Dabbling in Dialectical Behavioral Therapy (DBT) without adhering to its core principles can be detrimental to the effectiveness of treatment. At THIRA Health, a leading mental health treatment center, we understand the significance of practicing DBT with fidelity. In this article, we explore the dangers of deviating from true DBT and emphasize the importance of following its structured approach to providing optimal care for individuals seeking treatment for mental health.
Understanding True DBT: A Brief Overview
True DBT encompasses four essential modes of therapy, each playing a crucial role in promoting growth and healing:
Individual therapy
Group skills training
DBT consultation teams for therapists
On-call crisis counseling
Practicing True DBT with Fidelity: Unleashing the Power of Change
The primary goals of DBT, both for patients and therapists, revolve around fostering acceptance, facilitating behavioral change, and reducing extreme emotional symptoms. DBT is particularly beneficial for individuals grappling with severe symptoms that may be treatment-resistant, including self-harm tendencies and emotional instability. Hence, it becomes vital to prioritize the delivery of high-quality care, as it can sometimes be a matter of life or death.
Key Skills in DBT: A Path to Empowerment
DBT also involves honing four essential skills as part of the therapeutic process:
Mindfulness
Emotional regulation
Interpersonal effectiveness
Distress tolerance
The Four Stages of DBT: Thriving through a Structured Journey
A well-executed DBT treatment program provides patients with a structured framework that caters to their critical needs, guiding them beyond harmful behaviors and thoughts. Typically, patients progress through four stages during their DBT journey:
Initial stage: Patients may exhibit self-destructive tendencies, struggling with emotional instability and a sense of being out of control.
Intermediate stage: Harmful emotional states become less frequent, and self-harm tendencies decrease. However, emotional well-being is yet to be fully realized, and underlying issues demand attention.
Building stage: Empowering patients to construct the life they desire, equipped with essential emotional, interpersonal, and life skills necessary for a fulfilling existence.
Meaningful living (optional): While not applicable to all patients, finding a deeper sense of purpose in life becomes vital for some, ensuring that their progress remains purposeful and meaningful.
The Hazards of Deviating from DBT with Fidelity
The risks associated with straying from true DBT become apparent when considering the transformative journey patients undertake through the four stages. Each stage builds upon the successes and lessons of the previous one, making it crucial to adhere to the proper structure of DBT to avoid reversing progress and endangering patients' well-being.
Stage-Specific Hazards of DBT Without Fidelity
Insufficient structure in early stages:
Without the necessary support and consistent engagement provided by DBT practiced with fidelity, patients may feel discouraged, stuck in a cycle of unfulfilled progress, and plagued by persistent harmful thoughts and behaviors. The absence of on-call support or the omission of group work aimed at skill-building can leave patients feeling isolated, abandoned, or let down—an incredibly dangerous situation for individuals already experiencing emotional fragility.
At THIRA, we firmly believe that patients cannot fail at DBT. However, therapists can fail to practice true DBT, jeopardizing patients' well-being. That's why we prioritize fidelity to DBT, including comprehensive support systems for patients and ongoing professional development for our DBT therapists.
Overlooking deeper issues after initial progress:
While true DBT initially focuses on reducing harmful behaviors and emotional distress, it recognizes the importance of addressing underlying trauma and issues to foster lasting change. Skipping crucial structural components of a DBT treatment program prematurely can lead to the reemergence of symptoms, leaving patients to believe that therapy is ineffective or that they are personally failing. This misconception can hinder their overall progress and have a severe impact on their emotional well-being.
The failure of therapists attempting DBT without proper support:
Therapists require support systems that allow for idea exchange and shared experiences. Skipping this vital step deprives both therapists and patients of the necessary support. Without the support needed, therapists may experience burnout, struggle to find effective strategies for patients and fall behind in acquiring new skills essential to their practice. This lack of support can cause DBT to fail the patient or lead to the therapist's failure in delivering DBT.
THIRA Health: Practicing True DBT for Optimal Results
At THIRA Health, we uphold the fidelity of DBT, supporting our patients as they progress from severe symptoms to leading fulfilling lives. We prioritize the structure and comprehensive support inherent in true DBT to ensure our patients receive the best possible care. Contact us today to discover how our commitment to practicing DBT with fidelity can benefit you in your mental health journey.
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