A balance between acceptance and change strategies in therapy form the fundamental “dialectic” that resulted in the treatment’s name. “Dialectic” means ‘weighing and integrating contradictory facts or ideas with a view to resolving apparent contradictions.’ In DBT, therapists and clients work hard to balance change with acceptance, two seemingly contradictory forces or strategies. Likewise, in life outside therapy, people struggle to have balanced actions, feelings, and thoughts. We work to integrate both passionate feelings and logical thoughts. We put effort into meeting our own needs and wants while meeting the needs and wants of others who are important to us. We struggle to have the right mix of work and play.
The most important of the overall goals in DBT is helping clients create “lives worth living.” What makes a life worth living varies from client to client. All clients have in common the task of bringing problem behaviors under control. For this reason, DBT organizes treatment into four stages with targets. Targets refer to the problems being addressed at any given time in therapy. Here are the four stages with targeted behaviors in DBT:
Stage I: Moving from Being Out of Control of One’s Behavior to Being in Control
Stage II. Moving from Being Emotionally Shut Down to Experiencing Emotions Fully
Stage III. Building an Ordinary Life, Solving Ordinary Life Problems
Stage IV. Moving from Incompleteness to Completeness/Connection
In DBT, there are treatment strategies that are specifically dialectical; these strategies help both the therapist and the client get “unstuck” from extreme positions or from emphasizing too much change or too much acceptance. These strategies keep the therapy in balance, moving back and forth between acceptance and change in a way that helps the client reach his or her ultimate goals as quickly as possible.
Estelle Thibodeau
Licensed Independent Clinical Social Worker
(603) 941-4878
Licensed Independent Clinical Social Worker
(603) 941-4878
CKR
