Navigating Workplace Stress with DBT

Discover how Dialectical Behavior Therapy (DBT) provides employees with valuable tools to manage stressors and contribute to emotional resilience in high-pressure environments.

By Renaldo Pool, BHSc

Key takeaways

• To be aware of workplace stressors and understand how to implement the DBT approach for mitigating distress and managing emotional situations.
• The core DBT focus points—mindfulness, tolerating distress, regulating emotions, and improving interpersonal effectiveness—highlight the construct of navigating stressful situations in the work environment.
• Various strategies exist within DBT that aid in emotional regulation.
• DBT possesses techniques that contribute to practical interpersonal skill development and create a supportive workplace culture.
• Implementing DBT training sessions for management brings a positive approach to the work environment. The necessary skills are taught for management to understand and support their teams.

Introduction

If workplace stressors and the feeling of impending doom have you on the edge of your seat, contemplating whether you can manage excessive workloads, navigate circumstances out of your control or rise above a poor organizational culture, the answer is yes. And the time is now.

Implementing multifaceted dialectical behavior therapy (DBT), a versatile and multifaceted approach traditionally used in psychotherapy, can provide a roadmap for navigating today’s dynamic work environment. In the long run, these fast-paced and high-pressure environments result in overstimulation and emotional dysregulation. DBT introduces an individual to the tools necessary for combatting the various stressful challenges they will face in the workplace. It will improve mental health while simultaneously contributing to cognitive enhancement.

Typical Stressors in the Work Environment

An excessive workload.

• Poor relationships with co-workers and managers. ?
• Ineffective management practices that lead to strenuous working conditions.
• A need for a better work-life balance.
• Insufficient training can lead to poor job performance.
• Lack of control and support due to poor job design and a negative organizational culture.

What is DBT?

DBT is considered an alternative approach and an extension of cognitive behavioral therapy (CBT) to manage emotional dysregulation related to stress-associated cognitive conditions (Afshari et al., 2022). It combines two therapeutic practices, conventional CBT intervention and Zen Buddhism principles, as well as other acceptance-oriented approaches. By integrating these different aspects and effectively implementing them, individuals can sufficiently navigate stressors in the workplace.

It was initially proposed in the 1980s by Dr. Marsha Linehan to assist with borderline personality disorder (BPD) but has since been adapted to incorporate other mental health conditions. DBT is versatile in its application and, therefore, can also be facilitated in today’s work environment for anxiety and stress-related management.

DBT’s Core Principles

• Mindfulness
• Tolerating distress
• Regulating emotions
• Improving interpersonal skills

Emotional Dysregulation and Implementing DBT

The concept of emotional dysregulation refers to the inability to control and manage your emotions and responses effectively. It comprises a heightened emotional state, poor coping mechanisms, and a lack of impulse control. The DBT approach indicates that the state of unregulated emotions is influenced by an intricate combination of neuroscience, biological, psychological, and social factors - called the neurobiopsychosocial model (NBPS).?This model proposes that each person possesses emotional triggers, and when influenced by unfavorable environmental factors, it results in difficulty managing one’s emotions. When our thought processes are irrational or biased, they contribute to negative emotional states and maladaptive behaviors.

Critical influences of this cognitive model cause different cognitive distortions. Individuals express an all-or-nothing approach to thinking, exaggerating and overgeneralizing circumstances. This way of thinking causes heightened emotional distress. It is also accompanied by poor behavior in response to situations due to a lack of emotional regulation, which could lead to unhealthy coping mechanisms.

This is where the DBT approach enables individuals to take charge of their emotions, thought processes and behaviors through critical skills training. This includes emotional management, incorporating mindfulness practices, and dialectical thinking (Marshall et al., 2024). Dialectical thinking consists of acknowledging multiple perspectives of a situation and considering opposing opinions. The aim is to reduce black-and-white thinking, creating a subtle understanding of emotions and behaviors. Integrating psychoeducation to comprehend how your emotional state is adaptive enhances an individual’s emotional resilience. Individuals are encouraged to engage in behavioral interventions to form healthier coping mechanisms.

