How Can DBT Help?

The skills that DBT teaches – mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness – are all designed to help people tolerate and resist suicidal urges, and manage their emotions and their relationships without resorting to life-threatening behaviors. One dialectical element of DBT is the acceptance of suicidal behavior as an attempt to solve a seemingly insoluble problem, and finding new ways to solve that problem without resorting to self-harm. Another important dialectic is the emphasis on validating and accepting the pain that people feel, and at the same time making the necessary changes to enhance life experience. The process of DBT treatment usually includes group skills training, individual therapy to practice these skills, and after-hours coaching calls to incorporate these skills in everyday life to manage crisis situations. It helps people to better understand the factors that make them contemplate suicidal and other self-harming behaviors, and to use their new skills to deal with these factors in more constructive ways. Instead of regarding their situation as impossible, DBT encourages patients to understand the factors that contribute to their emotional state, and to find different problem-solving strategies to cope with them. DBT recognizes the importance of reducing life-threatening behaviors as a starting point for treatment. Anyone who undertakes a course of DBT treatment is asked to commit to the goal of reducing life-threatening behaviors as part of their treatment agreement. This is in order to increase commitment to life-enhancing behaviors. In addition, clients and therapists collaboratively create a “safety plan” at the beginning of treatment that clients agree to follow if faced with serious suicidal urges.