Dialectical behavioral and cognitive-behavioral treatments offer two different approaches to treating depression and addiction. Let’s take a look at both.
Cognitive Behavioral Therapy (CBT)
Cognitive-behavioral therapy was first embraced in the 1960s by therapists as a more effective psycho-social treatment than the Freudian focus on unconscious influences and impact from childhood experiences. Behavioral therapy focuses on a patient’s current distorted thoughts, beliefs, and attitudes.
Far in advance of modern psychotherapy, Alcoholics Anonymous was founded in 1935 implementing the 12-step program of therapy. At each AA meeting, the members recite the following serenity prayer:
“God grant me the Serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.
That in a nutshell is mindful behavioral therapy. Addiction therapists like to characterize their work as eradicating “stink’n think’n”. Today, behavioral therapies are often combined with a 12-step program.
Behavioral therapy is essentially mind control. It was originally used to treat depression. But it has become popular for treating many mental health conditions including post-traumatic stress disorder, marital problems, eating disorders, and addiction.
Dialectical Behavioral Treatment
Dialectical behavioral treatment (DBT) is a branch of behavioral therapy. It was developed in the 1980s to deal with suicidal thoughts. But it came to be used for treating substance addiction and borderline personality disorder. The term dialectical expresses a philosophy that seemingly opposite beliefs or behaviors can coexist.
What’s the Difference?
In CBT, patients identify their personal goals and also their perceived obstacles. They are then taught the mindful skills to overcome those obstacles. Mainly, those skills identify and eliminate the “stink’n think’n”.
The same is true for DBT. But DBT employs a much more structured therapy and mind training. Among the principal teaching modules are:
- Core mindfulness skills. Eastern meditation skills serve as the model for patients to be more objectively cognizant of and recognize their thinking of the moment.
- Distress tolerance. This looks a lot like the AA serenity prayer. It teaches that some things are beyond our control and we learn to live with them in peace and without self-blame.
- Interpersonal effectiveness. Patients are taught methods for establishing healthy relationships to deal with conflict.
- Emotion regulation. Patients are taught how to handle emotions and obstacles in order to manage their emotions. They are also taught to avoid situations that trigger harmful emotions.
Efficacy of Behavioral Therapy
Numerous studies have shown that behavioral therapy works. Among them is a manuscript published in July 2012 in PubMed Central (PMC), an archive maintained by the National Institute of Health.
The study, “The Efficacy of Behavioral Therapy: A Review of Meta-analyses” identified 269 meta-analytic studies and reviewed a representative sample of 106 meta-analyses examining behavioral therapy. The consensus conclusion was that CBT showed more efficacy than other compared treatments for many mental health issues including substance addiction, depression, and several other disorders.
Sands Treatment Center
At The Sands Treatment Center, we have many years of experience treating substance addiction as well as other disorders. We employ 12-step programs in combination with behavioral therapies. Contact us to find out more.Learn More
Folks who struggle with tolerating intense emotion and who find themselves acting out impulsively in ways that harm their wellbeing or personal relationships may benefit from working with a therapist who practices Dialectical Behavior Therapy. The mindfulness skills and interpersonal growth that can result from this kind of therapy can be a lifesaver for patients who don’t know where to begin their healing journey.
What is DBT?
You may have heard of Cognitive Behavior Therapy (CBT), a type of treatment that helps folks learn to recognize their own destructive thought patterns that contribute to unwanted behavior. Throughout the treatment process, clients learn to challenge these negative thought patterns and replace them with more constructive and realistic thoughts. Dialectical Behavior Therapy is a specialized form of CBT that was developed specifically to treat clients struggling with issues like borderline personality disorder (BPD), substance use disorder, and bipolar disorder. This therapy has four goals:
- Emotional regulation
- Healthy coping mechanisms
- Improved interpersonal relationships
- Living in the moment
DBT utilizes a variety of methods to achieve its goals.
Phone coaching empowers clients to learn to live in the moment through phone calls with their therapist between sessions. Talking to the client in the heat of the moment allows the therapist to directly access negative or destructive thoughts that are encouraging unwanted behavior.
Individual therapy is a powerful tool for achieving treatment goals. During sessions, therapists may use the time to explore client thought patterns and perform exercises related to mindfulness and distress tolerance.
Group therapy is critical to improving interpersonal relationships for patients as it gives therapists a chance to provide immediate feedback on the ways patients relate to others. Working in a group setting also creates opportunities to practice and learn new skills.
Therapists may teach their clients mindfulness skills, which can help patients change their focus during times of intense stress or anger. Exercises that develop mindfulness encourage a client to focus on sensations in their body or the room around them.
Does It Work?
DBT has been proven to be extraordinarily effective in treating certain conditions. Most research has focused on its efficacy with BPD, where 75 percent of patients no longer met the requirements for BPD after one year of treatment under this modality. Studies have also shown promising results for reducing suicidality and assisting in recovery from substance use disorder.
This kind of therapy is effective because as therapists ask the patient to change, they are simultaneously validating the worth of the person and teaching them real-life skills to help them cope with the potential distress of changing.
Where to Find Treatment
Most recovery centers including The Sands Treatment Center offer Dialectical Behavior Therapy when it is appropriate to a patient’s unique needs. Patients who see themselves benefiting from this kind of treatment can seek out treatment centers or therapists who have the specialization needed to practice this modality. Ultimately, learning skills to increase distress tolerance and improve personal relationships can be a gateway to recovery for patients struggling to thrive.Learn More