What is Dialectical Behavior Therapy?
DBT is a form of psychotherapy that uses one-on-one and group conversation to analyze and change negative behavior patterns. It helps participants gain more conscious control over their actions by breaking down the physical and psychological mechanisms behind harmful habits into distinct, manageable pieces. DBT builds skills including:
- Mindfulness — e.g., self-awareness and intentional actions
- Interpersonal effectiveness — e.g., healthy boundaries, clear communication and empathy
- Emotional regulation — e.g., constructive emotional outlets and physical influences on mood
- Distress tolerance — e.g., trigger identification and positive coping mechanisms
Participants learn to express themselves appropriately; to anticipate triggers and responses; to effectively communicate their needs and to build healthy coping and self-soothing habits. The goal of DBT is to ensure that any time an individual is at risk of falling into a negative behavior pattern, they are capable of recognizing their risk, taking steps to minimize it and ultimately avoiding the behavior altogether. This can apply to any range of behaviors, from substance use to panic attacks to anger management.
DBT practices have been carefully formed through years of research and study by doctors, scientists and other mental health professionals. DBT is a proven, effective method based on clinical evidence that people are capable of changing their behaviors, no matter how deeply rooted in their psyche those behaviors may be. While DBT was initially created to help patients struggling with borderline personality disorder and self-harm behaviors, its principles are appropriate for a wide range of mental health concerns as well as substance use disorders.
The applicability of DBT practices for substance use has made it a buzzword among treatment centers; however, not every center offering DBT adheres to its most vetted practices. Accrediting institutions have created a set of certified therapies and skills that are considered the standard of high-quality DBT treatment. At Stonewater, we have carefully crafted a unique DBT model with DBT-certified techniques specifically chosen to optimize our treatment for adolescents struggling with substance abuse and co-occurring disorders.
DBT at Stonewater
Stonewater believes in enacting lasting change for the adolescents we treat. We know that every young person in our program has so much to offer, and the treatment we provide ensures they can leave substance abuse behind to lead a fulfilling life. DBT is the key that unlocks our clients’ full potential: it allows them to be more self-aware, empathetic and in control, and it instills long-term healthy physical and psychological habits.
Our approach to DBT is entirely proprietary to our program. We intentionally incorporate elements of the certified DBT model, not only as specific therapies but also as a broader ethos underlying everything we do. DBT relies on active dialogue, self-acceptance and a willingness to work with others, on both the patient’s and the therapists’ part. DBT generates an environment of respect, teamwork and open-mindedness that encourages self-directed engagement, particularly among the age group we treat.
Part 1: Individual Introduction
In each patient’s first session with their therapist, they receive an individualized DBT orientation that includes an overview of DBT and what it looks like at Stonewater, as well as information about how this model promotes acceptance, change and long-term skill development. This orientation is an opportunity for therapists to start an ongoing conversation with the patient; it is not intended to be a lecture or a set of instructions, but rather an invitation to participate in the recovery process.
Part 2: Educational and Practical Modules
The official DBT model is composed of more than 30 skills that help patients establish healthier habits. At Stonewater, we focus on eight of these skills most relevant to our patients during their 60- to 90-day stays. Our goal is to ensure that every patient masters these eight skills completely, so they can leave our program and confidently implement them in everyday life right away. Within the first month of treatment, all eight skills are introduced through rotating therapy modules. Then, over the following weeks, they are reinforced through module repetition, practical applications and our other therapeutic modalities.
Part 3: An Intentional DBT-Informed Community
All members of Stonewater staff — including non-clinical team members — are trained in basic DBT principles. Every DBT therapy session is led, guided by or attended by two DBT-trained staff members who can employ DBT techniques within therapeutic exercises and utilize DBT skills to defuse emotionally charged situations.
DBT is incorporated across all of our modalities and within our patients’ daily schedules, including the following examples:
DBT is frequently group-based, as many of the skills we teach are intended to improve interpersonal relationships and communication. Often, the moments that trigger a negative emotional response or behavior pattern involve the actions or words of another person. Group therapy is the ideal setting to practice DBT-informed skills of self-awareness in conversation, learning about healthy boundaries and developing methods of de-escalation.
At Stonewater, we also incorporate educational group therapy sessions into patients’ regular programming. These sessions teach essential, practical DBT skills including self-care, nutrition, sleep and exercise while encouraging group participation and engagement with the subject matter.
Daily Individual Goal-Setting
Stonewater patients participate in a regular morning meditation session to take an emotional inventory for the day ahead. This includes anticipating challenges that may arise and preparing means of troubleshooting those challenges as they happen. These exercises emphasize the DBT principle of mindfulness: being aware of the moments that may cause distress and being able to intentionally employ a positive response rather than allowing a reflexive negative reaction to bubble to the surface.
Following the individual meditation session, patients participate in a group processing session to discuss their daily challenges and goals. Translating thoughts into words further cements patients’ confidence in their abilities to accomplish their goals, and the group setting encourages shared experiences, teamwork and empathy.
Physical activity is another component of DBT, strengthening the mind-body connection and often providing a healthy outlet for strong emotions. DBT also promotes the idea of the “wise mind” — a mental state at the intersection of emotion and reason where patients think, plan and execute rationally while still allowing room for emotions. The wise mind principle is often employed in problem-solving activities, particularly in fast-paced team activities where emotions may run high. Our adventure therapy sessions incorporate both of these ideals through outdoor group activities including ropes courses, mazes, team sports and more.
Adolescent Recovery at Stonewater
In DBT, the word “dialectic” refers to a philosophical mode of debate in which two people contribute equally to a conversation through questions and answers. At Stonewater, we believe that every person is on equal footing — we are all God’s creations, and we all deserve equal respect, dignity and empathy. DBT reinforces this mentality among our team and our patients, and we see the difference every day in the way every member of our community interacts with one another.
If you, your child or an adolescent in your life is in need of treatment for addiction or co-occurring substance use and mental health disorders, please reach out to Stonewater today. Our program is located in Oxford, Mississippi, and admissions are open to young people ages 12-18. Contact us today to learn more about what we do and how we can help you and your family overcome the consequences of substance use together.