Dialectical Behavior Therapy (DBT)

What is dialectical behavior therapy (DBT), and why does it have such a technical name?

DBT is a specific type of therapy created in the early 1990s by Marsha Linehan, a psychologist at the University of Washington, to treat borderline personality disorder, and it has since been shown to be effective in helping individuals who suffer from a broad range of disorders including depression, post-traumatic stress disorder, bipolar disorder and substance dependence. 

DBT's primary focus is providing a validating environment for someone with emotion dysregulation (i.e., problems stemming from out-of-control emotions, such as sadness or anxiety), and helping him/her to acquire skills to manage these emotions. The skills are taught in four parts and include mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance.

DBT is traditionally done in an outpatient setting and involves both individual psychotherapy with the therapist, as well as a group therapy component.

People who suffer from emotion dysregulation may also experience extreme swings in their emotions, see the world in black-and-white shades, and seem to always be jumping from one crisis to another. Because few people understand such reactions, they don’t have any methods for coping with these sudden, intense surges of emotion. DBT is a method for teaching skills that will help you manage these emotions.

Characteristics of DBT

  • Support-oriented: It helps a person identify his/her strengths and builds on them so that the person can feel better about him/herself and his/her life.
  • Cognitive-based: DBT helps identify thoughts, beliefs, and assumptions that make life harder: “I have to be perfect at everything.” “If I get angry, I’m a terrible person” & helps people to learn different ways of thinking that will make life more bearable: “I don’t need to be perfect at things for people to care about me,” “Everyone gets angry, it’s a normal emotion."
  • Collaborative: It requires constant attention to relationships between clients and staff. In DBT, people are encouraged to work out problems in their relationships with their therapist and the therapists to do the same with them. DBT asks people to complete homework assignments, to role-play new ways of interacting with others, and to practice skills, such as soothing oneself when upset. These skills, a crucial part of DBT, are taught in weekly lectures, reviewed in weekly homework groups, and referred to in nearly every group. The individual therapist helps the person to learn, apply and master the DBT skills.

Generally, dialectical behavior therapy (DBT) may be seen as having two main components:

1. Individual weekly psychotherapy sessions that emphasize problem-solving behavior for the past week’s issues and troubles that arose in the person’s life. 

2. Weekly group therapy sessions, led by a trained DBT therapist, where people learn skills from one of four different modules: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness.

For more in-depth understanding of DBT, visit www.dbtrecovery.com.