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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 based on principles of cognitive-behavioral therapy (CBT) but places greater emphasis on the psychosocial aspect of treatment. It blends standard CBT techniques for emotional regulation and reality-testing with concepts derived from Eastern meditative practice such as awareness, mindfulness, and attentiveness to current situations and emotional experiences to encourage acceptance. DBT specifically focuses on providing therapeutic skills in the following four key areas, also known as the four modules of DBT, provided by the Linehan Institute:

  1. Core Mindfulness: skills focused on improving an individual’s ability to accept and be present in any given moment.
  2. Distress tolerance: skills focused on increasing an individual’s tolerance of negative emotions instead of attempting to avoid or escape them.
  3. Interpersonal effectiveness: skills focused on increasing an individual’s communication strategies.
  4. Emotion regulation: skills focused on helping an individual identify, name, and understand the function of emotions, and increasing one’s ability to regulate emotions. 

The full DBT treatment program takes about six months to complete, as six weeks are allocated to each of the four modules. Dialectical behavior therapy is conducted in three different therapeutic settings, each with distinct goals. The two primary components of the full DBT program include weekly individual therapy sessions and weekly DBT group skills training sessions. The third component of DBT is as-needed phone coaching. The two types of structured therapy sessions are held in conjunction with one another and complement the different areas of focus. 

Individual therapy sessions provide one-on-one attention to help the person go over skills learned in the group sessions. It enables an individual to further explore and dissect how the processes of implementing the skills have been effective throughout the week as well as identify areas that may need further attention. The weekly DBT group skills training sessions are used to teach and help individuals develop skills in the four core areas. In DBT skills group therapy 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 applying the newly learned DBT skills in a controlled setting. These group sessions offer participants an emotionally safe environment to begin to implement the DBT skills alongside others working on similar issues. Group members are encouraged to share their experiences and provide mutual support, which can be invaluable to the therapeutic process. Phone coaching provides an individual with twenty-four-hour access to support between sessions, should a crisis arise.

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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