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The dialectical behavior approach refers to a form of psychotherapy, called dialectical behavior therapy (DBT) that combines techniques from western cognitive behavioral therapy (CBT), psycho-educational modules, and eastern mindfulness-based practices. Psychologist Marsha M. Linehan developed DBT in the late 1980s a therapeutic approach specifically geared to treat individuals diagnosed with borderline personality disorder (BPD), suffering from pervasive suicidal thoughts and/ or attempts. Psychology Today explains that the “goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes.” DBT remains the gold-standard form of treatment for individuals with BPD and according to the National Alliance on Mental Illness (NAMI), has since been recognized as an effective method of treatment for a wide range of other mental health disorders, such as depression, anxiety, post-traumatic stress disorder (PTSD), substance use disorder (SUD), eating disorders, and more. DBT is an evidence-based therapeutic modality that emphasizes the psychosocial aspects of treatment and cultivate the systematic learning of new emotional coping skills.

DBT Techniques

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. DBT focuses on providing therapeutic 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 enable 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 events.

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. 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.

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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