What Is DBT?

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Dialectical behavioral therapy (DBT) is an effective combination of cognitive and behavioral therapies. The goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes.

The effectiveness of DBT has been shown to help people diagnosed with an eating disorder regulate their emotions, build self-management skills, reduce anxiety and stress, and control destructive eating behaviors.[1] DBT is a researched-based way to establish coping mechanisms to implement in environments that may elicit old, destructive patterns of eating.

How Did DBT Begin?

The Linehan Institute was founded by Dr. Marsha Linehan, professor of psychology at the University of Washington. The Institute conducts cutting edge research on DBT and found that DBT was originally effective for people diagnosed with Borderline Personality Disorder (BPD). DBT proved to help people experiencing severe suicidal thoughts and difficulty managing emotions.

The success of DBT on the BPD population has led to its ongoing research and success with people diagnosed with eating disorders. This is due to the fact that DBT helps patients establish coping mechanisms to reduce anxiety in situations and environments that elicit the stress response associated with food.[2] Anxiety levels increase when people recovering from an eating disorder are put in environments that trigger old responses. DBT can help to shift negative and impulsive thinking into positive self-talk and mindful eating behaviors.

How Does DBT Work?

DBT is used for people with severe cases of eating disorders. DBT is used to create a controlled environment for individuals to have the opportunity to practice regulating their emotions and managing their behaviors associated with the particular disorder.

DBT incorporates a combination of group and individual therapy sessions that seek to teach the individual valuable self-management skills in daily life.

Individual Therapy Sessions. Individual sessions are extremely valuable for creating behavioral plans and goals for mindful eating. Patients have the opportunity to work with psychologists, therapists, and eating disorder specialists to create an individualized behavior plan to implement in the person’s daily life. These sessions offer an empowering experience for the individual because they help to establish self-compassion and purpose in the person’s life beyond the disorder.

Individuals have the opportunity to examine a deeper meaning of their lives through the DBT process of recovery. They will set goals for themselves, incorporate activities they enjoy, and mindfully understand their process of struggle. Therapists work alongside individuals to empathize with their journey and to ensure self-compassion and mindfulness are a part of the recovery process. A positive self-identity is created in these sessions in which the person establishes self-compassion, acceptance, and an increased sense of self-worth and purpose.

Group Therapy Sessions. Group sessions provide essential life skills to individuals. These sessions help to teach self-management skills such as mindful eating in group environments. These sessions also cultivate group support and aid the individual in understanding how his/her journey is shared amongst others.

Interpersonal relationships are strengthened by guided group sessions. Individuals have the opportunity to connect with people who are experiencing a similar journey and this cultivates an understanding of the shared human experience.

Coaching. One of the most helpful features of DBT is that it is not exclusive to individual and group therapy sessions. If an individual is struggling in between sessions, coaches are available by phone to help the person through any painful moment. Individuals can speak to therapists, psychologists, and eating disorder specialists if they have any questions on how to implement a particular management skill or self-soothing technique.

How Skills Learned from DBT Can Help People Recovering from Eating Disorders:

The skills learned from DBT can easily be incorporated into a person’s everyday routine. The individual learns the deeper meaning and purpose behind each skill. The person has the understanding that these skills are essential for self-growth and a healthful human being.

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The following skills learned in DBT will help the individuals redefine their identity and lead a more healthful life:

Mindfulness: DBT helps individuals establish techniques for mindful eating and acceptance of the present moment. Patients will keep a diary and reflect on their moments of difficulty and success on their journey.

Distress Tolerance: Individuals will learn how to cope with situations that cause stress and anxiety by reframing their thoughts, implementing self-soothing techniques, and understanding the present moment.

Interpersonal Effectiveness: DBT helps individuals learn how to establish what they want and how to assess their needs while maintaining self-respect and healthy relationships with others.

Emotional Regulation: DBT seeks to aid individuals in how to understand, adapt, and change their emotions to improve their mindset and take positive actions.

The Success of DBT on Eating Disorder Patients

Research conducted by the Linehan Institute on groups of people with bulimia nervosa, binge-eating disorder, and anorexia have shown the skills learned from DBT to be highly effective. In the studies, self-injury, negative thoughts about self-image, and binge-eating behavior have decreased amongst patients. In addition, the research has also shown that patients were less likely to restrict their eating behaviors and have continued to improve in follow-up sessions.[3]

DBT transforms negative mental thoughts and behaviors into an understanding of the person’s journey. The skills learned from DBT sessions prompts people to react to stressful situations in more productive, positive ways. DBT is essential in eating disorder recovery because it provides whole-bodied treatment for the mind, body, and soul and ultimately helps to establish mindfulness and self-compassion.

Greta Gleissner is the founder of Eating Disorder Recovery Specialists, a nationwide network of eating disorder treatment specialists that provide meal coaching and recovery skills such as CBT, DBT, ACT, MI, etc. EDRS work alongside treatment programs, teams, and families to provide transitional aftercare support for post-residential treatment clients.

To find a therapist, please visit the Psychology Today Therapy Directory.