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Dialectical behavior therapy (DBT) is an evidence-based, rigidly structured form of psychotherapy. It 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. DBT 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. It is carried out in three distinct therapeutic settings, including 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. Dialectical behavior therapy focuses on teaching skills in four primary areas, which are known as the four modules of DBT. Each module highlights distinct and specific skills that build upon each other and are individually and collectively integral to the success of this therapeutic intervention. 

1. Core Mindfulness: Focusing Skills

This module focuses on teaching an individual how to focus their mind and attention. Through learning and practicing the DBT mindfulness skills, individuals can focus on the present and tend to what is exactly happening in any given moment. Skills during this module help individuals learn and practice slowing down to focus on mindfully acknowledging and experiencing emotions without reacting impulsively and/ or destructively. It teaches individuals to avoid taking things personally, glean a better understanding of their emotions, become active listeners, and learn to sit with emotions instead of pushing them away. 

2. Distress Tolerance: Crisis Survival Skills

The purpose of the distress tolerance module is to help individuals learn tools and techniques to cope with feelings that do not have an immediately known resolution. Employing distress tolerance skills can help a person effectively minimize the intensity of emotional pain. Rather than becoming overwhelmed by or hiding from difficult emotions, this module teaches individuals skills to assist in finding meaning in, accepting, and tolerating distress, including short-term coping strategies intended to help manage emotional pain to avoid destructive behavior. Learning these skills can help an individual learn to acknowledge, process, and integrate emotions and situations in a non-evaluative and nonjudgmental fashion. 

3. Emotion Regulation: De-escalation Skills

This module teaches important skills surrounding emotional regulation, as well as providing education regarding the function of emotions. It helps individuals learn to experience strong emotions while simultaneously reducing the intensity of the emotions without acting on them. In this module individuals will learn a variety of helpful skills such as properly identifying and labeling emotions, increasing positive emotional events, increasing mindfulness to current emotions, identifying obstacles to changing emotions, and applying distress tolerance techniques. 

4. Interpersonal Effectiveness: Social Skills

The interpersonal effectiveness module is intended to teach people skills to navigate interpersonal problem solving, improve assertiveness, and hone social skills to modify aversive environments, and to realize goals in interpersonal encounters. These skills involve helping individuals identify and understand their own needs in a relationship. Interpersonal effectiveness skills help an individual learn to cultivate, engage, and maintain healthy relationships with others that enable one’s needs to be met. This includes advocating for one’s needs and communicating in way that is non-damaging, assertive, maintains self-respect, and strengthens 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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