Dialectical Behavior Therapy

Eileen Bailey Health Guide
  • Dialectical behavior therapy (DBT) was invented by Marsha Linehan as a way to treat patients with suicidal ideations, suicidal attempts and self-harm behaviors. She found that she was treating people with borderline personality disorder. Since then, DBT has been used to treat a number of different mental health issues, especially those who have emotion regulation issues.


    DBT uses some of the core concepts of cognitive behavior therapy (CBT) and adds mindfulness and acceptance. The term dialectical is used because this therapy seems to address and integrate opposite therapies. On one hand, the therapy aims to change undesired behaviors and thoughts and on the other hand it accepts and validates those behaviors and thoughts.

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    DBTSanDiego.com lists three components of DBT:


    Developing change strategies – these are similar to those used in CBT and include problem solving, developing more effective thinking, exposure therapy, and behavioral activation


    Learning acceptance skills – learning to see things (including your thoughts, emotions and other people) as they are, without judgment


    Mindfulness – a way to “decrease suffering by developing the ability to better tolerate emotional pain and accept yourself, your past and your current life.” [1]


    DBT works in stages. The first stage works to stabilize and prevent any injurious or self-harming behaviors. Once these issues have been resolved, the therapist moves on to other issues that may negatively impact lives and develop coping skills. In the last stage, the therapist introduces tools to help create positive and lasting change and works to improve “self-respect and self-trust.”[3]  


    Most DBT programs involve both individual therapy and group sessions. Individual therapy is meant to provide strategies for handling and managing problems and can address specific problems that come up in your life. Weekly skills sessions are highly structured programs that teach specific skills for mindfulness, distress tolerance, managing emotions, behaviors and relationships. According to GoodTherapy.com. “the criteria for this treatment is not met unless a weekly DBT meeting is held.” [2]


    Besides the two main parts, DBT can also include skills coaching, in person or via phone calls to help in emergency or problematic situations. Coaches and therapists work together to get each person through situations using the tools learned in the weekly skills classes. Overall, DBT is meant to provide a reason and joy for life that those who began the program did not previously have.


    According to the NAMI, long-term studies of DBT have shown positive changes and “suggests that the majority will experience significant and long-lasting periods of symptom remission in their lifetime. Many people will not experience a complete recovery (problems with self-esteem and the ability to form and maintain relationships may linger) but nonetheless will be able to live meaningful and productive lives.” [4]


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    See also: Different Types of Therapies: CBT, DBT, ACT




    [2] “Dialectical Behavior Therapy,” Reviewed 2013, Feb. Reviewed by Jacob L. Freedman M.D. and Ken Duckworth, M.D. NAMI


    [2] “Dialectical Behavior Therapy,” Updated 2013, May 14, Staff Writer, GoodTherapy.org


    [1] [3] “Treatment of Borderline Personality Disorder,” Date Unknown, Milton Z. Brown, Ph.D., DBTSanDiego.com


    “What is DBT?” Date Unknown, Staff Writer, Dialectical Behavior Therapy Center of Seattle


Published On: August 28, 2013