What is Dialectical Behavioral Therapy?

Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, PhD. In the 1980s, is a type of talk therapy originally devised for high risk, suicidal people diagnosed with borderline personality disorder.

Today, DBT is used to treat people struggling with a range of complex, intense emotions, including substance abuse and addiction, PTSD, bipolar disorder, eating disorders and depression. It is used in various settings, including addiction treatment centers, community mental health programs, hospitals, and schools.

With the help of highly trained and certified therapists, people who tend to see the world in terms of black and white are able to learn strategies that replace all-or-nothing thinking with a more balanced approach to difficult emotions.

Components of Dialectical Behavioral Therapy

DBT involves four major components:


Patients learn to be more aware of their actions; to live in the moment and accept life as it happens. Patients learn about the importance of acceptance and balance.

Distress tolerance

Involves crisis survival skills and ways to ride out distressful events and thoughts instead of escaping or acting on them.

Emotion regulation

Patients improve overall quality of life by learning ways to manage and change intense emotions that have caused problems in the past. Difficult emotions are abated so they are no longer overwhelming.

Interpersonal effectiveness

Involves methods of communicating with other people effectively, assertively and respectfully, thus decreasing conflicts in relationships.

How does DBT Work?

DBT teaches patients new skills and strategies for navigating the difficulties of day-to-life. While individual therapy and phone coaching are important, much of the training takes place in groups, which typically meet every week for 24 weeks.

During group sessions, a therapist guides patients through new skills and assigns regular homework. Role play helps patients practice newly learned ways of interacting with other people.

Dialectical Behavioral Therapy and Addiction Treatment

In addiction treatment, DBT helps patients cope with difficult emotions and manage cravings, thus reducing withdrawal symptoms that may result in early termination of drug and alcohol treatment. DBT can also help patients learn to identify and avoid situations that may trigger relapse after completing treatment or rehab.

If you think dialectical behavior therapy might help you, a mental health provider or addiction treatment center can offer suggestions. Ensure DBT practitioners are certified and experienced, with a master’s or doctoral degree in psychology, counseling or a related field. Otherwise, they may lack proper training and may do more harm than good.

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