In a survey of music therapists working in mental health settings, a researcher reveals a community of music therapists who perceive DBT-informed music therapy practice to be important and that music therapy has a unique contribution to offer to DBT.
Dialectical Behavior Therapy (DBT) is a psychotherapy that was initially developed in the 1980s to treat borderline personality disorders (BPD). DBT also helps reduce impulsive behaviors, such as suicidality, self-harm, substance abuse, eating disordered behavior, aggression, isolation, rumination, dissociation, anxiety, depression, and panic attacks. DBT teaches skills to control these behaviors by helping clients build a life worth living through tolerating distress, learning how to bear pain skillfully, regulating emotions, and improving relationships with others.
Why do music therapists use DBT?
Of the 18 respondents who use DBT, most indicated using DBT-informed music therapy with individuals who have BPD (77.8%, n = 14). Almost an equal number of respondents indicated using DBT-informed music therapy with individuals who have depression (66.7%, n = 12) or substance use disorders (61.1%, n = 11).
The next most frequent use of DBT-informed music therapy was for individuals with eating disorders (44.4%, n = 8) or post-traumatic stress disorder (44.4%, n = 8).
What DBT skills are addressed?
DBT helps patients develop four core sets of skills: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
More than half of the respondents indicated that they “frequently” use music therapy experiences to address mindfulness, emotion regulation, and distress tolerance. Fewer respondents addressed interpersonal effectiveness, and about a quarter of respondents indicated it is “Rarely” or “Never” the focus.
Respondents further indicated that mindfulness was most commonly addressed through music listening, followed closely by music and imagery, and music improvisation.
Fewer respondents indicated which music therapy experiences they use to address emotion regulation, but almost all of those who answered indicated that they use music listening. Music improvisation and song discussion were the most frequently reported experiences used to address distress tolerance and interpersonal effectiveness.
What are the advantages?
Of the 18 respondents who indicated implementing components of DBT in their music therapy practice, 13 provided a response to an open-ended question regarding perceived advantages of incorporating DBT concepts in their music therapy practice.
The responses were analyzed and categorized into the following themes:
provides a common language with other treatment team members and clients;
allows for teaching skills that can be used post-treatment; and
allows the client to learn skills in an integrative, nonthreatening, and motivational way.
Carolyn M. Chwalek, Cathy H. McKinney. 2015. “The Use of Dialectical Behavior Therapy (DBT) in Music Therapy: A Sequential Explanatory Study.” In Journal of Music Therapy, 52(2), 282–318.