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Community Psychology and DBT
Community psychology, which works with individuals and groups in the context of their neighborhoods, schools, religious groups, and other social environments, offers a framework for addressing mental health that is sensitive to the particulars of local norms and cultures. Rather than focusing solely on individual treatment in isolated clinical settings, community psychology seeks to build environments that support mental health and help resilience and equity. Within this framework, there is a need for scalable, skills-based interventions that can be delivered outside of traditional therapy offices and that can reduce the burden on emergency services.
Dialectical Behavior Therapy (DBT)
can be integrated into community psychology to build mental and emotional resilience in vulnerable groups. While DBT is often thought of in the context of intensive individual or group therapy, its core skill modules can be adapted for broader community use. By integrating DBT principles into community-based services, schools, and crisis prevention programs, mental health systems can shift from reactive to proactive care, which can mitigate mental health issues before they reach the ER.
DBT and Mental Health
DBT has been shown to be effective across a range of conditions—including borderline personality disorder, major depressive disorder, bipolar disorder, substance use disorders, eating disorders, and posttraumatic stress disorder. Importantly for community settings, DBT is also associated with significant reductions in psychiatric hospitalizations and ER visits, among high-risk patients. In addition to the positive implications for clients and patients, reducing the strain on hospitals has clear benefits for the community at large.
Its structured, teachable format and emphasis on emotional regulation and interpersonal skills make DBT particularly well suited for community psychology..By teaching clients and community members to manage impulses and intense emotions, self-soothe, and deal with challenging relationships and social situations, DBT helps provide skills that answer many mental health challenges before they escalate to needing emergency care. These skills are not tied to a particular diagnosis and can be delivered in diverse settings, which makes them adaptable across cultures and populations.
In addition, DBT aligns with community psychology’s values of accessibility and prevention. Skills can be taught in groups, which is cost-effective and creates a shared language and skill set within communities. For clients who might otherwise fall through the cracks due to stigma or limited access, DBT offers an entry point that is practical, affirming, and clinically-backed.
DBT Interpersonal Skills for Community Psychology
While all of DBT’s skill modules can be used in community psychology, interpersonal skills can be particularly relevant, as they relate directly to how clients interact with the people around them. Anxiety stems from unresolved fear, while depression is connected to the sense of not being able to change a harmful or troubling situation. These skills can help people feel more efficacious in handling challenges and meeting their needs, thereby addressing these needs at a wider scale.
The DEAR MAN skill is especially helpful for those who struggle with conflict, whether that’s because they are too eager to please or too quick to aggression.
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- Describe: The client describes the facts as they see them, establishing a common ground to work from.
- Express: They go on to express how they feel, often using “I feel” statements to differentiate these feelings from the basic facts.
- Assert: The client that states what they want, making their needs known and not assuming that their ask is implied already.
- Reinforce: They then back up their statement by saying why getting what they are asking for will have positive consequences. In some cases it will make sense to also say why the reverse will have negative consequences.
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- Mindful: The client stays focused on their goal without getting distracted or sidetracked.
- Appear confident: Making good eye contact and keeping a confident physical posture helps the client assert themselves and be heard.
- Negotiate: Once the ask is made, the client can make concessions and offers, provided they are maintaining awareness of their own needs and values.
- FAST
FAST is another skill for making requests and approaching difficult conversations in a way that is respectful to both sides.
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- Fair: Clients are taught to be thoughtful about what is fair and reasonable to themselves and the person they are speaking to.
- Apologize: Requests sometimes come with apologies, if they introduce a burden on the other person. Apologies can also be essential for mending relationships. However, clients should be made to understand not to over-apologize to the point of demeaning or shaming themselves.
- Stick to values: Clients should have a clear hold on their own values, and stay true to their own beliefs as they discuss and negotiate.
- Truthful: In challenging conversations, it can be tempting to bend the truth. However, remaining truthful engenders mutual respect and avoids problems later on.
While the above two skills deal more directly with challenging interactions, GIVE is a relationship management skill that can be used in a wide variety of contexts. GIVE can be valuable in community psychology, because it creates a welcoming social environment for people to express their concerns and advocate for themselves.
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- Gentle: Clients take a gentle approach to their interactions, not starting with a stance that is too aggressive or heavy handed.
- Act Interested: This encourages clients to genuinely engage with others, even on topics that aren’t ones they are naturally drawn to.
- Validate: Often clients struggle to advocate for themselves and their communities because they see their own concerns as not important enough. Validating the thoughts and experiences of others helps people state and address their issues.
- Easy manner: Similar to taking a gentle approach, an easy manner can defuse an otherwise challenging situation.
Conclusion
Community psychology practitioners need evidence-backed techniques that can adapt to a range of contexts and individuals. DBT provides exactly that, and can help clients manage their own challenges and advocate for their school, age cohort, employee group or other community. As a practical and powerful set of skills that can be learned individually or in a group, DBT can help realize the goals of community psychology and reduce the strain on an emergency system designed for lifesaving care.
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