Michelle Barratt Psychology only implements evidence-based psychological therapies. Our aim is to improve the over-all functionality of our clients and to teach them skills that will improve the quality of their life.
All treatments plans are discussed clearly with our clients because our upmost practice values are to build trust and faith in our practice, but most of all to ensure our client’s journey and recovery is effective and heart-felt.
DIALECTICAL BEHAVIOUR THERAPY
What is Dialectical Behaviour Therapy (DBT)?
Dialectical Behaviour Therapy (DBT) is an evidence based psychological therapy intervention developed by Marsha Linehan, a clinical psychologist from Seattle. This intervention was developed primarily to support highly suicidal young women who engage in persistent self-injurious behaviour and who struggle with intense and poorly controlled emotions. It is a behavioural treatment that teaches women who meet the criteria for a disorder called Borderline Personality Disorder (BPD), and have co-existing mood disorders, post-traumatic stress disorder, eating disorders, and alcohol and drug problems.
How is Dialectical Behaviour Therapy DBT different from standard cognitive and behavioural treatments?
The major innovation in Dialectical Behaviour Therapy DBT is the incorporation of the notion of dialectics. In short, it refers to the practice of considering strategies in which opposing views of a situation or extremes of a feeling are considered, and an attempt is made to identify “a middle path” of thinking and behaving which incorporates or combines elements of both opposing positions, that is, achieving an integration or synthesis of opposites.
The main dialectic in Dialectical Behaviour Therapy DBT is that of acceptance and change. Marsha and her team realised that previous, largely unsuccessful, treatments for Borderline Personality Disorder often stalled because clients struggled with the essentially change-based focus – clients felt invalidated, become upset and angry and /or withdrew from treatment when they felt continually pushed to change. A balance between acceptance and change was introduced and is a central theme of Dialectical Behaviour Therapy (DBT). Therefore, DBT therapists acknowledge people’s wish to be accepted as they are, and a simultaneous wish to change. These positions are opposite, but in dialectical terms can both be true at the same time i.e. the person wants to both change and not change.
Fundamentally, therapists communicate acceptance of clients as they are, while also acknowledging that in order to build a life worth living they have to change. Clients are validated, and it is made explicit that their behaviours, even deliberate self-harm, make sense in real ways. Therapists actively communicate that clients’ thoughts, feelings and behaviours are valid and that they can learn how and when to trust and use their own internal experiences and judgement.
A central component of Dialectical Behaviour Therapy DBT is skills training, with four modules of skills.
- Mindfulness and Distress Tolerance.
- Emotion Regulation and Interpersonal Effectiveness.
Why Are These Skills Taught?
Skills are usually taught in a group format, although they can also be taught in individual sessions. These skills are taught because they primarily teach individuals new coping strategies to manage painful emotions and to decrease conflict in relationships.
- Mindfulness is taught because is focuses on improving a person’s ability to accept who they are, and to just be present in the present moment.
- Distress Tolerance is has been engineered to teach skills to increase a person’s ability to tolerate negative emotion; to stand back from it, and allow it to ‘wash’ through you rather than to try to avoid or escape it.
- Emotion Regulation is important as it is fundamental for people to stay in the prefrontal cortex; they thus need to develop strategies where they learn to manage and change intense emotions that are causing problems in a person’s life.
- 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.
Skills acquisition is therefore a significant component of the effectiveness of Dialectical Behaviour Therapy DBT and is implemented to support clients to feel more in control and thus empowered to manage their emotions. They will begin to feel like they can deal with future problems more effectively because they learn to control their attention and awareness of the present moment, use interpersonal skills that are effective, start new relationships and improve current ones, understand how to regulate emotions, and tolerate emotional pain without feeling compelled to resort to behaviours that may be self-destructive.
Dialectical Behaviour Therapy DBT may be a suitable treatment for people struggling with:
- Substance dependence
- Eating Disorders
- Trauma-related difficulties
- Difficulties with mood management
- Feelings of emotional numbness or overly intense emotions including anger/emotional dysregulation
- Turbulent or otherwise difficult interpersonal relationships
- Urges to self-harm
- Frequent suicidal thoughts
If you or someone close to you is experiencing any of these kinds of problems, please consider making an appointment with our specialised psychologists who can support you through therapy.
COGNITIVE BEHAVIOUR THERAPY (CBT)
Cognitive Behaviour Therapy (CBT) is an evidence based intervention that has been shown to significantly improve mental health in patients. Fundamentally, CBT focuses on supporting clients to reflect on the thought patterns in their life that particularly drive negative thinking patterns that are dysfunctional, and often distorted,by deep wounds; which in turn trigger and perpetuate negative emotions and consequently behaviours.
Cognitive Behaviour therapy therefore helps to develop more positive thinking patterns, which in turn improves emotional regulation and thus find more positive coping strategies/helpful behaviours that improves a clients overall functioning.
This therapy was initially designed to treat depression, but has been proven to successfully improve symptoms for many disorders, including anxiety, and stress, and for many children, adolescent, couples and adult therapy’s.
Author: Michelle Barratt – Clinical Psychologist, and Clinical Director of Michelle Barratt Psychology, a Brisbane and Redland Bay based Clinical Psychology Practice – Promoting the Therapeutic Care and Therapy for Adolescents and Teenagers.