Dialectical Behavioral Therapy (DBT) is considered one of the most effective treatment options for borderline personality disorder (BPD) and other mental health disorders. As an evidence-based treatment, DBT combines cognitive and behavioral therapists to help people regulate emotions, transform negative thinking patterns, and change unhealthy behaviors.

How did DBT develop?

Dialectical Behavior Therapy (DBT) was created by Marsha Linehan, Ph.D., and colleagues in the late 1980s when they discovered that cognitive-behavioral therapy (CBT) alone did not work as well as expected in patients with BPD. Dr. Linehan, her team, and others have developed a treatment that meets the unique needs of these individuals.

DBT strategies

DBT teaches you four strategies that can help you change your behavior.

1. Mindfulness. Mindfulness skills help you center yourself in the present moment, whether you are meditating or simply sitting and breathing. It's an essential part of DBT, as it can help you be more aware of and in charge of emotional situations to move through them effectively. 
   
   
2. Distress tolerance. The concept of Distress Tolerance is the ability to accept and endure both emotional and physical distress (e.g., life's inevitable stressful events) without becoming overwhelmed with anxiety or discomfort. By learning how to handle being in a state of emotional distress, people can better control their own lives and not live out their problems through negative behaviors.
   
   
3. Interpersonal effectiveness. In DBT, interpersonal effectiveness is the skill to be able to manage relationships productively. This includes the ability to communicate effectively and identify strategies that will help you maintain desired relationship outcomes, as well as the ability to set boundaries. 
   
   
4. Emotion regulation. Emotion regulation is a set of skills you can learn to help you manage your emotions more effectively. The skills include identifying, naming, and changing emotions, as well as deepening and broadening them.

Aside from individual therapy sessions, DBT is often offered in group settings.  With guidance from experienced professionals, the group can offer an outlet for compassion, self-development, and learning strategies to cope with life stressors.

Is DBT right for you?

Although most DBT research has focused on its effectiveness for people with borderline personality disorder,  it may also be effective in treating: 

• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder
• Eating disorders (such as anorexia nervosa, binge eating disorder, and bulimia nervosa)
• Generalized anxiety disorder (GAD)
• Major depressive disorder (including treatment-resistant major depression and chronic depression)
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Substance use disorder

The bottom line

Overall, DBT helps clients find healthy ways to cope with problems while building skills that enable them to get the most out of life. If you or a loved one might benefit from DBT, it's essential to talk with a healthcare provider or mental health professional trained in the approach

School can be a source of support, belonging, learning, and community for kids. But for some, going to school can become challenging or distressing more than anything. According to the Anxiety and Depression Association of America (ADAA), school anxiety affects around 2% to 5% of school-age children.

If your child struggles with school anxiety, consider the following seven tips to see how you can best support them:

1. Have a discussion. Use their concerns as an opportunity to have an open discussion about what's causing them to feel anxious. Provide a supportive, safe place for your child to talk about school and what they're struggling with. While talking with them frequently, you have a chance to resolve issues before they escalate. 
   
   
2. Practice relaxation techniques: Talk to your child about strategies that help them feel calm. Deep breathing, guided imagery, and mindfulness are essential relaxation strategies that kids can practice at home and utilize in school. On the other hand, relaxation strategies could include things they can do after school-like spending time with particular friends, listening to music, playing outside, or watching their favorite movie.
   
   
3. Promote a consistent routine and structure: Anxious children benefit from predictable home routines. Avoid over-scheduling, as this can increase stress for anxious kids, and put specific morning and evening routines in place.
   
   
4. Role-play different scenarios. Once you’re aware of which situations at school cause your child to feel overwhelmed or anxious, rehearse potential responses and actions they could take. Over time, they’ll feel less anxious and more prepared to handle these situations as they arise. If your child is nervous about meeting new classmates, for example, you can ask your child questions and give them examples of how they can say hello and introduce themselves.
   
   
5. Stay mindful of your emotions. As a parent, it's hard to see your child having a hard time. You want to help, alleviate their stress, and reassure them. And although you can't control their emotions or every stress-provoking scenario they come across, you have a significant influence on how they respond to them. Kids look to your moods and reactions for clues on how they should handle stress.
   
   
6. Encourage good sleep hygiene: Sleep deprivation exacerbates symptoms of anxiety and stress. Develop good sleep habits, such as sleeping in a quiet, dark room and keep a regular bedtime schedule, including weekends.
   
   
7. Talk to the school guidance counselor. Meeting with the school counselor not only helps your child but can reassure you as well. They may present different options to you, like checking up on your child throughout the day or share other suggestions and strategies. 

Takeaway

Each child experiencing anxiety does so in their unique way. Learning about your child's specific experience can help you to be effective advocates and thoughtful parents. While school can sometimes be a challenge for kids, they can overcome the difficulties with the proper support.

Cognitive Behavioral Therapy (CBT) is considered to be the gold standard of psychotherapy for a number of reasons. As one of the best treatment options available for various mental health conditions, CBT aims to help you recognize and modify harmful thoughts, emotions, and behaviors. Although this technique has been around for some time now, it continues to be a viable and effective option for many who suffer from depression or anxiety.

The cycle of thoughts and behaviors

Here’s a closer look at how thoughts and emotions can influence behavior:

• Negative or unhelpful thoughts cause emotional distress.

• The distress you experience as a result of these unhelpful thoughts ultimately leads to unhelpful or harmful behavior.

• Over time, these thoughts and behaviors become a pattern.