?

By incorporating an acceptance-based strategy with Zen Buddhism principles, individuals are able to acknowledge their thoughts and emotions in a non-biased state. Acceptance of one’s emotions reduces the need for immediate reaction to stress-induced situations, and cognitive restructuring ensues. In addition, it mitigates a heightened emotional response from occurring.

DBT and Neuroscience

Recent studies have indicated the structural changes in the brain that occur with DBT strategies, especially in the brain regions focusing on emotional regulation and cognition (Mancke et al., 2018; Weyandt et al., 2020; Vijayapriya and Tamarana, 2023).

1. Increase in grey matter volume: With DBT, an increased volume in specific areas associated with higher cognition, such as the anterior cingulate cortex, inferior gyrus, and superior temporal gyrus, contributes to enhanced neuroplasticity and cognitive capabilities. The skill set associated with the DBT approach further emphasizes improved emotional and mental processing.
2. Improved functional connectivity: DBT can also improve the functional connectivity between the limbic and prefrontal regions of the brain while reducing limbic hyperarousal and altering brain activity patterns. This change allows for better control of emotional regulation during cognitive tasks.
3. Cognition enhancement: Improvement of cognition activities, such as attention, memory, and executive functions, across different mental health conditions, such as Borderline Personality Disorder (BPD), bipolar disorder, as well as Attention Deficit Hyperactivity Disorder (ADHD). This further highlights the transdiagnostic application of DBT effectiveness relating to other mental health conditions that are associated with emotional instability.

Advancements in DBT

Since its initial development to address BPD, it has evolved and expanded for application across various mental health disorders for different demographic groups. Studies have indicated the use of DBT for treating depression-associated symptoms in treatment-resistant depression, as well as for the adolescent population, preventing self-harm and suicidal behavior (Junkes et al., 2024). The transdiagnostic use of DBT has also been reviewed, providing research-based evidence of its versatility for other psychiatric disorders with different clinical presentations, i.e., post-traumatic stress disorder (PTSD), anxiety and eating disorders (Vijayapriya and Tamarana, 2023).

DBT intervention has also provided evidence for enhancements in various cognitive functions, with improvements in attention, inhibitory control, memory, fluency, planning, response inhibition, decision-making, and set-shifting. When comparing DBT and CBT interventions, the incorporation of skills learning during DBT was found to facilitate cognitive restructuring and increase neural plasticity, specifically in Generalized Anxiety Disorder. Other studies have been exploring the combination of DBT strategies with pharmacotherapy.

In addition, online and hybrid DBT formats have indicated their effectiveness through tailored approaches for each individual’s needs by maintaining the core DBT principles to ensure the optimal outcome (Lakeman et al., 2022). Lastly, there is a need for standardized measurement prior to DBT intervention and after treatment to gauge an individual's progress, ensuring optimal results (Gillespie et al., 2022; Azevedo et al., 2024).

Practical Implementation in the Workplace

1. Mindfulness exercises and workshops
2. Interpersonal Effectiveness
3. Self-soothing techniques
4. Stress Management Programs
5. DBT skill training for Management

The CBT method versus the DBT method

CBT and DBT are considered effective therapeutic strategies, although they differ in their methods and applications (Afshari et al., 2022). Where CBT focuses on identifying and restructuring negative thought patterns, DBT implements Zen Buddhism philosophies for accepting unfavorable conditions while promoting mindfulness and tolerating stress through skill learning. With these techniques, CBT has been widely implemented across various mental health conditions (American Psychological Association, 2017; Better Health Channel, 2022). DBT was initially used for borderline personality disorders but has since been exacerbated for other mental health conditions accompanied by emotional dysregulation.

