Dialectical behavior therapy (DBT) is a type of cognitive behavioral therapy (CBT) that is adapted for people who experience emotions intensely. Cognitive behavioral therapy (CBT) is a framework of talk therapy that helps clients understand how their thoughts affect their emotions and behaviors.

“Dialectical” means synthesizing opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives and unhelpful behaviors. DBT is effective for people who have difficulty managing and regulating their emotions, and has proven to be effective for treating and managing a wide range of mental health conditions, including:

• Borderline personality disorder (BPD).

• Self-harm.

• Suicidal behavior.

• Post-traumatic stress disorder (PTSD).

• Substance use disorders.

• Eating disorders, specifically binge eating disorder and bulimia.

• Depression.

• Anxiety.

DBT has proved effective for treating these conditions because each of these conditions is thought to be associated with issues that result from unhealthy or problematic efforts to control intense, negative emotions. Rather than depending on efforts that cause problems for the person, DBT helps people learn healthier ways to cope. Continue below to learn about the different modules of DBT Skill Building.

Mindfulness is often the first module participants will learn with Brian. This skill builds on traditional mindfulness concepts from eastern cultures. In DBT skill building, Mindfulness is delivered in a practical and accessible way. Clients learn how to pay attention on purpose to the present moment without judgment.

Core Principles of DBT Mindfulness

DBT teaches clients to bring the mindfulness skills of “wise mind” - a synthesis of emotional mind and reasonable mind. You will learn how to observe, describe, and participate in daily life to help manage emotions, thoughts and problems more effectively. Mindfulness is the foundation on which the other skills are learned and applied.

Mindfulness skills cultivate awareness to be able to sit with difficult emotions and states of mind, identify problems before they spiral out of control, and allow clients to implement skills that will make either the make situation better or at least help cope in a way that doesn’t make it worse.

The second DBT module, Distress Tolerance, focuses on managing crisis situations and difficult events in our life. Essentially, it teaches how to not make a bad situation worse.

Some of us act out on unhelpful urges in moments of desperation. Whether that’s  substance use, disordered eating, high risk sexual behavior, compulsive spending, self-harm or any other risky or unhelpful behaviors. The problem is that while some of these strategies can provide short-term relief, distraction and comfort, this is usually short-lived and causes more problems while lowering self-worth because we’re not living in accordance with our values. Self-medication often takes us further away from our goals and the life we want to live.

Distress tolerance teaches skills to manage crisis more effectively, helping us tolerate problems and manage impulsive behaviours. Clients will learn how to think through what are the consequences of acting on these urges.

At first it can be difficult or feel nearly impossible to stop yourself from acting on an impulsive urge. However, with practice it can make a very real difference to our lives. Increasing our choices about how to respond to any situation.

The third module, emotion regulation, is focused on helping clients manage their emotions more effectively. This initially includes learning what emotions are, their purpose and function in day-to-day life and the factors that can interfere with regulating emotions.

Some clients are shaped in early development to learn that some emotions are bad or shouldn’t be expressed. Academic literature shows that what we believe about emotions can impact our emotional wellbeing. DBT teaches a comprehensive model of emotions and helps individuals understand how they work by looking at the components that make up an emotional experience. This includes internal and external factors. 

We can’t change our emotions by just willing ourselves to feel differently or someone telling us how we should feel. There are many ways that we can intervene to take more control of our emotions. Some of these skills such as checking the facts, opposite action to emotion and problem solving are ways of changing unwanted emotions. Another key aspect of this module is exploring your emotional vulnerability. This looks at factors that make us more vulnerable to feeling certain emotions, experiencing higher reactivity, and acting on emotion urges – even though we don’t want to.

Do you find it difficult to ask for things or say no? Are you frequently finding that interactions with family and friends can end in conflict? Struggling to maintain boundaries?

The interpersonal effectiveness module targets relationship and social skills. Interpersonal skills can be tricky to navigate; however, with guidance and practice, it is possible to build confidence and skills to maintain and build healthy long-lasting relationships. Brian will challenge you to think about areas you struggle with. Then, through discussions and role play, you will develop interpersonal skills in a safe environment. Topics range from assertiveness training, to building relationships and self-respect effectiveness. Clients learn how to improve communication style in day to day interactions and manage conflict more skilfully.

An important area for many clients is learning about, setting, and maintaining boundaries. Establishing healthy boundaries can be an important factor in maintaining positive relationships. Often, being too rigid or too flexible can create problems. Brian will help you know your boundaries and values while guiding you through various interpersonal situations.

You do NOT have to be a doormat. Some relationships are harmful and interfere with the quality of our life. Using problem solving skills to overcome difficulties can be used in these instances. However, there may be times that a relationship is destructive and that we need to consider if its sustainable long term. Learning when and how to end a relationship is also a topic is covered in this module.