What is Dialectical Behavioral Therapy (DBT)?

Dialectical Behavioral Therapy (DBT) is a comprehensive cognitive-behavioral treatment that emphasizes the psychosocial aspects of therapy. Originally developed by Dr. Marsha M. Linehan in the late 1980s to treat individuals with borderline personality disorder (BPD) and chronic suicidal thoughts, DBT has since been adapted for a wide range of other mental health issues, including depression, binge-eating, substance abuse, and post-traumatic stress disorder (PTSD). At its core, DBT focuses on providing therapeutic skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Core Principles of DBT

1. Balance and Dialectics: DBT is founded on the concept of dialectics, which involves finding a balance between acceptance and change. The therapy encourages clients to accept themselves and their current situation while simultaneously working to change their behavior and improve their lives.

2. Mindfulness: This fundamental component of DBT involves teaching clients to be fully present in the moment, increasing their awareness of thoughts, feelings, and surroundings without judgment. Mindfulness practices are crucial for developing self-awareness and emotional regulation.

3. Distress Tolerance: DBT provides strategies to tolerate and survive crisis situations without resorting to self-destructive behaviors. These skills help clients manage and accept distress using various techniques, including distraction, self-soothing, and weighing the pros and cons of a situation.

4. Emotion Regulation: Clients learn to identify and label emotions, decrease vulnerability to emotional triggers, increase positive emotional events, and change emotions that are not helpful. Emotion regulation skills are vital for individuals who experience intense, overwhelming emotions.

5. Interpersonal Effectiveness: DBT teaches skills to enable clients to communicate more effectively and assertively in relationships, maintaining self-respect and strengthening relationships while achieving their objectives.

The Process of DBT

DBT is typically delivered through a combination of individual psychotherapy sessions, group skills training, telephone coaching for crises or immediate support, and a therapist consultation team that supports the therapist in delivering the treatment. This multifaceted approach ensures that clients receive comprehensive support and learn practical skills that can be applied to everyday situations.

1. Individual Therapy: Focuses on enhancing client motivation, applying DBT skills to specific challenges, and addressing obstacles that arise during treatment.

2. Group Skills Training: Provides a structured environment where clients learn and practice DBT skills alongside others, facilitating mutual support and learning.

3. Telephone Coaching: Offers clients immediate support and guidance on applying DBT skills to manage real-life situations as they occur.

4. Therapist Consultation Team: Ensures therapists remain motivated and competent in providing DBT, promoting adherence to the treatment model and addressing therapist burnout.

Effectiveness of DBT

Evidence supports the effectiveness of DBT in reducing suicidal behavior, self-harm, hospitalizations, and improving symptoms of borderline personality disorder, among other conditions. Its skills-based approach empowers individuals to manage their emotions, navigate interpersonal situations effectively, and cope with distress in a healthy manner.


Dialectical Behavioral Therapy is a dynamic and evidence-based treatment that addresses the needs of individuals struggling with a spectrum of psychological issues. By emphasizing both acceptance and change, DBT helps clients develop the skills needed to navigate life's challenges, improve relationships, and achieve a sense of mastery over their emotions and behaviors. Through its structured approach and emphasis on practical skill development, DBT offers a pathway to a more stable and fulfilling life for those it serves.