DBT Therapy in London by City Psychological Services

DBT Therapy in London: Learn all about DBT

Developing an alliance with the patient is not always a simple task. However, understanding models that enable this process is essential for the success of psychotherapy professionals. Among the main approaches that allow the development of this alliance, the DBT therapy in London stands out as a reference.

It has already been scientifically proven that there are high success rates in psychotherapy processes in which a good relationship with the therapist was nurtured. This is because patients tend to feel more committed to processes that perceive that there is an emotional collaborative bond. 

So, if you are interested in knowing more about the approach and its characteristics, just keep reading this article!

What is Dialectical Behavior Therapy?

Dialectical Behavior Therapy was developed in the early 1980s by psychologist Marsha Linehan. Also known as DBT, it is one of the main approaches of the so-called 3rd Wave in Cognitive Therapy, in which therapeutic interventions have a more integrative character, prioritizing the therapist-patient relationship.

The model is considered a type of Cognitive-Behavioral Therapy . He employs several strategies that are based on acceptance techniques. These practices were incorporated from Zen therapy, methodologies and concepts from behavioral science, as well as other methods of contemplation, such as mindfulness.

The fundamental dialectic in this model of therapy focuses on validation and acceptance of the patient in his entirety. Thus, it simultaneously elaborates a context to help you change, with the central objective of helping in the process of emotional regulation and in the development of skills taught in therapy.

Originally, the model was developed with the aim of treating chronically suicidal patients diagnosed with Borderline Personality Disorder . This was the first psychotherapy that demonstrated effectiveness in treating the disorder, which was proven by clinical trials.

Through this, and with the completion of other clinical trials, it was realized that Dialectical Behavioral Therapy could be applied to several cases. Since then, the approach has been used to treat other cases of personality disorder.

What are the top 4 skills covered in DBT therapy in London?

During the process of DBT therpapy in London, 4 skill modules are addressed, which are divided into 2 groups: acceptance and change skills. This is so that the patient will have the necessary tools to deal with and modify his emotional dysregulation. We will explain about them below.

Acceptance Skills

mindfulness

Individuals who have severe emotional dysregulation commonly report:

• Absence of sense of self;
• Feelings of emptiness;
• Lack of self-knowledge.

This happens because they perceive reality through their emotions and not through how it really is.

Thus, to treat the feeling of losing oneself, mindfulness is one of the skills addressed in the therapeutic process. It makes the patient see the ability to consciously experience and observe himself, accurately observe and describe present internal and external events, without judgment or distortion of reality.

Tolerance to malaise

Often, patients with high emotional dysregulation have patterns of dysregulated behavior. Then, they abuse drugs and alcohol, self-harm and attempt suicide, in addition to several other behaviors generated by impulsivity.

Thus, the patient is guided towards the development of behaviors that enable tolerance to situations that may generate feelings such as anguish. Therefore, they avoid impulsive behavior, which results in a greater ability to tolerate this discomfort until more effective solutions are found.

Changing Skills

interpersonal effectiveness

The experience in chaotic and intense relationships, in addition to the difficulty in disconnecting and eliminating this type of relationship is a report present in individuals with high emotional dysregulation. Therefore, they have many problems of anger, jealousy, envy and shame.

In this way, the interpersonal effectiveness skills taught aim to increase the chances that the patient's desires in a specific situation will be achieved. At the same time, it is intended that they do not harm their relationships or self-respect.

emotional regulation

Problems in identifying emotions are common in some subjects. They may have greater difficulty describing and naming what they feel, as well as avoiding or even knowing how to act when certain emotions arise.

Thus, the patient is instructed to carry out this identification. He is also instructed in skills that can modify his current emotional responses as well as reduce vulnerability to the emotional mind.

How does Dialectical Behavior Therapy work?

The success of the treatment will depend on the quality of the relationship between the patient and the therapist. This must emphasize the creation of a real human relationship, in which both members are important and in which the needs of both must be considered. 

This type of process can generate some levels of burnout in therapists. Therefore, it is important for the professional to be alert to possible signs.

During the treatment process, the therapist should seek to interact with the patient in a way that:

• Accept the patient as he is, but encourage change;
• Centered and firm, but flexible when circumstances require it;
• Feeding, but demanding with benevolence.

To continue the process, the professional must use two styles of communication, which must be mixed and balanced according to the progress of the treatment:

Reciprocal communication style — primary model of relationship and communication, involves elements such as receptivity, cordiality and authenticity on the part of the therapist, being able to use self-disclosure, but always keeping the interests of the patient.

Irreverent communication style — has characteristics of greater confrontation and challenge, being a style considered more alternative. It serves to bring the patient up with a start in order to deal with situations where therapy seems to be stuck or moving in an unhelpful direction.

Thus, in general, there are four main modes of treatment in DBT, namely:

• Individual therapy;
• Phone number;
• Group skills training;
• Consultation groups with the therapist.

Stages of Dialectical Behavior Therapy

Patients may present several problems that may pose difficulties for the therapist when choosing prioritization. Thus, the following stages of treatment are indicated for the development of a better orientation:

• Pretreatment: assessment, commitment, and orientation to therapy;
• Stage 1:  Focus on suicidal and therapy-interfering behaviors and behaviors that interfere with quality of life, along with developing the skills needed to resolve these issues.
• Stage 2: Dealing with Post Traumatic Stress Disorders (PTSD)
• Stage 3:  focus on self-esteem and individual treatment goals.

When to use DBT?

DBT originally emerged with the purpose of being applied in the treatment of patients who had Borderline Personality Disorder. However, the applicability of the approach is no longer limited to just 1 disorder. Its effectiveness is proven in several other treatments, such as:

• Eating disorders;
• Substance-related disorders;
• Major Depressive Disorder (MDD).
• chronic MDD;
• Bipolar Mood Disorder (BBD);
• ​Post Traumatic Stress Disorder (PTSD);
• Attention Deficit/Hyperactivity Disorder (ADHD);
• Oppositional defiant disorder;
• Couples with intense emotional conflicts/conjugal violence (for violent partners);
• Relatives of patients with BPD and suicidal patients.

Dialectical Behavioral Therapy is a great option for therapists. However, knowing how and when to use it is essential. Knowing the main approaches of psychotherapy will make you become an even more recognized and renowned professional in the market.

For this, you can keep up to date through the courses and specializations that we have in our institute.