What is DBT?

Teenager consoling her friendDialectical Behavior Therapy (DBT) is a well-researched, comprehensive treatment for people who have intense emotions they are unable to manage in constructive ways. When people struggle with intense emotions, the results can be impulsive or emotion-based actions that cause pain and problems in their lives and the lives of those around them. These behaviors can be raging, self-harm, depression, suicide attempts, self-harm, substance abuse, eating disorders, being emotionally numb, over-shopping, or gambling. Individuals with these problems are often diagnosed with borderline personality disorder. However, they may have other mental health diagnoses as well.

DBT works by teaching participants to become more aware of their particular sensitivity to emotions, especially ones such as anger and shame. It offers alternative ways to manage feelings, deal effectively with painful situations, and improve relationships. It teaches skills necessary to tolerate these feelings and then begin to regulate them. DBT therapy is provided through a compassionate treatment relationship that builds on the clients’ inherent strengths, understands the person’s emotional sensitivity, and offers powerful and concrete methods to build a life that feels worthwhile and meaningful.

Dialectical behavior therapy (DBT) was developed by psychologist Marsha M. Linehan. She purposefully combined change techniques from cognitive-behavior therapy with acceptance strategies from Zen practice.

Happy African American Father and Mixed Race Son Playing Piggyback in the Park.The change strategies include problem-solving, skills training, developing more effective thinking, behavioral activation, and exposure therapy. The primary acceptance skill is mindfulness, which involves learning to focus attention, and being able to accept things for what they are, including thoughts, emotions, and other people, without getting caught up in judgments, assumptions, or interpretations. While you are working to make changes, it is often necessary to tolerate some distress, so you learn coping skills as well. You develop ability to better tolerate emotional pain and accept yourself, your past, and your current life.

Using both acceptance and change strategies, DBT asks both client and therapist to find the balance between accepting reality as it is, and maintaining a strong commitment to change. DBT therapists work to provide treatment in a way that is warm and validating, while at the same time offering enough challenge and guidance to stimulate behavioral change and reduction of harmful behaviors. The goal is to help clients create “a life worth living.”

Since first being developed, DBT has been modified as a treatment for other complex and challenging mental disorders that involve emotional dysregulation, such as dual diagnoses, PTSD, eating disorders and severe mood disorders.