Dialectical Behavior Therapy DBT: How It Works, What It Helps, and More

Another problem is that there aren’t many DBT-trained providers in less populated parts of the country. Online DBT therapy may be an option, although its effectiveness hasn’t been studied. «We’re starting to recognize that the majority of people can improve just doing the skills groups and don’t need the full DBT,» says Dr. Aguirre.

Therapist Consultation Team

The four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness). Dialectical behavior therapy is especially effective for individuals who experience intense emotions or struggle with behaviors that feel difficult to control. While originally developed for borderline personality disorder, DBT has since been adapted to support a wide range of mental health concerns.

How does DBT differ from cognitive behavioral therapy?

• But it can help people with other mental health problems, including suicidal behaviour, self-harm, substance use, posttraumatic stress disorder (PTSD), depression and eating disorders.
• «They say things like, ‘I’m stupid,’ or ‘I can’t control my anger,’ or ‘No one will ever love me,'» he says.
• Put simply, DBT helps people find a middle ground and teaches that it’s possible to achieve both acceptance and change.
• But you can learn different ways to cope with stress and tolerate distressing emotions.
• Therapists use dialectics to help people accept the parts of themselves they do not like.

Dialectical behavior therapy (DBT) is a structured outpatient treatment developed by Dr Marsha Linehan for the treatment of borderline personality disorder (BPD). Dialectical behavior therapy is based on cognitive-behavioral principles and is currently the only empirically supported treatment for BPD. Randomized controlled trials have shown the efficacy of DBT not only in BPD but also in other psychiatric disorders, such as substance use disorders, mood disorders, posttraumatic stress disorder, and eating disorders. Traditional DBT is structured into 4 components, including skills training group, individual psychotherapy, telephone consultation, and therapist consultation team. The skills include mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. Given the often comorbid psychiatric symptoms with BPD in patients participating in DBT, psychopharmacologic interventions are oftentimes considered appropriate adjunctive care.

• DBT’s focus on accepting thoughts and emotions may help you accept the aspects of life you cannot change, and ease feelings of helplessness that often accompany depression.
• To address this function, standard DBT includes a therapist consultation-team meeting, for which DBT therapists meet once per week for approximately 1 to 2 hours.
• People completing mindfulness will learn to focus on their thoughts in a non-judgemental way and notice any negative thoughts that may arise.
• CBT tends to be a shorter-term course of therapy, with results often possible in 5-20 sessions, whereas a DBT course often takes 12 months.
• In fact, the cornerstone of DBT — the skills training — can help anyone navigate emotionally charged situations with more ease.

Some people experience emotional extremes they cannot regulate, often when there is a history of trauma or when they feel threatened or abandoned. Emotion regulation skills help you label your emotions without judging them. You learn how different emotions shape your behavior and what obstacles prevent you from managing your emotions. If you’re looking to build skills like mindfulness and emotional Sober living home regulation in therapy, DBT could be a good option for you. DBT is evidence-based, meaning that there is research supporting its effectiveness. Data show reduced rates of suicidality, hospitalizations, and self-injury.

Skills Training Group

For instance, Behavioral Tech Institute is a group that trains therapists in DBT and offers a list of providers. Several studies and organizations support DBT’s efficacy in the treatment of BPD. In the final stage, individuals work toward advancing their lives and achieving spiritual fulfillment. In the context of DBT, mindfulness is broken down into “what” skills and “how” skills.

How DBT Helps

• This is largely because it was originally developed as a treatment for BPD, which is often marked by dramatic swings in mood and behavior that can make having relationships with others difficult.
• It’s a common therapy for people with borderline personality disorder, but therapists provide it for other mental health conditions as well.
• This process continues on a weekly basis (or more, depending on the severity of your symptoms) and may last for several years until you are equipped with the tools to manage independently.

There is some evidence that DBT is effective in lowering psychotropic medication use in patients. This is an area that deserves further consideration, given the mixed evidence for medication effectiveness, medication side effects, and potential for misuse of psychotropic medications. For example, mindfulness in DBT encourages greater self-awareness and acceptance without judgment. One way that DBT helps with changing behaviors is through teaching emotional regulation skills. This would include learning how to identify triggers, challenging unhelpful thoughts, and developing healthier ways to cope. In DBT, “dialectical” means finding a balance between two seemingly opposite things, like acceptance and change.

It teaches practical tools that individuals can apply in everyday life to navigate emotions, reduce stress, and build stronger relationships. With its clear structure and emphasis on active skill-building, DBT supports lasting personal change 2. Ideally, DBT includes one-on-one sessions with a therapist (who is also available between sessions for phone or text coaching). The one-on-one sessions are combined with weekly group sessions led by a therapist who teaches the specific, interconnected skills and gives homework that helps to reinforce the skills. Participants are encouraged to keep a daily diary to track their emotions, behaviors, reactions, and examples of how they’re practicing their skills. We’re not just listeners; we’re active participants in your journey, balancing acceptance with transformative change.

DBT can even be an effective treatment for mental health conditions such as anxiety, PTSD, substance use disorder, bipolar disorder, and depression. One study showed that 77% of people with a borderline personality disorder diagnosis showed an improvement in symptoms after a course of dialectical behavioral therapy. Since its development in the late 1980s, dialectical behavior therapy has grown into one of the most widely used and well-researched approaches for treating emotional dysregulation. While it was originally created to support individuals with borderline personality disorder, DBT has been successfully adapted for many other mental health conditions, including anxiety, depression, and post-traumatic stress.

Skills training

DBT therapists are often available by phone between sessions to deal with crises. Through DBT, people can learn interpersonal skills, such as listening, assertiveness, and other social skills. Individuals will learn to recognize and accept their emotions without judgment. Both therapies allow people to better understand and manage their thoughts and behaviors.

For instance, instead of thinking, ‘It’s not fair,’ they may ask themselves instead, ‘Can I control the situation? If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. Checking with your primary care physician, other therapists, or your local college, university, or medical center could all be helpful options. To find a DBT therapist, you can use online tools like Behavioral Tech’s directory of therapists who specialize in DBT. At its root, DBT takes a biosocial approach to understanding how people’s symptoms arise and continue. It is usually important that someone receive significant supervision by someone considered an expert in DBT.