PROGRAM SPOTLIGHT:

Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a treatment modality that POWER staff is adding to its skills base thanks to training by POWER’s Associate & Clinical Director, Diane Johnson.

Avoiding painful feelings makes sense. Feelings of fear, anxiety, and shame can be overwhelming at times and can often drive us to behave in ways that we may not be proud of, leading to even more shame. It becomes a vicious cycle, with emotions causing us to behave badly, and our “bad” behavior making us feel even worse. Round and round we go. This kind of emotional dysregulation is commonly seen in women who have a history of trauma and substance abuse often alleviates painful emotions such as shame, sadness, and loneliness. Unfortunately, in the end, substance abuse just causes more pain and suffering. However, it may seem to some that taking away the substance andjust leaving a person open and exposed to their own painful emotions is cruel and unusual punishment. It is one reason the work of recovery can be so difficult. The good news is women in early recovery can acquire skills to help them tolerate painful emotions without the use of substances as a numbing agent. In fact, it’s essential.

When emotional dysregulation plays a significant role in a woman’s continued use of alcohol and other drugs, as it often does in trauma victims, Dialectical Behavior Therapy (DBT) seems to be a good fit. DBT was originally developed for individuals with affective dyscontrol — episodic but intense feelings of depression, irritability, or anxiety, resulting in uncontrollable, frequently violent and self-harming behavior, including abuse of alcohol or other drugs. All DBT strategies directly or indirectly serve to enhance emotion regulation with the overarching goal of helping the client build a life worth living. Through the practice of skills, clients gain balance in their lives, especially as it relates to acceptance of life on life’s terms and the need for change. This balance of acceptance and change is fundamental to DBT and is consistent with the philosophical approach of 12-Step programs expressed in the serenity prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference”.

It is for these reasons that POWER staff has been introduced to DBT. Through workshops and a series of DBT skills sessions, POWER is learning DBT principles and concepts and practicing those skills. POWER has embraced the DBT Assumptions (what we assume about others) and the DBT Therapist Consultation Agreements (how we agree to treat others) to futher strengthen the foundation of POWER’s trauma-informed work. The DBT skills include Core Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance. Many POWER staff members have participated in the DBT workshops and skills training series. Staff learns the skills in a group setting just as a client attending DBT skills training would. Staff is faced with the challenges of doing “homework”, completing diary cards, and practicing the skills on a daily basis, while being exposed to how a DBT skills group can be structured. Introductory DBT trainings will continue into this new fiscal year with a plan to start a DBT skills group for clients by the end of the calendar year.