Skip to main content

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that emphasizes the psychosocial aspects of treatment. Psychologist Marsha M. Linehan developed DBT in the late 1980s as a therapeutic method specifically geared to treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal thoughts and/ or attempts. DBT remains the gold-standard form of treatment for individuals with BPD and according to the National Alliance on Mental Illness (NAMI), has since been recognized as an effective method of treatment for 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. Psychology Today explains that the “goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes.” Dialectical behavior therapy can help individuals that have a difficult time modulating strong emotions and/ or those that are emotionally vulnerable. DBT is a therapeutic modality that combines techniques from western cognitive-behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices to foster the systematic learning of new emotional coping skills.

DBT Format

Dialectical behavior therapy is a multifaceted, rigidly structured therapeutic approach. It allows 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 different therapeutic settings, each with distinct goals. DBT includes weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching.

Weekly DBT skills training group sessions are used to teach and help facilitate fostering skills in each of the four modules. The one-on-one therapy sessions provide a client and his or her clinician with the opportunity to co-create behavior plans that incorporate long and short-term goals as well as delve deeper into and process the client’s life journey while also learning skills to improve self-worth, establish self-compassion, acceptance, and a positive self-identity. These individual therapy sessions are empowering and help reinforce applicable social and emotional skills. Phone coaching provides an individual with twenty-four-hour access to support between sessions, should a crisis arise.

Duration

The full DBT program is intended to take twenty-four weeks to complete, as six weeks are allocated to focusing on each of the four DBT skills modules. The Linehan Institute explains that it is not uncommon for the DBT curriculum to be repeated, creating a one-year-long program. Shorter options that teach only a subset of the DBT skills have also been developed, which would reduce its overall duration. The Association for Behavioral and Cognitive Therapies refers to research suggesting “that ‘behavioral control’, that is the absence of suicidal behaviors and other life-threatening behaviors as well as the severe quality of- life interfering behaviors, can often be achieved within four to eight months of comprehensive DBT.” It is important to note that the length of time it takes for DBT therapy to work will be variable, as each person is different. Further, 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. 

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, or 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.