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Dialectical behavior therapy (DBT) is a rigidly structured, evidence-based psychotherapy that combines standard cognitive behavioral therapy (CBT) techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice (e.g., awareness, mindfulness and attentiveness to current situations and emotional experiences) to emphasize the psychosocial aspect of treatment. Psychologist Marsha M. Linehan developed dialectical behavior therapy in the late 1980s as a means to more effectively treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). The primary goal of DBT, according to Psychology Today, is to “transform negative thinking patterns and destructive behaviors into positive outcomes.” While it was originally developed 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. Due to the nature of this therapeutic intervention, it can be difficult to do DBT at home. Gaining a basic understanding of DBT can help illuminate some of the challenges that an individual doing DBT at home may encounter. 

Standard DBT Format

Dialectical behavior therapy is made up of three distinct therapeutic settings, which include weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. Within each therapeutic setting, DBT focuses on teaching applicable skills in four key areas, known as the four modules. They include the following, provided by the Linehan Institute:

  1. Core mindfulness (focusing skills): the practice of being fully aware and wholly present in the current moment.
  2. Distress tolerance (crisis survival skills): learning tools and techniques to accept, find meaning through, and tolerate distress.
  3. Interpersonal effectiveness (relationship/ people skills): learning assertive communication methods that allow an individual to engage with others in a way that maintains self-respect and simultaneously strengthens relationships.
  4. Emotion regulation (de-escalation skills): learning to recognize, label, and adjust emotions to assist in regulating emotions and subsequently shift reactions to external stimuli.

The full DBT program is intended to take twenty-four weeks to complete, as six weeks are allocated to focusing on each of the four DBT skills modules. Each therapeutic component of the DBT process is integral to its success. One-on-one therapy sessions provide a client and his or her clinician with the opportunity to co-create behavior plans that focus on long- and short-term goals. Weekly DBT skills training group sessions are used to teach and help facilitate fostering skills in each of the four modules. Phone coaching provides an individual with twenty-four-hour access to support between sessions, should crisis arise. Yes, in theory, you could do DBT at home, however, to participate in all aspects of DBT, attendance through video communication will likely be required and additional modifications may be necessary.

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.

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