What is Dialectical Behavioral Therapy?

If you’re studying psychology or counseling, it’s likely that you’ve come across the term dialectical behavior therapy (DBT) but may be confused on its uses. First invented by psychologist Marsha Linehan in the late 1980s, DBT is a specialized kind of cognitive-behavioral therapy that places an emphasis on the psychosocial aspects of treatment. It was initially formed to treat chronically suicidal and self-injurious patients who were formally diagnosed with borderline personality disorder (BPD). However, through the years, DBT has evolved as a powerful psychotherapy tool that can be added to treatment plans for combating a wide range of other mental illnesses, too. The following is a broad overview on how DBT is effectively used by therapists today.

Characteristics of Dialectical Behavior Therapy

Like other forms of cognitive behavioral therapy, DBT is focused on identifying and changing negative thinking patterns to produce positive behavioral changes. In particular, DBT uniquely brings together both acceptance and change to garner better results. Therapists make use of DBT to help their patients accept uncomfortable thoughts or feelings rather than struggling against them. Once patients validate their mental processes, it’s easier for them to gradually transform their behaviors and develop better coping skills. As a support-oriented, collaborative approach, DBT helps individuals identify their strengths and build upon them to master their mental illness. Patients who undergo DBT often effectively develop mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance.

Four Stages of DBT Treatment

Although the process can be altered depending on the severity of an individual’s behaviors, there are typically four stages involved with DBT treatment. When starting stage one, patients often exhibit self-destructive behaviors that are out of control. Therefore, therapists start DBT with the initial goal of helping individuals achieve behavioral control through one-on-one psychotherapy sessions. In stage two, therapists seek to help patients move from quiet desperation and emotional invalidation with group therapy, as well as phone coaching, if needed, in crises. Within the stage four, patients begin building self-esteem and start learning to live life through skills training. In stage four, individuals are challenged to find deeper meaning through spirituality by participating in yoga or mindfulness meditation.

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Who Benefits Most from DBT?

DBT is most often used for high-risk individuals with borderline personality disorder or extreme suicidal behaviors. Most DBT patients have multiple diagnoses, experience intense bursts of anger, have rapidly shifting moods, and react strongly to rejection. Patients with BPD who are showing impulsive behaviors, such as substance abuse, self-injury, and risky sex, are often perfect candidates for DBT. Research has shown that DBT makes great strides in decreasing the frequency of self-destructive behaviors, increasing patients’ motivation to change, teaching new coping skills, reducing anger, and improving social functioning. Some therapists also use DBT to treat mood disorders, binge eating, ADHD and post-traumatic stress disorder.

Overall, DBT is a unique cognitive-behavioral therapy technique that seeks to replace life-threatening and therapy-interfering behaviors with new coping skills to help tough-to-treat patients on the path to recovery. If you’re interested in delivering DBT, it’s recommended that you supplement your psychology degree with certification from the Linehan Institute. Then, you’ll have the education, skills knowledge, clinical experience, and formal mindfulness training needed to effectively the change lives of people in extreme need through dialectical behavior therapy.