CBT addresses these specific patterns to help you deal with stressors and problematic situations as they arise so you can better manage them now and in the future.

CBT strategies

So, how does one go about reworking these patterns? CBT involves the use of many techniques. Your therapist will work with you to find those that work best for you.

Overall, the goal of these techniques is to replace unhelpful or self-defeating thoughts with more encouraging and realistic ones. Here are some of the most popular strategies used in CBT:

Goal setting. Setting goals is one of the first and most essential steps in CBT. Your therapist will work with you to identify your goal, distinguish between short and long-term goals, set SMART goals, and guide you throughout the process to get to the desired outcome.

Journaling. You may be asked to keep track of any negative thoughts or beliefs that occur between sessions, as well as how you handled them. This is also a great way to practice new skills and address any difficulties you come across. 

Cognitive restructuring. This involves analyzing and modifying any cognitive distortions (also known as thinking errors) that are affecting you— such as black-and-white thinking, jumping to conclusions, or catastrophizing. 

Thought recording. In this technique, you’ll come up with unbiased evidence supporting your negative belief and evidence against it. Then, you’ll use this evidence to develop a more realistic thought.

Practice new skills. Homework is one of the most important aspects of cognitive-behavioral therapy because it helps you practice the skills you've learned in session. You may start practicing new coping skills, relaxation techniques, or rehearing new thinking patterns when you're in a stressful situation or faced with a trigger.

Situation exposure. In most cases, CBT is a gradual process that guides you in taking the steps needed for behavior change. For example, if you're afraid of public speaking, you might first practice getting up and talking in front of only one or two people. As time goes on, you might work your way up giving speeches in front of larger crowds.

What can CBT help with?

CBT can be effective as a short-term treatment that teaches people how to modify their thoughts and beliefs. CBT is used in treating a variety of conditions, including

• Addictions
• Anger issues
• Anxiety
• Bipolar disorder
• Depression
• Eating disorders
• Panic attacks
• Personality disorders
• Phobias
• Stress management

Takeaway

Cognitive-behavior therapy can help you view yourself and your issues in a new light, and help you make lasting change. If you feel that you could benefit from CBT, contact a CBT therapist or counselor to see if it’s right for you.

If you’ve ever experienced trauma, anxiety disorder, or panic disorder, then you may have realized just how much it can control you.  For many people, exposure therapy may be a way to regain that sense of control, and ultimately overcome your fears.

This article covers the basics of exposure therapy, how it can help, and what you can expect if you're suffering from severe anxiety or phobias.

What is exposure therapy?

Exposure therapy is a psychological technique that involves gradual, controlled exposure to the thing you're afraid of through repeated and prolonged contact. With the guidance of a professional, you'll ultimately feel more confident in your ability to cope with the fear and get past it. 

How does exposure therapy work?

Typically, when someone experiences an anxiety-provoking fear, they’ll go out of their way to avoid any reminders of it. Although avoidance provides temporary, short-term relief, this pattern only strengthens the fear itself. 

 Exposure therapy aims to reduce those irrational fears that someone experiences once they've assigned them to an object or situation by gradually exposing them to various aspects of it. 

Together, the therapist and client work to define the best treatment method based on their experiences and present circumstances. While it's meant to help regain a sense of control, exposure therapy actively confronts a person's fears and anxieties, so it must be done incredibly carefully by a trained therapist. 

What techniques are utilized?

Exposure therapy can take several different forms to promote the reduction of distressing emotional responses. Generally, these methods can include:

• In vivo exposure: During in vivo exposure, a person will confront a phobia or fearful situation in real-time. For example, if someone has a phobia of enclosed spaces, they may gradually work their way up to riding in a crowded elevator.
• Imaginal exposure: If a real-world exposure isn't feasible, a therapist will guide someone in confronting it mentally by picturing it in their mind. Imaginal exposure is commonly used for complicated or dangerous scenarios-such as combat-related PTSD.  Visualizing the origin of fear or anxiety with a therapist can reassure someone that they're safe and ultimately reduce feelings of distress.
• Virtual reality exposure: Virtual reality, like imaginal exposure, is a tool that can be used to help people confront fears and worst-case scenarios. For example, someone with a crippling fear of flying can take a flight virtually in their therapist's office, using equipment to replicate the same sounds, sights, and smells they would experience if they were actually on a plane. 

• Interoceptive exposure: The technique of interoceptive exposure involves creating bodily sensations closely resemble those associated with panic and anxiety. Despite being harmless, these sensations would cause a lot of distress to someone with anxiety or panic disorder. 

Who can benefit from exposure therapy?

Exposure therapy can help treat a variety of anxiety and fear-based disorders, including:

• Phobias
• Panic Disorder
• Social Anxiety Disorder
• Obsessive-Compulsive Disorder
• Posttraumatic Stress Disorder
• Generalized Anxiety Disorder

How can it help?

Based on a significant amount of research, exposure therapy has proven to be a safe technique that promotes the following:

• Habituation: A natural process that happens over time; habituation is when a person finds themselves responding less to feared situations or stimuli. 

• Extinction: Exposure can help reduce or weaken the association between the feared object or situation.

• Self-efficacy: Exposure therapy can help show someone that they can confront their fears and manage discomfort. 

• Emotional processing: Throughout treatment, a person can adopt more helpful, realistic beliefs about their fears, ultimately becoming more accepting and comfortable with them.

Taking the next step

Although there are different ways to deal with trauma and many different exposure therapy types, the key is to find a mental health professional who can execute the most suitable treatment for your situation. When done efficiently, the outcomes can be life-changing.