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Psychologist Marsha M. Linehan developed dialectical behavior therapy (DBT) in the late 1980s as a means to help better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is an evidence-based psychotherapy that is founded on the principles of cognitive behavioral therapy (CBT), but places greater emphasis on the psychosocial aspect of treatment. It combines standard 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 encourage acceptance. DBT is not only the gold standard form of treatment for individuals diagnosed with BPD, but according to Behavioral Tech has been found to be effective in treating other mental health conditions such as bipolar disorder, eating disorders (e.g., bulimia nervosa, binge eating disorder, etc.), trans diagnostic emotion dysregulation, attention-deficit hyperactivity disorder (ADHD), depression, and more. Psychology Today explains that the “goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes.” 

DBT Format

Dialectical behavior therapy is made up of three distinct therapeutic settings, which include weekly individual therapy sessions, weekly DBT skills training group therapy sessions, and as-needed phone coaching. Each component of the DBT process is integral to its success. 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 to improve self-worth, establish self-compassion, acceptance, and develop a positive self-identity. Weekly DBT skills training group sessions are used to teach and help facilitate fostering skills in each of the four modules. Phone coaching provides an individual with twenty-four-hour access to support between sessions, should crisis arise. 

Four Modules

Within each therapeutic setting, DBT focuses on teaching applicable skills in four key areas, known as the four modules. They include the following, provided by the Linehan Institute:

  1. Core mindfulness (focusing skills): the practice of being fully aware and wholly present in the current moment.
  2. Distress tolerance (crisis survival skills): learning tools and techniques to accept, find meaning through, and tolerate distress.
  3. Interpersonal effectiveness (relationship/ people skills): learning assertive communication methods that allow an individual to engage with others in a way that maintains self-respect and simultaneously strengthens relationships.
  4. Emotion regulation (de-escalation skills): learning to recognize, label, and adjust emotions to assist in regulating emotions and subsequently changing reactions to external stimuli.

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. Dialectical behavior therapy is a multifaceted, rigidly structured therapeutic approach that is designed to help individuals learn to manage painful emotions and decrease conflicts in relationships.

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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