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Dialectical behavior therapy, also known as DBT, is a form of evidence-based psychotherapy that is founded on the principals of cognitive behavioral therapy (CBT). Psychologist Marsha M. Linehan developed DBT in the late 1980s as a more effective therapeutic method to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT places primary emphasis on the psychosocial aspects of treatment. DBT 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. 

Four DBT Modules

Behavioral Tech explains that individuals undergoing DBT are taught strategies to effectively change their behavior through the following four modules: 

  • Core mindfulness: focuses on improving an individual’s ability to accept and be present in any given moment. The skills in this module help individuals learn the importance and value of slowing down and taking pause instead of succumbing to intense emotions and acting in destructive ways. 
  • Distress tolerance: focuses on increasing an individual’s tolerance of negative emotion as opposed to attempting to avoid or escape from it. The skills in this module help individuals learn various techniques for handling crisis (e.g., distraction, self-soothing, improving the moment, etc.). 
  • Emotion regulation: focuses on helping an individual identify, name, understand the function of, and regulate their emotions. The skills taught in this module are intended to help an individual learn to decrease the intensity of their emotions, sit with and experience strong emotions that are causing problems in one’s life, without impulsively acting on them.
  • Interpersonal effectiveness: focuses on increasing an individual’s communication strategies. The skills taught in this module help an individual learn to identify what their own needs are in a relationship and develop assertive and effective communication methods to ensure those needs are met in a healthy, nondestructive way. 

Dialectical behavior therapy is conducted in three different therapeutic settings, each with distinct goals.

DBT Techniques

Dialectical behavior therapy remains the gold standard method of treatment for those diagnosed with BPD. Its clinical application has expanded and is currently viewed as an effective treatment method for other mental health disorders (e.g., depression, bulimia, binge-eating disorder, bipolar disorder, substance use disorder, etc.). The techniques used in DBT include:

  • Group therapy: group DBT skills sessions focus on teaching and building upon behavioral skills in each of the four modules. 
  • Individual therapy: weekly individual therapy sessions provide one-on-one support where an individual can go over any challenging situations that have arisen throughout the week as well as provide a space for the individual to review the lessons learned in the group skills sessions with his or her clinician.
  • Phone coaching: as-needed coaching provides an individual with twenty-four-hour access to support between sessions, should crisis arise.

Homework is often assigned after each group skills sessions to help further facilitate understanding the information taught. The entire DBT program takes around six months to complete, as six weeks are allocated to each module. Longer DBT programs may elect to repeat the skills modules, going through them twice, which would extend the length of the program to last about twelve months long. DBT is intended to help treat individuals who have difficulty with emotional regulation and/ or are exhibiting self-destructive behaviors.

Disclaimer: 

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 as a means to disregard professional advice or delay seeking treatment.