Dialectical Behavior Therapy Intervention Summary

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. "Dialectical" refers to the issues involved in treating patients with multiple disorders and to the type of thought processes and behavioral styles used in the treatment strategies. DBT has five components: (1) capability enhancement (skills training); (2) motivational enhancement (individual behavioral treatment plans); (3) generalization (access to therapist outside clinical setting, homework, and inclusion of family in treatment); (4) structuring of the environment (programmatic emphasis on reinforcement of adaptive behaviors); and (5) capability and motivational enhancement of therapists (therapist team consultation group). DBT emphasizes balancing behavioral change, problem-solving, and emotional regulation with validation, mindfulness, and acceptance of patients. Therapists follow a detailed procedural manual.

Descriptive Information

Areas of Interest Mental health treatment
Co-occurring disorders
Outcomes Review Date: October 2006
1: Suicide attempts
2: Nonsuicidal self-injury (parasuicidal history)
3: Psychosocial adjustment
4: Treatment retention
5: Drug use
6: Symptoms of eating disorders
Outcome Categories Drugs
Mental health
Social functioning
Suicide
Trauma/injuries
Treatment/recovery
Ages 18-25 (Young adult)
26-55 (Adult)
55+ (Older adult)
Genders Male
Female
Races/Ethnicities American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
White
Race/ethnicity unspecified
Settings Inpatient
Outpatient
Other community settings
Geographic Locations No geographic locations were identified by the developer.
Implementation History DBT has been implemented in many therapeutic settings in Argentina, Australia, Canada, Germany, Japan, New Zealand, the Netherlands, Norway, Spain, Sweden, Switzerland, the United Kingdom, and the United States since the publication of treatment manuals in 1993. Evaluations of DBT have been conducted in Canada, Germany, the Netherlands, New Zealand, Spain, and Sweden. Some clinicians have conducted and published results from independent randomized controlled trials of DBT.
NIH Funding/CER Studies Partially/fully funded by National Institutes of Health: Yes
Evaluated in comparative effectiveness research studies: Yes
Adaptations Adaptations of DBT have been developed for:
  • Suicidal adolescents
  • Individuals with substance use disorders
  • Individuals with eating disorders
  • Individuals with comorbid HIV and substance use disorders
  • Developmentally delayed individuals
  • Older adults with depression and one or more personality disorders
  • Individuals with schizophrenia
  • Families of patients
  • Women experiencing domestic violence
  • Violent intimate partners
  • Individuals who stalk
  • Inpatient and partial hospitalization settings for adolescents and adults
  • Forensic settings for juveniles and adults
Adverse Effects No adverse effects, concerns, or unintended consequences were identified by the developer.
IOM Prevention Categories IOM prevention categories are not applicable.