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In the late 1980, Marsha M. Linehan developed Dialectical Behavior Therapy (DBT) as a therapeutic method to better treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal ideations. It is currently recognized as an effective therapeutic method for treatment in a wide range of other mental health disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), eating disorders, and more. DBT is a specific type of cognitive-behavioral therapy (CBT) that places greater emphasis on the psychosocial aspects of treatment. It combines many of the standard CBT techniques for emotional regulation and reality testing and adds concepts derived from Buddhist meditative practice such as awareness, mindfulness and attentiveness to current situations and emotional experiences to encourage acceptance. 

Timeline

Dialectical behavior therapy is carried out in three distinct therapeutic settings, including weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills group sessions, and access to twenty-four hour support between sessions via phone coaching, when needed. There are four primary modules of DBT, with approximately 6 weeks allocated to each module. Behavioral Tech explains each module below: 

  • 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. 

In DBT skills group session 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 using the DBT skills learned. After each DBT skills group session the clinician will assign homework to help practice and reinforce the information taught during the session.

Duration

The full DBT skills curriculum is intended to take twenty-four weeks long to complete. According to the Linehan Institute, this curriculum is often repeated to create a one-year long program. Shorter options that focus on only a subset of the DBT skills have also been developed and are used in particular populations and settings. Although these timeframes are usually adhered to, the exact timeframe of a particular DBT program will depend on the specific needs of its participants, as the program may conclude in less time than the scheduled twenty-four weeks, or extend beyond, lasting longer than the twenty-four week period. 

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.