The Combined Effect of CBT and DBT

The good news is that these two approaches overlap in various aspects, such as sharing a common goal of managing maladaptive behaviors to alleviate emotional distress (American Psychological Association, 2017; Better Health Channel, 2022).

• It provides a comprehensive approach that considers various factors for an optimal outcome for individuals experiencing emotional turmoil.
• Healthier coping mechanisms can be formed, which benefits stress management, anxiety and other emotional challenges.
• It creates an environment of self-awareness where individuals acknowledge their thoughts, behaviors and feelings.
• A boost in interpersonal relationships, improving communication.
• The necessary tools are taught that aid in a reduced risk of relapse, especially for individuals with substance abuse disorders.
• Complex issues become more accessible to navigate.
• Cognitive restructuring, alongside the core principles of DBT, contributes to effective stress and emotion management.

Conclusion

The adaptability of DBT’s comprehensive approach across various mental health conditions emphasizes the necessity of implementing it for stress management in the workplace. It also provides a framework for managing emotional dysregulation caused by multiple stressors. By highlighting mindfulness, emotional regulation and interpersonal improvement, DBT provides individuals with the tools to manage their emotions and behaviors.

An organization’s commitment to creating awareness of mental health and emotional well-being cultivates a support network and builds employee resilience. Implementing DBT-based strategies can result in healthier work environments, overall employee satisfaction, and increased productivity.

The ongoing exploration of DBT-based applications in various contexts can set the foundation for its essential role in boosting emotional and cognitive functioning in the modern work environment. Furthermore, advancements in research provide valuable insight, highlighting the necessity to understand neurobiological processes in evidence-based interventions for optimal treatment outcomes.

Frequently Asked Questions

1.????? How can the effectiveness of DBT interventions for stress management be measured in the workplace?

Assessing the efficacy of DBT-based strategies for stress management in the work environment is necessary. By developing standardized metrics and incorporating longitudinal studies, the influence of DBT can be measured on employee well-being and the overall organizational culture.

2.????? How can cognitive involvement and improvement be analyzed with DBT strategies?

Neuroimaging techniques, such as fMRI, can be used to investigate cognitive improvement after DBT interventions.

3.????? How can digital tools be incorporated for DBT stress management in the work environment?

With increased machine learning development, algorithms and AI-coupled interventions can be established to create DBT-based tools tailored to an individual’s unique stress profile. A personalized approach to treatment for each case could become the future.

4.????? How can DBT skills training be monitored for efficacy through management training programs?

Assess the effect of DBT training on management through longitudinal studies. Transparently reporting the outcomes of such a study could motivate the implementation of DBT-based strategies.

References

1.????? Afshari, B., Jafarian Dehkordi, F., Asgharnejad Farid, A. A., Aramfar, B., Balagabri, Z., Mohebi, M., Mardi, N., & Amiri, P. (2022). Study of the effects of cognitive behavioral therapy versus dialectical behavior therapy on executive function and reduction of symptoms in generalized anxiety disorder.?Trends in psychiatry and psychotherapy,?44, e20200156. https://doi.org/10.47626/2237-6089-2020-0156

2.????? American Psychological Association. (2017). What Is Cognitive Behavioral therapy??American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral?

3.????? Azevedo, J., Carreiras, D., Hibbs, C., Guiomar, R., Osborne, J., Hibbs, R., & Swales, M. (2024). Benchmarks for dialectical behavioural therapy intervention in adults and adolescents with borderline personality symptoms.?International journal of clinical and health psychology : IJCHP,?24(2), 100446. https://doi.org/10.1016/j.ijchp.2024.100446

4.????? Bay Area CBT Center. (2024).?Practical DBT Therapy for Stress Management. https://bayareacbtcenter.com/dbt-therapy-for-stress-management-skills/?

5.????? Better Health Channel . (2022).?Cognitive Behaviour Therapy. Vic.gov.au. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy?

