Assumptions about Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) takes a unique approach to the therapeutic process by clearly laying out a contract of sorts between patients and their DBT therapists. Expectations, goals, and guidelines for conduct are defined and agreed upon as the course of DBT therapy begins.

Dialectical Behavior Therapy is an intensive, lengthy, and sometimes arduous process for both patients and their DBT therapists. It matters at the outset that both sides of the DBT equation are clear about what the ultimate goals are and how to best achieve them through mutual respect and commitment.

There are sets of Dialectical Behavior Therapy “assumptions” for both patients and DBT therapists that help to clarify one of the underlying principles of the DBT process – that it is a partnership of equals in which each side is afforded the benefit of the doubt but is also held accountable for a standard of behavior and personal responsibility.

Here is a look at the assumptions that Dialectical Behavior Therapy works off of:

DBT Assumptions: Patients

  • Patients are doing the best they can
  • Patients want to improve
  • Patients need to do better, try harder, and be more motivated
  • Patients may not have caused all of their own problems, but they have to solve them anyway
  • Patients must learn new behaviors in all relevant contexts
  • Patients cannot fail in DBT

The patient assumptions make clear that Dialectical Behavior Therapy does not seek to solve mental health-related problems for the client, but assumes that their success is a direct result of their own efforts to adopt new ways of thinking and behaving. There will be setbacks, difficulties, and struggles, but the patient is expected to be an invested, full participant in their own recovery.

DBT Assumptions: Therapists

  • The most caring thing a therapist can do is help patients change in ways that bring them closer to their own ultimate goals
  • Clarity, precision, and compassion are of the utmost importance in the conduct of DBT
  • The therapeutic relationship is a real relationship between equals
  • Principles of behavior are universal, affecting therapists no less than patients
  • DBT therapists can fail
  • DBT therapy can fail even if therapists do not

Assumptions about Dialectical Behavior Therapy clearly acknowledges the commitment of the DBT therapist to helping patients achieve their goals, but also acknowledges that therapists are fallible and human and that it is not realistic to imagine them otherwise.

Dialectical Behavior Therapy is a partnership that requires active participation on both sides. DBT assumptions make it clear that DBT seeks to view both DBT therapists and patients with compassion and understanding while still holding them accountable for fulfilling their role in the process.

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