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Behavioral Health: Dialectal Behavioral Therapy

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Dialectal Behavioral Therapy (DBT) is a cognitive behavioral therapy that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

Who is DBT for?

DBT is for any adult who suffers from borderline personality disorder (BPD).

What happens during DBT?

DBT includes four sets of behavioral skills:

  • Mindfullness: the practice of being fully aware and present in this one moment

  • Distress Tolerance: how to tolerate pain in difficult situations, not change it

  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others

  • Emotion Regulation: how to change emotions that you want to change

The term "dialectical" means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness).

How effective is DBT?

Research has shown DBT to be effective in reducing suicidal behavior, non-suicidal self-injury, psychiatric hospitalization, treatment dropout, substance use, anger, and depression and improving social and global functioning.

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