Dialectical-Behaviour Therapy

Dialectics refer to “the existence of opposites”¹. Dialectics acknowledges that life is complex, and health does not remain static. It is an ongoing, changing process that is negotiated continuously through self and others. DBT constantly works to balance opposing forces². There is a need to investigate powerful negative emotions without having to get stuck in them. A core feature of DBT is “building a life worth living”³. It features a culmination of the importance of both acceptance and change by accepting clients as they are and where they are in their experience in their past, present, and future, while also aiming for change and progress through strategies aimed at problem-solving, acceptance, and distress tolerance. Dialectics aims at synthesizing these opposites in treatment. 
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The guidelines of the DBT treatment approach indicate what to treat and when to treat it in various stages. Stage 1 is dedicated to decreasing imminent harmful behaviours (particularly related to suicide); decreasing behaviours that are reducing quality of life, such as substance use and unemployment; and increasing skills and coping mechanisms. Stage 2 refers to controlling actions while allowing for the client to experience their emotions. Stage 3 is aimed at reducing problems in living, and stage 4 is focused on reaching completeness and joy³. 
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There are further manualized psychoeducational skills training approaches in areas of mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. Mindfulness is used to develop the wise mind and participate in the present without judgment. Distress tolerance teaches how to tolerate strong emotions and pain without escalating conflict, with self-soothing or distracting activities for short-term crisis and radical acceptance for more chronic emotional challenges. Interpersonal effectiveness involves setting boundaries and developing and maintaining healthy relationships. Emotional regulation teaches self-validation of emotions, including identifying emotions and understanding how certain emotions become triggered as well as thoughts, body sensations, and actions that arise from various emotions⁴. Pervasive emotional dysregulation shapes the ethology and symptomology of many diagnoses⁴. By incorporating tenets of CBT, DBT helps clients become aware of and challenge their thinking patterns as they pertain to negative feelings and unproductive or harmful behaviours².