Understanding the Four Pillars of DBT: A Path to Emotional Balance
Standard DBT has four primary modes of treatment delivery. This is different than many other psychotherapies that consist of just one mode or aspect of treatment, such as individual therapy.
Individual Psychotherapy
Individual psychotherapy is a mode that serves two functions within DBT.
Enhance Motivation with Individual Therapy:
DBT individual therapy is focused on enhancing client motivation and helping clients to apply the skills to specific challenges and events in their lives. In the standard DBT model, individual therapy takes place once a week for as long as the client is in therapy, and it runs concurrently with DBT skills training.
Structure the Environment with Case Management in Individual Therapy:
Case management strategies help the client manage his or her own life, such as their physical and social environments. The therapist applies the same dialectical, validation, and problem-solving strategies in order to teach the client to be his or her own case manager. This lets the therapist consult to the patient about what to do, and the therapist will only intervene on the client’s behalf when absolutely necessary.
Skills Training
Problematic behaviors evolve as a way to cope with a situation or attempt to solve a problem. While these behaviors might provide temporary relief, they often are not effective in the long-term. DBT assumes that clients are doing the best they can, AND they need to learn new behaviors in all relevant contexts.
Enhance Capabilities
The function of DBT Skills is to help enhance a client’s capabilities. There are four skill sets taught in DBT:
Mindfulness: the practice of being fully aware and present in this one moment
Distress Tolerance: how to tolerate pain in difficult situations, not change it
Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
Emotion Regulation: how to change emotions that you want to change