Dialectical behavior therapy (DBT) is one of the most popular and powerful treatments for young people struggling with mental health disorders. A branch of cognitive behavioral therapy, DBT is largely known for its ability to address the underlying emotional dysregulation that accompanies anxiety and depression. DBT encourages individuals to develop important life skills, improve relationships, break cycles of negative thinking, and lead more stable, fulfilling lives. But what exactly is DBT, and how does it work?

Let’s explore more about dialectical behavior therapy, and its application to anxiety and depression treatment, below.

What is Dialectical Behavior Therapy?

Dialectical behavior therapy (DBT) is a type of psychotherapy that helps people manage their emotions and cope with life’s challenges. It is based on the cognitive behavioral therapy (CBT) model, but focuses more specifically on the emotional and social aspects of mental health. DBT is designed to support individuals who experience very intense emotions and potentially harmful behaviors. As such, DBT was originally intended to help those struggling with borderline personality disorder (BPD), but is now used to treat a variety of mental health conditions, including anxiety, depression, post-traumatic stress disorder (PTSD), and substance addiction.

How Does Dialectical Behavior Therapy Work?

Dialectical behavior therapy is based on the idea that some people are more prone to intense emotional responses than others, and that these emotions can lead to maladaptive behaviors. The therapy works to validate these emotions, but also regulate them and turn them into more positive, healthy behaviors. This is where the “dialectical” comes into play—the therapy aims to find balance between acceptance and change.

In DBT, therapists exercise compassion and mindfulness. They approach conversations without judgement and encourage clients to be present and aware of their thoughts and emotions. As explained in an article from Harvard Health, “DBT teaches people to pay careful attention to the nature, quality, and volume of their thoughts. The idea is to observe these thoughts as separate from yourself without identifying with their meaning. This is the first step to addressing the impact of those thoughts.”

With that in mind, there are a few key components that make DBT work:

1. Dialectical thinking. In DBT, clients are encouraged to think dialectically – recognizing there is more than one way to view a situation, and not everything is black and white. For example, dialectical thinking for anxiety might involve accepting one’s worry and fear, recognizing that they are doing the best they can, but still taking steps to get better and to change their perception or thought patterns.
2. Validation. Validation is a key component of DBT, as clients with intense emotions need to (and deserve to) feel understood. During DBT, therapists acknowledge and validate clients’ feelings and experiences. This helps clients feel seen and heard, and eventually gives way for change.
3. Behavioral therapy. The behavioral therapy portion of DBT is aimed at identifying the negative emotions and behaviors associated with one’s mental health condition, as well as understanding what triggers these to occur. Once the root of these is uncovered, clients and therapists can then work together to develop coping strategies and skills to live a more productive, satisfying life.
4. Mindfulness. Dialectical behavior therapy also requires mindfulness, which clients learn through ongoing sessions with their therapist. Mindfulness enables clients to be more present and aware of their thoughts, feelings, and surroundings. It gives them control over what’s happening internally, as well as their reactions and behaviors.
5. Emotional regulation. Due to the intensity of emotions felt with many mental health disorders, part of DBT’s focus is to help individuals understand and manage those emotions with more stability and control. Emotional regulation is taught through various techniques, including the simple act of identifying and labeling emotions.

Dialectical behavior therapy might be delivered in a variety of ways, but is most often offered as one-on-one, individual therapy. Group skills trainings and therapy sessions are also available, along with texting and phone coaching. 

Dialectical Behavior Therapy (DBT) for Depression and Anxiety

Dialectical behavior therapy can be applied to the treatment of depression and anxiety disorders, helping to reduce and manage the symptoms associated with each disorder. This is largely due to DBT’s focus on mindfulness.

Mindfulness, which focuses on being present in the moment, helps individuals become more aware of their thoughts and feelings. When a person can recognize the negative thoughts or emotions associated with anxiety and depression, they are better equipped to change their perception or way of thinking. Mindfulness helps to reduce rumination and teaches individuals not to become overwhelmed by negative thought cycles. This contributes to a more balanced and centered state of mind.

DBT also centers around emotional regulation, which is also crucial for managing the intense emotions associated with depression and anxiety. By practicing DBT skills, those struggling can learn how to identify, label, and control their emotions. They can understand which factors trigger negative emotions and develop strategies to increase positive thoughts and experiences. This includes strategies distraction, self-soothing, meditation, positive imagery or reflection, as well as engaging in activities that promote overall well-being.

Overall, DBT offers a comprehensive and structured approach to treating anxiety and depression. DBT addresses the underlying emotional and behavioral patterns contributing to these conditions, using a multifaceted approach that gives individuals the tools they need to achieve better emotional health and build a more fulfilling life.

Is DBT Effective for Treating Depression and Anxiety?

While cognitive behavioral therapy (CBT) is considered the most effective treatment for anxiety and depression, there are numerous benefits to integrating dialectical behavior therapy (DBT) into one’s treatment plan. Specifically, DBT can be highly effective in reducing and managing symptoms associated with both mental health disorders.

In fact, numerous studies have shown that DBT is effective in decreasing:

• Self-harm behaviors
• Suicide attempts
• Psychiatric hospitalizations
• Emotional dysregulation

For those struggling with anxiety and depression, cognitive behavioral therapy (CBT) is typically the most effective therapy for reducing negative symptoms (though this will vary by individual). However, one study found that dialectical behavior therapy (DBT) can improve executive function—such as planning, problem-solving, and psychological flexibility—in individuals with anxiety and depression. 

DBT has also been found effective for adolescents struggling with mental health disorders like depression and anxiety. This is because, during the teen years, adolescents are undergoing significant changes and heightened emotions. DBT provides the regulation and structure they need, as well as the validation they crave, during these vulnerable years. Adolescents can learn practical life skills through DBT to cope with difficult symptoms, navigate negative emotions, and prioritize their mental well-being. 

Like any mental health treatment approach, dialectical behavior therapy (DBT) is not one-size-fits-all. Most often, DBT is offered in conjunction with other therapies and treatments, including CBT. Every person has different experiences and distinct needs—it is important to find a treatment program that offers a customized approach for you or your loved one.

If you would like to learn how Turnbridge supports individuals with anxiety and depression, or to learn more about DBT as part of our holistic treatment approach, please do not hesitate to reach out. Call 877-581-1793 to learn about our mental health treatment programs.