From the Guidelines
Dialectical Behavior Therapy (DBT) is a highly effective treatment approach that focuses on teaching four key skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, and is recommended as the primary treatment for individuals with borderline personality disorder and other mental health conditions. DBT is a specialized form of cognitive-behavioral therapy that was originally developed to treat borderline personality disorder but is now used for various mental health conditions including depression, anxiety, PTSD, substance use disorders, and eating disorders. The therapy typically involves weekly individual therapy sessions, group skills training classes, phone coaching between sessions, and therapist consultation teams 1. What makes DBT unique is its dialectical approach, which balances acceptance of the patient's current emotional state with the push for positive behavioral change. Treatment usually lasts 6-12 months, though some people benefit from longer engagement. DBT is effective because it provides practical skills for managing overwhelming emotions and reducing self-destructive behaviors while creating a supportive therapeutic relationship that validates the patient's experiences, as supported by recent studies 1. Some of the key components of DBT include:
- Core Mindfulness Skills module to diminish identity confusion and self-dysregulation
- Interpersonal Effectiveness Skills module to enable interpersonal problem-solving through assertiveness training
- Distress Tolerance module to reduce impulsivity by teaching acceptance and tolerance of painful situations
- Emotion Regulation Skills module to identify emotions, reduce emotional vulnerability, and increase positive events 1. Unlike traditional talk therapy, DBT is highly structured and skills-based, requiring active practice between sessions for maximum benefit. Recent studies have consistently shown that DBT is an effective treatment approach for reducing suicidal ideation and behavior, and improving overall mental health outcomes 1. Therefore, DBT is a highly recommended treatment approach for individuals with borderline personality disorder and other mental health conditions, due to its effectiveness in reducing self-destructive behaviors and improving overall mental health outcomes.
From the Research
Definition of DBT
- Dialectical Behavior Therapy (DBT) is a type of psychotherapy that emphasizes the acquisition and use of strategies to down-regulate negative emotion 2.
- DBT is an evidence-based treatment for borderline personality disorder (BPD) and has been shown to be effective in reducing symptoms of BPD, post-traumatic stress disorder (PTSD), and depression 3, 4, 5, 6.
Key Components of DBT
- DBT involves the use of strategies to manage emotions, tolerate distress, and improve relationships 2.
- DBT Prolonged Exposure (DBT PE) is a protocol that can be added to DBT to target PTSD symptoms specifically 3, 6.
- DBT has been shown to be effective in reducing self-harm and suicidal behaviors in individuals with BPD and PTSD 5, 6.
Effectiveness of DBT
- Studies have shown that DBT can lead to significant reductions in PTSD symptom severity, depression, and dissociative symptoms 3, 2, 6.
- DBT has also been shown to be effective in reducing BPD-associated symptoms, such as emotional instability and impulsivity 4, 5.
- The effects of DBT can be maintained over time, with some studies showing that improvements can last for at least 1-2 years after treatment completion 4.