6.????? Catapano, P., Cipolla, S., Sampogna, G., Perris, F., Luciano, M., Catapano, F., & Fiorillo, A. (2023). Organizational and Individual Interventions for Managing Work-Related Stress in Healthcare Professionals: A Systematic Review.?Medicina (Kaunas, Lithuania),?59(10), 1866. https://doi.org/10.3390/medicina59101866

7.????? Cognitive Behavioral Therapy (CBT) vs. Dialectical Behavior Therapy (DBT). (2024). Paloaltou.edu. https://concept.paloaltou.edu/resources/business-of-practice-blog/cbt-dbt?

8.????? DBT: Dialectical Behavior Therapy - Skills, Worksheets, & Videos. (n.d.). DBT. https://dialecticalbehaviortherapy.com?

9.????? DBT vs CBT Therapy: Choosing the Best Approach. (2024). The Counseling Center Group. https://counselingcentergroup.com/dbt-vs-cbt-therapy/?

10. Gillespie, C., Murphy, M., Kells, M., & Flynn, D. (2022). Individuals who report having benefitted from dialectical behaviour therapy (DBT): a qualitative exploration of processes and experiences at long-term follow-up.?Borderline personality disorder and emotion dysregulation,?9(1), 8. https://doi.org/10.1186/s40479-022-00179-9

11. Greenwald, A. (2020).?DBT Mindfulness: Quick and Easy Exercises | DBT Therapy NYC. Empower Your Mind Therapy. https://eymtherapy.com/blog/dbt-mindfulness-exercises/?

12. Junkes, L., Gherman, B. R., Jose Carlos Appolinario, & Nardi, A. E. (2024). Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis.?PloS One,?19(5), e0303967–e0303967. https://doi.org/10.1371/journal.pone.0303967?

13. Lakeman, R., King, P., Hurley, J., Tranter, R., Leggett, A., Campbell, K., & Herrera, C. (2022). Towards online delivery of Dialectical Behaviour Therapy: A scoping review.?International journal of mental health nursing,?31(4), 843–856. https://doi.org/10.1111/inm.12976

14. Mancke, F., Schmitt, R., Winter, D., Niedtfeld, I., Herpertz, S. C., & Schmahl, C. (2018). Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder.?Journal of psychiatry & neuroscience : JPN,?43(3), 171–181. https://doi.org/10.1503/jpn.170132

15. Marshall, L., Kletzka, N., Kanitz, J., Opperman, K. J., & Rockwell, J. (2024). Effectiveness of Dialectical Behavior Therapy (DBT) in a Forensic Psychiatric Hospital.?Journal of the American Academy of Psychiatry and the Law Online,?52(2). https://doi.org/10.29158/JAAPL.240009-24?

16. Pindar, J. (2022).?Top 10 Causes of Stress at Work | 2022. Champion Health. https://championhealth.co.uk/insights/top-causes-stress-work/?

17.?Vijayapriya, C., & Tamarana, R. (2023). Effectiveness of dialectical behavior therapy as a transdiagnostic treatment for improving cognitive functions: a systematic review.?Research in Psychotherapy: Psychopathology, Process and Outcome,?26(2). https://doi.org/10.4081/ripppo.2023.662

18. Weyandt, L. L., Clarkin, C. M., Holding, E. Z., May, S. E., Marraccini, M. E., Gudmundsdottir, B. G., Shepard, E., & Thompson, L. (2020). Neuroplasticity in children and adolescents in response to treatment intervention: A systematic review of the literature.?Clinical and Translational Neuroscience,?4(2), 2514183X2097423. https://doi.org/10.1177/2514183x20974231?

About Renaldo Pool, BHSc

As a medical laboratory scientist, I'm passionate about scientific research and writing. I combine theory and practice to explore healthcare advancements. My lab expertise helps me investigate areas for improvement in healthcare through research and practical implementation. I aim to conduct thorough studies to advance medical knowledge and aid healthcare professionals in decision-making. Ultimately, I strive to bridge the gap between scientific research and practical application, contributing positively to the general population's health.