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What is DBT Therapy?

Brad Brenner, Ph.D.

Dialectical behavior therapy (DBT) is a type of psychotherapy. In DBT, patients work with therapists to learn how to enjoy the present moment, develop new skills to cope with difficult emotions, and improve their interpersonal relationships.

As a form of cognitive-behavioral therapy (CBT), DBT was developed in the 1970s by Dr. Marsha Linehan and colleagues. They discovered that CBT alone did not work as expected in individuals with borderline personality disorder (BPD). Originally intended to treat BPD, Dr. Linehan added techniques to develop an effective talk therapy treatment for the unique needs of individuals with BPD.

Over the years, DBT has been adapted to treat a wide variety of mental illnesses. In particular, DBT can help individuals who struggle with emotional regulation or problematic behaviors, including substance use and eating disorders. In some cases, therapists also utilize DBT to treat post-traumatic stress disorder (PTSD).

What is DBT Therapy?

Components of Dialectical Behavior Therapy

DBT has evolved to become an evidence-based psychotherapy approach that can help treat a wide range of mental health conditions, according to the American Psychological Association. Some modules commonly used in DBT include:

  • Group therapy: In skills groups, individuals develop behavioral skills by completing homework assignments and roleplaying with other group members. Group sessions are typically led by a group leader and meet every week for group skills training.
  • Individual therapy: During individual therapy sessions, DBT providers help clients learn to adapt behavioral skills, mindfulness skills, and other essential DBT skills to their specific life challenges and practice them in their everyday lives.
  • Phone coaching: Many DBT programs also offer DBT phone coaching, which involves meeting with your consultation team between therapy sessions to receive guidance on coping with challenging situations.

Unlike other types of psychotherapy, DBT treatment involves four primary components, with each element intended to meet a specific function. The main aspects of treatment are:

Core Mindfulness

During individual therapy, therapists help clients develop mindfulness skills to focus on the present or “live in the moment.” Core mindfulness skills can help you connect with your thoughts, feelings, behaviors, and impulses, allowing you to use your senses to tune into the current situation.

In turn, mindfulness techniques help you relax, breathe, and focus on using DBT skills to cope with stressful situations. Mindfulness can also promote calmness amid intense emotions, helping you avoid impulsive behaviors and problematic thought patterns.

Distress Tolerance

Distress tolerance skills can help you practice self-acceptance and come to terms with your current situation. Distress tolerance techniques for handling crises include:

  • Distraction
  • Improving the moment
  • Self-soothing
  • Considering the pros and cons of not tolerating emotional distress

Throughout treatment, practicing distress tolerance skills can help you prepare for intense negative emotions. The goal of distress tolerance is to help you cope with intense negative emotions healthily.

Interpersonal Effectiveness

Interpersonal effectiveness skills help you practice assertiveness in interpersonal relationships, for example, by saying “no” to friends and family members while maintaining a healthy relationship. Interpersonal effectiveness skills can also help you listen and communicate more effectively and gain more respect for yourself.

Emotional Regulation

Emotional regulation helps you navigate intense emotions more effectively. DBT skills training helps you learn to recognize negative emotions and transform them into more positive ones.

When you learn how to identify negative emotions, such as sadness, it reduces your emotional vulnerability. Moreover, by learning new skills to cope with intense negative emotions, you’ll be able to enjoy more positive emotional experiences in your everyday life.

What can dialectical behavior therapy help with?

DBT was initially developed to treat BPD patients. Today, DBT may be an effective treatment for a wide variety of mental illnesses and concerns, including:

Benefits of Dialectical Behavior Therapy

During individual therapy sessions, a client and therapist work together to promote positive behavioral change, vulnerability, and radical acceptance. As an essential aspect of treatment, validation helps clients practice self-acceptance and experience less psychological distress toward the idea of change.

Each DBT provider has their treatment structure, and each client will have unique treatment goals. Whether you choose to pursue DBT group skills training, individual therapy, or phone coaching, DBT offers the following benefits.

  • Radical acceptance and positive change: During DBT, you’ll learn new skills to navigate life’s obstacles, accept yourself, and cope with emotional dysregulation.
  • Behavioral change: You’ll learn valuable problem-solving skills to analyze problems and identify problematic behavior patterns.
  • Cognitive change: With the encouragement of your treatment provider, you’ll learn how to change your negative emotions and thoughts into more positive ones.
  • Collaboration: You’ll learn social adjustment skills to communicate more effectively, maintain positive relationships, and work together as a team.
  • Support: You’ll learn how to recognize your strengths and use them in everyday life.

Is dialectical behavior therapy effective?

Although it takes time and effort, DBT skills training is a valuable treatment option for many individuals, according to the American Psychiatric Association. DBT has only been around for a few decades, but extensive research has demonstrated its efficacy. In BPD patients, a 2014 clinical trial showed that 77% of participants experienced remission and no longer met the diagnostic criteria for BPD after DBT treatment. DBT is commonly recognized as the “gold standard” in the treatment of BPD.

In suicidal patients, another study found that interventions that incorporated DBT training as a treatment component led to more significant reductions in suicidal thoughts than DBT without skills training. DBT views suicidal behavior as an attempt to solve an unsolvable problem and works to help suicidal individuals recognize that life is worth living by developing problem-solving skills and encouraging positive behavior change.

How can I find a DBT therapist?

The best way to find a DBT provider is to search for mental health professionals with DBT training and experience. Your therapist consultation team or individual therapist will assess your mental health symptoms and treatment goals to determine whether DBT may be an effective treatment for you.

If you’re unsure where to start, use WithTherapy’s therapist search tool to find and schedule an appointment with a licensed therapist. Whether you’re trying therapy for the first time or seeking to start therapy again, working with an experienced mental health professional can help provide the support you need in your journey toward mental wellness.

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