What is Dialectical Behavior Therapy?

People who have mood disorders and other conditions that are being treated by a therapist might be experiencing dialectical behavioral therapy. This term refers to the format of treatment; opposite methods of approaching mental health issues, acceptance, and change, are utilized together to achieve a positive result not seen with the application of only one method.

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Defining Dialectical Behavioral Therapy

This is a form of cognitive behavior therapy designed to help people suffering from mood disorders as well as those who need to change negative patterns of behavior. The client learns what triggers his behavior and then identifies coping skills useful to apply in these situations. The unique aspect of this type of therapy is that it addresses the tendency of many people to see their worlds in black-and-white, all or nothing perspectives. The therapist works with the client to accept his or her behavior while finding ways to move toward change.

History of the Therapy

This therapy was discovered in the late 1980s by Marsha Linehan, who taught psychology at the University of Washington. Initially, it was used to treat borderline personality disorders and individuals with suicidal tendencies. It was found to be effective in treating other areas as well. According to an article in Psychology Today, this therapy is valuable in treating depression, addictions, PTSD and traumatic brain injuries, as well as other conditions.

How it Works

There are four aspects of DBT. Mindfulness is the term given to the ability to accept the reality of the situation and b present. Distress Tolerance refers to the increased tolerance of negative emotion and pushes back the desire to escape it. Emotion Regulation involves recognizing how thoughts, sensations, behaviors, and feelings interact to form intense emotions, then strategizing to manage these emotions. Interpersonal Effectiveness is a method of communication that is assertive and supports self-esteem while strengthening relationships. These four concepts are used in individual therapy with a trained therapist and in group sessions. Groups meet once a week for six months. Sessions are usually two hours long. Group sessions allow clients to share their experiences and introduce the concept of group support. The therapist teaches skills and leads the group in exercises to practice them. Homework is assigned to the group as well. Another aspect of the therapy is telephone support from the therapist between sessions.


This therapy method is used to help people who have seen little or no improvement through other therapies. It is effective in part because the therapists themselves receive support. Because of the severity of the behaviors they treat, burnout is a chronic problem. DBT therapists receive continuous support and supervision. Most therapists work within a treatment team structure consisting of other therapists and group leaders. Several studies have shown that clients who received DBT had fewer incidents of self-harming behaviors than people within other types of therapy models. The one drawback to this evidence is that studies have not been done over extended periods of time. Additionally, practicing DBT requires rigorous training and supervision.

There are many types of cognitive behavior therapy. It is useful, in all of its forms, to treat diverse mental health and behavioral issues. Practitioners who utilize this method of behavior modification have discovered its effectiveness in several varieties of severe emotional and behavioral issues. Dialectical Behavioral Therapy is showing great promise in its ability to teach clients to maintain their progress and even to progress to better life skills.