What Is Dialectical Behavior Therapy (DBT)?

Dialectical behavioral therapy (DBT) is an approach within clinical psychology that aims to treat personality disorders and other mental health conditions. DBT was developed out of cognitive behavioral therapy, or CBT. CBT helps people become aware of and work to adjust flawed thought patterns that cause unhelpful or distressing emotions and/or behaviors. Dialectical Behavior Therapy also does this, and tacks on additional dialectical components and skills training. Depending on the symptoms or challenges you’re experiencing, DBT might be an effective therapeutic option to consider seeking out.

Key Components Of DBT

Dialectical behavior therapy, DBT,was originally conceptualized by psychologist Marsha Linehan. She saw that CBT was effective for identifying negative thought patterns and changing them, but noticed that it lacked a component to help people learn how to handle situations when their emotions were heightened or intense.

Dialectical therapy focuses on helping people learn to manage emotional distress and intense emotions. It’s intended to equip an individual with a toolbox of behavioral skills to help them cope with pain and intense negative emotions. DBT skills training focuses on the following areas:

• Mindfulness skills, or being aware of and calmly accepting one’s feelings in the present moment

• Distress tolerance, or recognizing painful emotions and managing them effectively and healthily with emotional control skills

• Interpersonal effectiveness, which involves learning how to better communicate with others and navigate relationships

Who Can Benefit From DBT

Research has found that comprehensive DBT can be a clinically effective treatment for a variety of mental health conditions. It’s most commonly recommended for those with borderline personality disorder (BPD). This mental illness is characterized by an intense fear of abandonment, impulsive and/or risky behaviors, wide mood swings, angry outbursts, rapid changes in self-identity, and suicidal threats or behavior. DBT can help with these symptoms by assisting individuals in learning to improve distress tolerance skills, emotion, control, and adopt healthy coping skills. 

If you or someone you know is experiencing suicidal thoughts or behaviors, seek help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988.

In addition, ongoing research is in progress to determine whether DBT may also be a clinically effective treatment for disorders and mental health conditions like depression, anxiety, eating disorders including binge eating disorder, and post-traumatic stress disorder. That said, virtually anyone can benefit from learning some dialectical behavior skills since everyone experiences difficult emotions and self-destructive behaviors from time to time. Whether it’s used as the primary clinical treatment for a certain, specific condition depends on the individual and the professional opinion of their provider.

DBT treatment may or may not be used in conjunction with medication for certain mental health issues. It can take the form of individual sessions, group sessions, or a combination of both. Contacting a licensed mental health professional is typically the best way to know whether DBT might be right for your particular situation. 

What To Expect From A DBT Session

Depending on your unique situation, a therapist may recommend just one on one sessions of DBT, or one on one sessions in addition to group therapy sessions. Individual therapy with a DBT therapist are generally intended to offer you a safe, nonjudgmental space where you can take a look at past emotional reactions, identify where they may have come from, and learn better coping techniques for the future. Group CBT sessions may also be designed to teach healthier coping mechanisms and offer the opportunity to practice them in a communal setting. 

Learning and implementing mindfulness techniques will likely be an important part of either format, since they can help an individual cultivate a nonjudgmental awareness of their emotions as they arise so they can more calmly and effectively cope. Note that whatever session structure your provider decides is best, it’s usually important to stick with it for the duration they recommend for skills training—often a period of six months or more. This is because DBT is like a training method for rewiring how you relate to your own emotions, which can take time to be effective.

Seeking Out DBT

If you feel that DBT could be helpful for you, connecting with a qualified mental health provider to discuss your situation more specifically is usually a good first step. You can search for "DBT therapy near me" to locate a therapist in your area or to see available DBT therapists if you prefer to meet with someone in person. Or, if you prefer the convenience of attending therapy sessions from the comfort of your own home, you might consider an online therapy platform like BetterHelp. The licensed provider you get matched with can evaluate you and let you know if online, individual DBT sessions might be right for you, or if some other type or format of therapy may be better for your situation. One study suggests that “Online delivery of DBT programmes is feasible and may be more accessible, acceptable and as safe and effective as face-to-face delivery”. Meeting with a qualified provider can help you find out what might be best for you.