-session phone coaching with therapist
- This provides an opportunity for DBT skills to be generalized to life outside of therapy sessions.
Have a question or comment? Drop me a line in the comments section below.
Check back tomorrow for day four of the DBT Spotlight Blog Series: DBT? There's an app for that.