Dialectical Behaviour Therapy (DBT) and its Application to a Specialist Client Group
Dialectical Behaviour Therapy (DBT) is a psychosocial intervention initially developed by Dr. Marsha M. Linehan to treat individuals with Borderline Personality Disorder (BPD). However, its application has expanded to other populations, including those with self-harm behaviors, suicidal ideation, substance use disorders, eating disorders, and other complex mental health conditions.
DBT is a comprehensive treatment approach that integrates cognitive-behavioral techniques with mindfulness-based practices. It aims to help individuals develop skills in four core areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills are taught through individual therapy sessions, group skills training, phone coaching, and consultation team meetings.
The literature on DBT highlights its effectiveness in reducing self-harm behaviors, suicidal ideation, and improving overall psychological functioning in individuals with BPD and other complex mental health conditions. For example, a meta-analysis by Kliem et al. (2010) found that DBT was significantly more effective than treatment as usual or other active treatments in reducing self-harm behaviors and improving general psychopathology.
DBT’s application to a specialist client group can vary depending on the specific population being treated. Here, we will discuss its application to individuals with substance use disorders.
Research literature supports the use of DBT as an effective intervention for individuals with substance use disorders who also exhibit high-risk behaviors and difficulties managing emotions. Studies have shown that DBT can reduce substance use, improve treatment retention rates, and enhance emotion regulation skills in this population (Linehan et al., 2002; Harned et al., 2008).
The integrated approach of DBT addresses the complex needs of individuals with substance use disorders by combining strategies such as functional analysis, chain analysis, and problem-solving techniques with the core DBT skills modules. The focus is on helping clients develop mindfulness skills to increase awareness of triggers and cravings, distress tolerance skills to cope with urges to use substances, emotion regulation skills to manage intense emotions without resorting to substance use, and interpersonal effectiveness skills to improve relationships and build a supportive network.
Critically evaluating the application of DBT to individuals with substance use disorders, it is important to consider some limitations. First, while DBT has shown promising results, it may not be effective for all individuals with substance use disorders. Some clients may require additional interventions or a modified approach tailored to their specific needs.
Secondly, the resource-intensive nature of DBT may pose challenges in terms of accessibility and feasibility in certain settings or populations. The ongoing individual therapy sessions, group skills training, phone coaching, and consultation team meetings require a significant commitment from both clients and providers.
Lastly, there is a need for further research evaluating the long-term outcomes and cost-effectiveness of DBT for individuals with substance use disorders. While studies have demonstrated short-term benefits, more evidence is needed to determine the sustained impact on substance use relapse prevention and overall functioning.
In conclusion, DBT is a valuable psychosocial intervention that has shown effectiveness in treating individuals with Borderline Personality Disorder and other complex mental health conditions. Its application to individuals with substance use disorders can help address high-risk behaviors, emotion dysregulation, and interpersonal difficulties commonly associated with this population. However, further research is needed to better understand its long-term outcomes and identify the most effective ways to tailor DBT for specific populations within the substance use disorder spectrum.
