Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is skills-based treatment approache that can help people regulate their emotions more effectively, improve their interpersonal relationships, increase their ability to tolerate distress and be more mindful of their thoughts, feelings and behaviour.

DBT was originally designed to treat Borderline Personality Disorder (BPD) but there is now evidence to support its effectiveness in treating drug and alcohol abuse and a wide range of mental health issues including depression, anxiety, PTSD and eating disorders.

Because of this effectiveness, DBT is used extensively across all clinical platforms at EHN-Canada. In fact, Edgewood is one of the few treatment programs nationwide to use DBT the way it was in intended in its residential and outpatient treatment programs.

How Does Dialectical Behavior Therapy Work?

Dialectical Behavior Therapy (DBT) is an evidence based treatment that combines elements of Cognitive Behavioral Therapy (CBT) with Buddhist practice of meditation and principles of self-awareness. Through individual DBT sessions and DBT skills groups, patients learn how to incorporate practical tools into their lives so that they are empowered to better navigate the world and negotiate challenges more effectively.

DBT skills training include a standardized approach to teaching all patients mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.

DBT treatment is often characterized by 4 stages. They include:

  • Stage 1 is focused on establishing behavioral control for patients who are dysregulated and emotionally activated. Stage 1 lays the foundation for recovery by helping individuals ground themselves and stop engaging in life-threatening behaviors, treatment interfering behaviors, and behaviors that interfere with functional daily life.
  • Stage 2 occurs when patients achieve behavioral control and are prepared to explore how to express feelings in a healthy way. The focus is on “emotional experiencing,” where the therapist helps the patient identify, experience, and better express their emotions.
  • Stage 3 focuses on problem-solving and helping patients increase their ability to manage challenges in everyday life. This stage of treatment focuses on patients owning their own behavior, building trust in themselves and learning to value who they are as people. The goal is to achieve “a life worth living.”
  • Stage 4 brings all the lessons and skills of the preceding stages together to help patients connect with the outside world and build a capacity for joy.

What Is the Evidence Behind Dialectical Behavior Therapy?

Marsha Linehan, PhD, originally developed Dialectical Behavior Therapy (DBT) to help female patients with Borderline Personality Disorder (BPD) and suicidal tendencies manage their emotions and decrease their impulsive behavior. In a study conducted by the National Institute of Mental Health in the United States, Dialectical Behavior Therapy (DBT) showed twice the success rate of reducing suicide attempts among those diagnosed with BPD in comparison to other therapies.

Studies have shown that DBT can also reduce anger/impulsivity, depression, self-harm, disordered eating and hopelessness. When used to treat substance abuse, DBT can decrease urges to use, cravings, and physical discomfort from abstaining.

Clinical staff across EHN-Canada have had extensive and on-going DBT education, training and supervision. Patients across all clinical programs are given comprehensive DBT skills training focused on the key areas of mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness. DBT across Egdewood is standardized and employs the use of evidence based modules, worksheets and assignments.

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