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Dialectical behavior therapy (DBT) 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. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT combines standard CBT techniques for emotional regulation and reality-testing with psycho-educational modules and concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences. Through DBT negative and erroneous thoughts or beliefs that are often the source of emotional turmoil are gradually challenged and subsequently shifted to foster the systematic learning of new emotional coping skills. Although it was originally developed for and remains the gold standard method of treatment for individuals diagnosed with borderline personality disorder, evidence has shown it to be a successful treatment method for individuals struggling with other mental health conditions.

DBT Format

Dialectical behavior therapy is a multifaceted, rigidly structured therapeutic approach that is conducted in three different therapeutic settings, each with distinct goals. Every individual is unique and will require some form of customized treatment plan within the larger DBT program. Dialectical behavior therapy allows participants to engage in individualized and collective treatment by focusing on the four modules of DBT, which are: core mindfulness (focusing skills), distress tolerance (crisis survival skills), emotion regulation (de-escalation skills), and interpersonal effectiveness (social/ relationship skills). The three components of DBT include:

  • Individual therapy sessions: weekly one-on-one sessions are essential in creating a forum for the client to work on his or her own nuanced issues with personalized guidance from his or her clinician. They enable the client to work in a co-creative fashion with his or her mental health clinician to identify prohibitive, damaging, and maladaptive thoughts and behaviors. Through positive reinforcement, individual therapy sessions motivate change and emphasize a client’s strengths, which helps to repair and improve his or her sense of self. They are also focused on enhancing the client’s motivation and practice of applying certain DBT skills to relevant challenges.  
  • DBT skills training group sessions: weekly group sessions are facilitated by a qualified mental health clinician who will adhere to lessons provided in the DBT curriculum, teach the DBT skills in each module, and facilitate activities to allow the participants to practice implementing the newly learned DBT skills. They can offer a safe environment to connect with other individuals experiencing similar life challenges. Furthermore, they allow individuals to engage in healthy interpersonal connections, while simultaneously cultivating a support network. Individuals have an opportunity to share their experience as it relates to their personal recovery process as well as offer support and insights to others in the group. 
  • As-needed phone coaching: provides an individual with twenty-four-hour access to support between sessions, should a crisis arise.

The entire DBT program takes about six months to complete, as six weeks are allocated to each of the four modules. 

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.