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Dialectical behavioral therapy (DBT) is an evidence-based psychotherapy that combines cognitive behavioral therapy (CBT) with Zen Buddhism. Created by Marsha M. Linehan, in the late 1980s, it was originally used to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). Now it is used to treat a wide range of other mental health conditions, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), eating disorders, as well as different emotional dysregulation and impulse control disorders and symptoms. Dialectical behavior therapy allow 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). 

DBT is conducted in three therapeutic settings: weekly individual therapy sessions, weekly DBT skills group training sessions, and as-needed phone crisis coaching between sessions. Each therapeutic setting has its own structure and goals:

  • 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 help 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 insight to others in the group. 
  • As-needed phone coaching: this component provides an individual with twenty-four-hour access to support between sessions, should crisis arise.

The entire DBT program takes about six months to complete, as six weeks is allocated to each of the four modules. DBT helps an individual identify ways to hold two seemingly opposite perspectives simultaneously. This, in turn, promotes balance and minimizes the tendencies to think in absolutes. 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.

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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