Dialectical Behavior Therapy (DBT)

One of the ways we at CCI treat mental illness is through the use of psychotherapy (“talk therapy”). One such form of therapy is dialectical behavior therapy (DBT). Unlike cognitive-behavioral therapy (CBT), which focuses on identifying inaccurate perceptions of others and themselves, DBT focuses on using concepts of mindfulness and acceptance or being aware and attentive to current situations and emotional states. This form of therapy was originally developed to treat borderline personality disorder (BPD); however, in more recent years, it has been shown to help with a myriad of mental disorders. DBT also gives clients the skills they need to control intense emotions and reduce self-destructive behaviors. This makes it an excellent candidate for treating substance use disorder (SUD).

What Does DBT Look Like?

DBT incorporates eastern meditative practices and focuses on acceptance and change. It incorporates mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance.

Core Mindfulness

According to the National Institute of Mental Health (NIMH), mindfulness is a psychological process of actively paying attention to the present moment. This means being aware of your thoughts, feelings, behaviors, and urges. By practicing mindfulness, we are given the power to be aware of ourselves in a way that promotes and assists in emotional regulation. We learn to accept ourselves and change ourselves.

An example of practicing mindfulness may be approaching an employer to request a certain day off. Perhaps it’s your parent’s birthday, and you want to help with their surprise party. When you approach your employer, you may be tempted to make assumptions about their reaction:

“My employer will definitely say no, then I’ll arrive late to their surprise party and everyone will say that I’m the worst and I won’t get any cake and no one will come to my party in 3 months all because my employer is a jerk.”

Your behavior may reflect this assumption. You may come across as combative or irritable as you make your request. By practicing mindfulness, you stay in the present moment:

“I’m going to ask my employer, politely, if I can have this day off. They may say no, they may say yes. Here is what I will say, and this is how I will act when I say it.”

By being mindful of your thoughts, feelings, and actions, you empower yourself.

Interpersonal Effectiveness

One of the major goals in DBT is to build and maintain positive relationships. DBT has dissected interpersonal skills that those with healthy interpersonal relationships develop naturally and breaks them down into a series of descriptive acronyms. Mastering these skills can be helpful to anyone, but they are especially helpful for individuals who have experienced trauma or were otherwise unable to develop healthy interpersonal communication skills organically.

Using these skills can help you navigate the above scenario. Using the acronyms, you can walk through the interpersonal effectiveness steps before and after interacting with your employer. The more you practice interpersonal effectiveness, the more natural these skills become. Eventually, you should subconsciously begin practicing them amid everyday conversations without even thinking about it.

Emotional Regulation

If you are suffering from a mental disorder, you may have found that you have a negative relationship with the concept of feelings. You may even blame them for negative experiences you’ve had throughout your life. It is important to remember that emotions serve an important purpose: to communicate information to us about our experiences and environment. DBT uses a variety of tools to help those who feel as though their emotions control them. Some goals of emotional regulation include:

  • Naming and understanding emotions
  • Decreasing the frequency of negative emotions
  • Decreasing our vulnerability to emotions
  • Decreasing emotional suffering

In the earlier illustration, should your meeting with your employer go negatively, for example, this skill will allow you to process the disappointment and frustration positively and helpfully so that you may continue to practice interpersonal effectiveness.

Distress Tolerance

Distress is an unfortunate but natural part of life. We may experience it due to major life events, such as the death of a loved one, loss of employment, or the end of a significant long-term relationship. On the other hand, there are less drastic events that can cause different kinds of distress, such as finding yourself stuck in traffic, being unhappy with your appearance, or being unable to participate in a major event for a loved one (such as you guessed it, your parent’s surprise birthday party).

DBT teaches a series of skills designed to help navigate emotional crises of all forms. It gives us the ability to accept what is causing the distress and move forward with our lives despite it.

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Is DBT Right for You?

DBT is a powerful tool that can help clients who are suffering from suicidal thoughts and destructive behavior. For this reason, it is often used in the treatment of many different mood disorders, personality disorders, and SUDs. At Crownview Co-Occurring Institute, DBT is just one of several psychotherapies we use to ensure our clients have the tools they need to overcome their mental illness and lead healthier lives.

Using a comprehensive diagnosis process, we identify and diagnose the disorder (or co-occurring disorders) that has disrupted the lives of our clients and their loved ones. We understand that each individual who walks through our doors is not just a statistic but a person who needs help.

If you or a loved one is suffering from a severe mental or substance abuse disorder, we may be able to help. Call us at (760) 477-4754 for more information.

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