Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment approach with two key characteristics: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes. DBT is a specialized form of cognitive behavioral therapy (CBT) designed specifically as a treatment for individuals with self-harmful behaviors (such as cutting), and suicidal thoughts, urges and/or suicide attempts. Many clients with these behaviors meet criteria for borderline personality disorder (BPD). It is not unusual for individuals diagnosed with BPD to also struggle with other problems – depression, bipolar disorder, posttraumatic stress disorder (PTSD), anxiety, eating disorders, or alcohol and drug problems.

DBT takes the approach that individuals have previously developed ineffective ways of regulating emotional and cognitive experiences, coping with distress, and navigating interpersonal relationships. Although adaptive at the time individuals developed them, these ineffective patterns and strategies are no longer helpful, and DBT assists individuals with learning and practicing new skills that are more effective. The four skill areas that are taught and practiced are as follows:

  1. Mindfulness
  2. Emotion Regulation
  3. Interpersonal Effectiveness
  4. Distress Tolerance