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Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that is founded on the principles of cognitive-behavioral therapy (CBT) and rooted in mindfulness practices based on Zen Buddhist teachings. The term “dialectical” derives from the idea that combining two opposites in therapy (acceptance and change) yields better results than either would on its own, as is described by WebMD. 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). Currently, DBT is not only considered to be the gold standard form of treatment for individuals diagnosed with BPD but has become an effective and relied upon the psychotherapeutic method in the treatment of many other mental health conditions. The National Alliance on Mental Illness (NAMI) indicate that DBT can be helpful in treating:

  • Bipolar disorder
  • Attention-deficit/ hyperactivity disorder (ADHD)
  • Generalized anxiety disorder (GAD)
  • Eating disorders
  • Obsessive-compulsive disorder (OCD)
  • Major depressive disorder
  • Substance use disorder
  • Post-traumatic stress disorder (PTSD)

DBT empowers a client to learn applicable social and emotional skills, healthy coping mechanisms, and use mindfulness techniques to enable a client to effectively cope with stress, live in the moment, regulate emotions, and improve relationships with others. Dialectical behavior therapy has become a mainstream form of psychotherapy, with providers spanning all over the world. Specifically, Southern California is home to a plethora of mental health clinicians that are qualified, DBT providers.

DBT Format

DBT places primary emphasis on the psychosocial aspects of treatment. It is a multifaceted approach that is comprised of the following four components:

  • Individual therapy: focused on improving client motivation and helping clients apply and integrate skills learned to navigate specific life challenges.
  • Group DBT skills training: focused on improving and teaching healthy client behavioral skills, as well as provide a forum to practicing integrating the skills.
  • As-needed, distance/ phone coaching: in-the-moment coaching to assist in and provide crisis management support between sessions.
  • Consultation team: this component is solely for the mental health provider treating the client. A consultation team serves as support for the clinician in treating clients with severe, complex, and/ or challenging to treat disorders. 

Clients also agree to complete out-of-session assignments (e.g., group skills homework, diary cards, etc.) to continue to practice implementing the information learned and integrating DBT skills into their daily life.

Four Modules

DBT specifically focuses on providing therapeutic skills in the following four key areas, provided by the Linehan Institute:

  1. Core Mindfulness: skills focused on improving an individual’s ability to accept, become more aware of oneself and others, and be attentive to the present moment.
  2. Distress tolerance: skills focused on increasing an individual’s tolerance of negative emotions instead of reacting impulsively.
  3. Interpersonal effectiveness: skills focused on increasing an individual’s communication strategies.
  4. Emotion regulation: skills focused on helping an individual identify, name, and understand the function of emotions, and increasing one’s ability to regulate emotions. 

The entire DBT program takes about six months to complete, as six weeks is allocated to each of the four modules. Longer DBT programs may elect to repeat one or more of the four skills modules. If each of the four modules is repeated it would extend the length of the program to last about twelve months long. 

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.