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Dialectical behavior therapy (DBT) 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. It is a rigidly structured, evidence-based psychotherapy that combines standard cognitive behavioral therapy (CBT) techniques for emotional regulation and reality testing with concepts derived from Buddhist meditative practice (e.g., awareness, mindfulness and attentiveness to current situations and emotional experiences) to emphasize the psychosocial aspect of treatment. Dialectical behavior therapy focuses on teaching skills in four primary areas, which are known as the four modules of DBT. DBT 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. Although it was originally developed 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.

Four Stages 

This form of therapy is designed to treat issues systematically and comprehensively, in order of severity. DBT was originally developed for people with severe emotional issues, including suicidal ideation. For this reason, DBT occurs in stages to ensure all concerns are eventually addressed. As explained by Good Therapy, DBT involves the following four stages:

  • Stage 1: The focus of this stage is stabilization. People may be dealing with trauma, suicidal thoughts, self-harm, or addiction, and therapy during this time is centered on safety and crisis intervention. It is common for individuals in this stage of treatment to feel like they are at an all-time low point in their lives. The goal of this stage is to help people achieve some control over problematic behaviors.
  • Stage 2: In the second stage, behaviors are more stable, but mental health issues may still be present. During this time, emotional pain and traumatic experiences usually reveal themselves and are safely explored. The goal of this stage is for people in treatment to experience their emotional pain instead of silencing or burying it.
  • Stage 3: Stage three is centered on enhancing one’s quality of life. This is accomplished through setting realistic goals to achieve steady progress in promoting happiness and stability.
  • Stage 4: The last stage is focused on discovering a deeper meaning of life. In therapy, people may improve upon learned skills or work toward spiritual fulfillment. The goal of this stage is to help people achieve and maintain an ongoing capacity for happiness and success.

Dialectical behavior therapy helps individuals foster healthy coping mechanisms and useful techniques for managing stress, regulating emotions, and improving relationships with others.

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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