Dialectical behavior therapy: Skills to manage emotions

Dialectical behavior therapy: Skills to manage emotions

Dialectical Behavior Therapy (DBT) sounds a lot like Cognitive Behavioral Therapy (CBT). DBT is based on CBT, one of the most commonly practiced forms of psychotherapy. The idea that there are better

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Tracey Griffin, LMHC
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August 10, 2019
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Key takeaways

Dialectical behavior therapy (DBT) sounds a lot like Cognitive behavioral therapy (CBT). DBT is based on CBT, one of the most commonly practiced forms of psychotherapy. The idea that there are better ways to think about our feelings is the core concept behind cognitive behavioral therapy. Dialectical behavior therapy takes this concept a step further. DBT focuses on helping people who tend to have extreme emotional reactions. Above all, this form of therapy teaches people how interact with the environment in a healthier way.

What is the difference between CBT and DBT?

CBT focuses on how your thoughts, feelings and behavior influence each other. Dialectical behavior therapy emphasizes regulating emotions, being mindful, and learning to accept pain. CBT seeks to give patients the ability to recognize when their thoughts might become troublesome. CBT then gives them techniques to redirect those thoughts. DBT focuses on helping people change their behavior patterns, rather than to trying to think or talk through the issues they are struggling with

Who is dialectal behavior therapy for?

Dialectical behavioral therapy was created to treat borderline personality disorder. The first major study was done by Dr. Marsha Linehan in 1991. However, research shows that DBT has also been used successfully to treat people experiencing depression, bulimia, binge-eating, bipolar disorder, post-traumatic-stress disorder, and substance abuse. DBT skills are good for those who wish to improve their ability to regulate emotions, tolerate distress and negative emotion, be mindful and present in the given moment, and communicate and interact effectively with others. DBT often is the most effective therapy for those who struggle with self-harm behaviors like cutting and chronic suicidal ideation. Sexual trauma survivors also respond well to DBT techniques.

How does DBT work?

As its name suggests, dialectics, or the idea of balancing opposites, is a major part of DBT. The therapist consistently works with the patient to find ways to hold two seemingly opposite perspectives at once. This promotes balance and avoids black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.

Dialectical behavior therapy provides individuals with new skills to manage painful emotions and decrease conflict in relationships. This type of CBT helps those who have developed patterns of intense emotional reactions and impulsive behaviors in response to what patients describe as overwhelming feelings of pain and rejection. DBT specifically focuses on providing therapeutic skills in four key areas.

  1. Mindfulness focuses on improving an individual's ability to accept and be present in the current moment.
  2. Distress tolerance increases a person’s tolerance of negative emotion.
  3. Emotion regulation covers strategies to manage and change intense emotions that are causing problems in a person’s life.
  4. Interpersonal effectiveness consists of techniques that allow a person to communicate with others in a way that is assertive, maintains self-respect, and strengthens relationships.

What does DBT treatment involve?

DBT does not differ dramatically from how you would visit your doctor in other forms of talk therapy. However, DBT does tend to require greater commitment on the part of both the therapist and the patient alike to develop a satisfying and meaningful life. Generally speaking, there are three major components of DBT in its standard, outpatient form.

  • Weekly individual (one-to-one) therapy sessions: The content of these therapy sessions generally revolves around targeting a high-priority event that occurred within the past week, helping the patient identify all the factors that led up to and followed the event and then determining and practicing new ways of responding in the similar situations.
  • Weekly skills-training sessions: Usually in the form of group therapy, this part of DBT involves teaching patients specific skills designed to help improve their life in the four major areas we mentioned above.
  • As-needed consultation with your doctor outside of sessions

About Talkiatry

Talkiatry is a local, accessible and complete mental healthcare solution that accepts insurance. We close the gap for individuals who want to get better, but feel that mental health care has been challenging to navigate up until this point and want a more convenient way to take the first step. Talkiatry takes the traditional local mental health visit and combines it with technology, scale, efficiency, and design to provide the best possible environment for healing.

Talkiatry is a mental health practice, and our clinicians review everything we write. However, articles are never a substitute for professional medical advice, diagnosis, or treatment. If you think you may need mental health help, talk to a psychiatrist. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
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Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Tracey Griffin, LMHC

Tracey Griffin is a Licensed Mental Health Counselor who is dedicated to helping people align with their most authentic selves over the last 11 years. This includes addressing the struggles of mental health in an open, empathetic, and non-judgmental, therapeutic relationship. She is dedicated to establishing a collaborative working relationship with individuals to help achieve their goals while living a fulfilled and balanced life. Tracey received her Master of Science in Mental Health Counseling from Pace University following her Bachelor of Arts in Applied Psychology from the same institution. She has been trained in performing biopsychosocial assessments and is also a Credentialed Alcohol and Substance Abuse Counselor.

Tracey’s treatment approach is person-centered in conjunction with evidence-based practices such as cognitive behavioral therapy, dialectical behavioral therapy, mindfulness, and motivational interviewing while remaining culturally sensitive and inclusive. She is well versed in harm reduction as well as abstinence-based approaches to addiction treatment and roots her practice to focus on treating the whole self which can include exploration of spirituality and purpose. Tracey has experience working with individuals who experience co-occurring disorders, anxiety, depression, codependency, addiction, personality disorders, LGBTQ, men’s issues, and trauma.

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