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Dialectical behavior therapy (DBT) was developed by psychologist Marsha M. Linehan in the late 1980s as a means to better treat individuals diagnosed with borderline personality disorder (BPD), suffering from chronic suicidal ideation. It 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 such as awareness, mindfulness and attentiveness to current situations and emotional experiences to emphasize the psychosocial aspect of treatment. Although it was originally developed to 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.

DBT Format

Dialectical behavior therapy is carried out in three distinct therapeutic settings, which include: weekly individual psychotherapy sessions, weekly DBT skills training group sessions, and as-needed phone coaching. DBT focuses on providing therapeutic skills in four fundamental areas, known as the four modules, include the following, as explained by Behavioral Tech:

  • Core mindfulness: the practice of being fully aware and entirely present in any given moment. 
  • Distress tolerance: focuses on developing tools and techniques to accept, find meaning through, and tolerate distress.
  • Emotion regulation: focuses on helping an individual identify, name, understand the function of, and regulate their emotions. 
  • Interpersonal effectiveness: focuses on developing assertive communication methods that enable an individual to engage with others in a way that is nondestructive, maintains self-respect, and strengthens relationships.

Weekly individual therapy sessions provide an individual and his or her clinician with the opportunity to co-create behavior plans that incorporate long- and short-term goals to improve self-worth, establish self-compassion, acceptance, and cultivate a positive self-identity. In DBT skills training group sessions 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 training group session the clinician will assign homework to help reinforce the information taught during the session. Phone coaching provides participants with access to twenty-four-hour support between sessions should crisis arise.

Duration

The full DBT skills curriculum is intended to take twenty-four weeks long to complete, as approximately 6 weeks is allocated to each of the four modules. According to the Linehan Institute, this curriculum may be 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 various populations and settings. Although these timeframes are usually adhered to, the exact duration of a particular DBT program will depend on the specific needs of its participants, and the program may conclude in less time than the scheduled twenty-four weeks, or extend beyond, lasting longer than the twenty-four-week period.

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.