Dialectical behavior therapy (DBT) is an evidence-based cognitive-behavioral treatment that provides individuals with tools to help reduce negative behaviors and regulate intense emotions. Although it was originally created to treat borderline personality disorder (BPD), it has been effectively adapted to treat other mental health conditions, such as depression, bipolar disorder, and eating disorders. Its objective is to help people understand and accept difficult and often contradictory feelings, and then learn the skills to manage them. Read our overview to learn how it works, who can benefit from DBT, and what treatment looks like.

What is Dialectical Behavior Therapy (DBT)?

DBT is a comprehensive treatment that includes many aspects of other cognitive-behavioral approaches, such as exposure, problem-solving, and stimulus control, as well as cognitive restructuring. In plainer terms, DBT focuses on helping individuals to change unhelpful ways of thinking and behaving while at the same time focusing on self-acceptance. DBT teaches four sets of behavioral skills: mindfulness, distress tolerance, improved interpersonal skills, and emotion regulation, so that individuals have the tools to make positive and healthy changes in their lives.

The key to DBT is the term, dialectical. Here, dialectical means learning to understand how two seemingly opposing perspectives can both be true. In this way, DBT promotes balance and avoidance of “black and white”, “all-or-nothing” styles of thinking. For example, accepting yourself and changing your behavior might feel contradictory, but DBT teaches that it's possible to achieve both goals together. At the heart of DBT are acceptance and change.

Who can benefit from DBT?

DBT has been adapted to treat those with mental health issues such as eating disorders, suicidal and self-harming behavior, bipolar disorder, treatment-resistant depression, and substance use issues. The thinking is that since these disorders are often associated with unhealthy attempts to control intense, negative emotions, DBT’s emotion-regulation approach can help. 

Indeed, multiple research studies have shown that DBT can be effective in treating substance use issues, and decreasing suicide ideation, hopelessness, anger, and depression, and also that the effects of DBT treatment can last for sustained periods of time.

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"We have seen how DBT therapy can truly help transform the lives of those who struggle specifically with depression, substance abuse, and suicidal thoughts, much like many of our service members with PTSD do. As DBT work focuses on finding the balance between change and acceptance, it can help clients focus on developing a life worth living rather than a life where they are just surviving. When all 4 of the DBT skills are incorporated into our everyday lives it supports us in leading our best and most productive life."

— Jodie Nierintz LMFT, Telemynd Director Clinical Operations

What does DBT treatment look like?

Although highly effective, DBT can take many therapy sessions and multiple months (sometimes over a year) of treatment in order to see change. It typically involves weekly one-on-one therapy sessions, weekly group skills training sessions, homework, and regular therapist check-ins (often by phone or video).

According to the research, DBT treatment consists of four stages which go in order, with each phase having specific goals, such as:

• Treating issues related to past trauma

• Reducing therapy-interfering or quality-of-life-interfering behaviors, such as suicidal ideation or self-harming

• Developing renewed self-esteem and improving day-to-day behavioral skills

• Developing the capacity for optimum life experience and for finding a higher purpose.

Please note, if you or a loved one have thoughts of suicide, contact the National Suicide Prevention Hotline at 1-800-273-TALK (8255), Option 1.

If you or a loved one are living with disorders such as depression, an eating disorder, or other self-harming behaviors, consider DBT

DBT treatment requires fairly extensive training in order for behavioral health specialists to offer it to clients. Some get trained in DBT in graduate school or postdoctoral work, and others can get DBT-certified with supervised, on-the-job training. A qualified mental health professional will first assess your symptoms, treatment history, and your goals, and from there, figure out which type of therapy treatment is best for you. Because each illness responds differently to treatment techniques, you’ll want to go with what’s been shown most effective for your diagnosis and symptoms.

Many of Telemynd’s clinicians are DBT-certified. If you’re a client, request an appointment online or call our live support for assistance in scheduling care today! If you’re a behavioral health provider looking to join our network, see all the benefits and learn how to apply here.

Sources Indian Journal of Psychological Medicine BMC Psychiatry Borderline Personality Disorder and Emotion Dysregulation