Dialectical Behavioral Therapy (DBT)
Effectively helping people with DBT
Dialectical Behavioral Therapy (DBT) is a modified form of Cognitive Behavioral Therapy (CBT) that was developed in the 1980’s by Marsha Linehan to better treat Borderline Personality Disorder and people experiencing chronic suicidal ideation.
Since its inception, DBT has been used to treat a wide range of disorders. Research demonstrates that DBT is effective in treating substance abuse/dependence, depression, Posttraumatic Stress Disorder (PTSD), and eating disorders.
Helping people regulate emotions
This treatment modality focuses on helping people increase their ability to successfully regulate emotions and cognitions, thereby changing behavior. DBT psychotherapists work with individuals to identify what triggers negative emotional, cognitive, and behavioral reactions while teaching them skills to promote more positive outcomes.
Psychotherapists using a DBT approach target problematic behaviors to improve treatment effectiveness. Life threatening behaviors are addressed first and include suicidal ideation, self injurious behaviors, and all other self harming behaviors. Therapy interfering behaviors are addressed next due and consist of any behavior that may impede treatment progress.
Improve Quality of life behaviors
Quality of life behaviors are examined in the next stage of treatment and may include relationships, other mental health issues, substance abuse, housing, and financial distress. Skills acquisition is the final stage of treatment, during which individuals learn new skills to help them replace ineffective behaviors and promote personal growth.
DBT psychotherapists focus on teaching specific skills to individuals to help improve mood and address dysfunctional patterns of behavior. DBT teaches individuals about mindfulness, the practice of being fully present in this moment in time. Another important skill taught and practiced in DBT is distress tolerance, learning how to tolerate pain in difficult situations, not change it. Interpersonal effectiveness teaches one how to set boundaries and say no while maintaining self respect and relationships with others. Emotion regulation teaches individuals how to change emotions that one wants to change.
Drawing from Eastern Meditative Traditions
DBT also draws from Eastern meditative traditions including Buddhist meditative practices. The term “dialectical” refers to the integration or synthesis of opposites. For example, DBT psychotherapists accept individuals as they are while also recognizing their need for change to address current problems. The skills taught in DBT embody this integration of opposites. Mindfulness and distress tolerance are acceptance skills while interpersonal effectiveness and emotion regulation are change oriented skills.
A Comprehensive program of treatment
DBT is an evidenced based practice (EBP) for treating Borderline Personality Disorder when provided as a comprehensive program of treatment. EBPs are treatment modalities that integrate the best available research with clinical expertise in the context of an individual’s characteristics, culture, and personal preferences. DBT, as a comprehensive program of treatment, consists of individual therapy, group therapy, phone calls for support between group and sessions, and a clinician consultation team.
Cassie Matsuzaki, MS, LMHC, NCC
Licensed Mental Health Therapist
LightHeart Psychological Associates