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Why dialectical behavior therapy is so effective

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“We’re dealing with someone’s future – not just after 30, 60 or 90 days – but their entire lifetime,” explains Tikvah Lake Recovery’s Clinical Director Dr Jeff Allen. “The therapy we feel works the best is cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT). Both are used for individuals that have addictions or a mental health issue.”

So what is CBT and DBT and why are they such effective therapies? As their name suggests they are connected as DBT is in fact a type of CBT.

CBT seeks to identify and alter negative thinking patterns. If these can be replaced by positive thinking it causes beneficial behavioral changes.

DBT developed from CBT, that in turn can be seen to have started with the development of “behavior therapy” around 100 years ago. Then psychologist Alfred Adler (1870-1937) is considered by many experts to be the first to address cognition – the mental process of acquiring knowledge and understanding through thought, experience and the senses.

In fact Adler is seen as the father of CBT. He realized the link between thoughts and feelings and that similar events can be differently interpreted because of the meaning that is placed on them.

So for instance if someone is asked to help clean the dishes they may start thinking it’s because the person who’s asking is angry with them because they are never good enough. They will then feel scared and sad. However, most people would just see that they are being asked to help.

Adler worked on the fact that enduring positive change required getting outside of our comfort zone. His work strongly influenced psychologist Albert Ellis (1913-2007) who developed the first form of CBT in the 1950s.

Ellis thought people frequently have mistaken beliefs about situations they’re in. These beliefs cause problems and distress. But through various techniques they can be challenged and changed.

He termed his theory rational emotive behavior therapy (REBT). From REBT came CBT in the 1960s and then DBT that was first used in the 1980s by psychologist Marsha M. Linehan.

She had developed DBT to treat borderline personality disorder (BPD). Since then, it’s been used to treat other mental health illnesses.

“Dialectical” means “concerned with or acting through opposing forces”. It came from the theory that bringing together two opposites in therapy – acceptance and change – was much more effective than having just one or the other.

DBT aims to:

  • Teach the client how to live in the now.
  • Control emotions.
  • Improve relationships with everyone in the client’s life.
  • Develop positive methods to deal with stress.


DBT has been especially effective in treating BPD. This is a mental illness that most often causes a distorted sense of self, excessive emotional reactions and a long-term series of unstable relationships.

A person with BPD often suffers from abandonment fears and feelings of emptiness. There is also frequently an overwhelming and frightening detachment from reality.

Depression, eating disorders and substance abuse are frequently connected to BPD. In one study the lifetime prevalence of BPD was 6.2 percent of women and 5.6 percent of men.

DBT has been used to help with: 

  • BPD.
  • Substance abusers (particularly those with BPD).
  • Mood disorders such as bipolar disorder.
  • Attention deficit hyperactivity disorder (ADHD).
  • Binge eating.
  • People with chronic thoughts of suicide.
  • Post-traumatic stress disorder (PTSD).
  • Bulimia.
  • Self-harm.


How does DBT work?

Treatment commonly starts with guiding someone to accept themselves and their life how it actually is. This is as opposed to how they think it should be.

Then the therapist will help them recognize they need to change how they are if they want to survive and get on in their life. So after accepting themselves they need to realize they have to make changes.

So for instance with someone who has substance abuse problems a DBT therapist will steer them towards accepting they are abusing substances. When this point has been reached the therapist will guide them to start taking certain actions to make changes.

In this way DBT is similar to the 12 Steps that’s used for recovery by such as Alcoholics Anonymous. Our guests can be introduced to the 12 Steps as part of our 30-90 Day Personalized Treatment Program.

DBT aims to help someone regulate their emotions. One way to do this is with “distress tolerance” where a strong emotion like anger is recognized and felt without the person reacting as they usually have by such as turning to substance abuse.

Mindfulness is also a part of DBT. This is when a person learns how to keep life in the now and gain awareness of self and others.

DBT will also look to help with self-esteem. Connected to that is the person’s relationship with themselves and others. DBT will attempt to improve feelings of connection.

Why DBT is especially beneficial in a luxury rehab center

Better connection is a major reason why DBT therapy is so effective in a recovery center. This is because there are others around who are also trying to improve their emotional and mental health wellbeing – and that gives an instant connection.

Then there is our experienced team that is on hand to help 24 hours a day while you are a guest with us. This means you have someone to talk to whenever you need or get any help you might want.

We ensure that every meal is healthy, nutritious and made only with the finest ingredients. Our first-class chef Jason Shenefield makes sure every meal is delicious. There are also fresh healthy snacks including fruit available all day long.

We have helped many people from the entertainment industry as well as executives and governors. Treatment here is completely confidential and personalized – we only ever have a maximum of six guests.

So many positive outcomes show us we have the most effective treatments. These are complemented by our luxury house and its beautiful surroundings right beside a tranquil lake in stunning natural scenery

“We are a home here at Tikvah Lake,” says Dr Jeff Allen. “When I think of home I think of dinners, family, love, help, smiles and laughter – and we have this right here.

“We try to develop a place where our guests feel wholesome – they feel there is hope. We try to do everything we possibly can to get our guests back into a restored lifestyle.”

We would love for you to see this for yourself and feel the benefits. Contact one of our experts today to discover what we can do for you or someone you love.

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David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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