Dialectic Behavioral Therapy: A Skills Based Approach

Fran Dinehart, LCSW

 

By Fran Dinehart, LCSW

 

Recently I was privileged to attend a training on Dialectic Behavioral Therapy (DBT) hosted by Imagine Recovery, and am excited to integrate what I have learned into my therapy practice.  Although DBT was developed for people with borderline personality disorder, it also borrows widely from Mindfulness Based Stress Reduction and other well established therapeutic approaches, and the techniques can be widely applicable to a variety of problems.  This is the third training on DBT I have attended and have has success using its techniques with my clients with general anxiety and depression.  What I like about DBT is it’s “a la carte” approach to finding what works to help you live your best life.  I often use the metaphor of “expanding your toolbox.”  For example, when you have a chronic problem in your life triggering negative emotions, you have a few options you already know to try and deal with that situation.  The goal of creative and effective therapy is not to avoid all problems, which is unrealistic, but to give you more and better tools for how to deal with problems when they occur.  So like I said DBT did not invent communication skills training for example, but did come up with some really cute and easy to remember acronyms for specific interpersonal effectiveness skills.

 

One of my favorites is FAST (see below).  This is a skill to use when you are struggling to keep your sense of self-respect in your interactions with a challenging person.  Think of a recent situation in which you felt overly passive toward another person.  Think of an applicable value statement that is important to you and relevant to the situation, for example, “Bullying is wrong,” “People should be treated equally,” “Punctuality is important.”

 

Now hold that value statement in your mind and take on an assertive body posture in preparation for your next interaction with the difficult person and follow the mnemonic below:

F – be Fair to yourself and others

A – only Apologize if you are truly in the wrong.  Don’t apologize for having an opinion or needs and wants

S – Stick to values, don’t compromise your integrity, be clear on your values

T – be Truthful, don’t lie manipulate or act helpless when you are not

 

How did that feel? Is this a tool that might be useful to you in challenging situations?

To learn more about DBT, https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/