Psychologist Marsha M. Linehan developed dialectical behavior therapy (DBT) in the late 1980s as a means to better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is an evidence-based psychotherapy that is based on principles of cognitive-behavioral therapy (CBT) but places greater emphasis on the psychosocial aspect of treatment. It combines standard CBT techniques for emotional regulation and reality-testing with concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences to encourage acceptance. DBT remains the gold standard form of treatment for individuals diagnosed with BPD, and according to Behavioral Tech is now recognized as an effective method of treatment for other mental health conditions such as bipolar disorder, eating disorders (e.g., bulimia nervosa, binge eating disorder, etc.), transdiagnostic emotion dysregulation, attention-deficit hyperactivity disorder (ADHD), depression, and more. Dialectical behavior therapy is made up of three distinct therapeutic settings, which include weekly DBT skills group therapy sessions, weekly individual psychotherapy sessions, and as-needed phone coaching. Each component of the DBT process is integral to its success.
DBT Skills Training
The DBT skills group session makes up an imperative component of the overall DBT program. Research has found that “DBT skills training group is effective in reducing symptoms for both adults with borderline personality disorder and adolescents with oppositional defiant disorder.” DBT skills group therapy sessions are focused on enhancing the capabilities of each participant by teaching behavioral skills related to the four modules that make up the pillars of DBT. They include the following, provided by the Linehan Institute:
- Core Mindfulness (focusing skills): the practice of being fully aware and wholly present in the current moment
- Distress Tolerance (crisis survival skills): learning tools and techniques to accept, find meaning through, and tolerate distress
- Interpersonal Effectiveness (relationship/ people skills): learning assertive communication methods that enable an individual to engage with others in a way that maintains self-respect and simultaneously strengthens relationships
- Emotion Regulation (de-escalation skills): learning to recognize, label, and adjust emotions to assist in regulating emotions and subsequently changing reactions to events
In DBT skills group therapy sessions the clinician running the session will follow the lessons provided in the DBT curriculum, teach the skills, and facilitate activities to allow the participants to practice implementing the newly learned DBT skills. These group sessions offer participants an emotionally safe environment to begin to implement the DBT skills alongside other adults working on similar issues. Group members are encouraged to share their experiences and provide mutual support, which can be invaluable to the therapeutic process. The work that occurs during the skills groups continues, as homework that corresponds to the DBT skills taught or visited during each DBT group session is regularly assigned.
The information above is provided for the use of informational purposes only. The above content is not to be substituted for professional advice, diagnosis, or treatment, as in no way is it intended as an attempt to practice medicine, give specific medical advice, including, without limitation, advice concerning the topic of mental health. As such, please do not use any material provided above to disregard professional advice or delay seeking treatment.