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Dialectical behavior therapy (DBT) is an evidence-based psychotherapeutic modality that emphasizes the psychosocial aspect of treatment. 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). DBT combines standard cognitive behavioral therapy (CBT) techniques for emotional regulation and reality testing with psycho-educational modules and concepts derived from Buddhist meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences. 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 is a rigidly structured therapeutic intervention that includes a multifaceted approach. The primary goal of DBT, according to Psychology Today, is to “transform negative thinking patterns and destructive behaviors into positive outcomes.” The DBT process is comprised of three therapeutic settings, which are: weekly individual psychotherapy (one-on-one therapy) sessions; weekly DBT skills training group sessions, and access to twenty-four-hour support between sessions via phone coaching. Each therapeutic setting has its own distinct structure and goals. Dialectical behavior therapy encourages participants to take an active role in the treatment process. DBT focuses on providing therapeutic skills in four areas, known as the four modules, that make up the pillars of this therapeutic modality, which are:

  • Core mindfulness: the practice of remaining fully present in the moment at any given time.
  • Distress tolerance: learning to increase one’s ability to tolerate pain in challenging situations rather than attempting to escape or avoid experiencing negative emotions.
  • Interpersonal effectiveness: increasing one’s self-awareness and authentically advocating for one’s own wants and needs in a relationship in a way that is both self-respecting and non-damaging.
  • Emotion regulation: decreasing emotional impulsivity by learning skills to help manage and shift intense emotion without reacting instinctively to them.

DBT encourages an inclusive worldview and perspective instead of an exclusive outlook on life. Dialectical behavior therapy helps teach clients healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others. 

Its Efficacy

The DBT process is heavily influenced by the philosophical perspective of dialectics, or the balancing of opposites. Behavioral Tech explains that “DBT works because it successfully increases clients’ ability to use effective coping skills, particularly strategies for expressing, experiencing, and regulating intense emotions.” Studies have found that certain improvements, can be fully or partially attributed to learning and implementing DBT skills (e.g., improvements in emotion regulation, reduced experiential avoidance, minimized assertive anger, etc.). Research has found DBT to be an effective therapeutic intervention regardless of a person’s gender identity, sexual orientation, age, and ethnicity/ race.

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.