Dialectical behavior therapy

Developed by Marsha M. Linehan, a psychology researcher at the University of Washington, dialectical behavior therapy (DBT) is a system of therapy used to treat those struggling with borderline personality disorder (BPD).  Combining the standard cognitive-behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance and mindful awareness are what make up DBT.

It is said that DBT may be the first therapy that has been experimentally demonstrated to be effective in treating those suffering from BPD.  Recent studies show that DBT can also be helpful  in treating patients who presented with varied symptoms and behaviors associated with spectrum mood disorders (including self injury) as well as sexual abuse survivors and those struggling with chemical dependency.

DBT strives to change the adversarial nature of the therapist/client relationship.  During DBT, the therapist aims to accept and validate their client’s feelings while also informing them that some feelings and behaviors could use improvement and then shows them better alternatives.

DBT is comprised of two components:

1)    Individual

2)    Group

The individual component involves the therapist and patient discussing issues that arise during the week, recorded on diary cards, and follow a treatment target hierarchy.  Self-inflicted injury and suicidal behaviors take first priority where behaviors that are not directly harmful to themselves or others, but are still interfering with the course of treatment, take second.  Quality of life issues and working towards improving one’s life in general are ranked third.

The group component has the group usually meeting once a week for two to two and a half hour.  It is here where client’s to use specific skills that are broken down into four modules; core mindfulness skills, interpersonal effectiveness skills, emotion regulation skills and distress tolerance skills.

Both components are always used together.  Suicidal urges and uncontrolled emotional issues are kept under control as a result of the individual component while group is used to teach skills unique to DBT while also providing practice with regulating emotions and behavior in a social setting.


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