Dialectical Behavior Therapy (DBT)

What is dialectical behavior therapy (DBT) used for?

Individual DBT therapy involves weekly sessions with your therapist. Each session lasts about 40 minutes to 60 minutes.

Individual DBT therapy sessions have the following goals:

• To help keep you safe by reducing suicidal and self-harming behaviors, if applicable.
• To limit behaviors that get in the way of productive therapy.
• To help you reach your goals and improve your quality of life by addressing what’s blocking your progress, such as mental health conditions or relationship issues.
• To help you learn new skills to replace unhelpful behaviors.

Your therapist will likely ask you to keep a diary to track your emotions and actions and to look for patterns of behavior. You’ll bring this diary with you to your sessions so you and your therapist can decide what to work on for each session.

In these sessions, your therapist will teach you skills in a group setting. This isn’t to be confused with group therapy, in which you discuss your problems with others. Think of it more like a teaching and learning session in a classroom setting.

DBT skills aim to help enhance your capabilities in day-to-day life. The four skills your therapist will teach include:

• Mindfulness: This is the practice of being fully aware and focused in the present instead of worrying about the past or future.
• Distress tolerance: This involves understanding and managing your emotions in difficult or stressful situations without responding with harmful behaviors.
• Interpersonal effectiveness: This means understanding how to ask for what you want and need and setting boundaries while maintaining respect for yourself and others.
• Emotion regulation: This means understanding, being more aware of and having more control over your emotions.

Dialectical behavior therapy (DBT) has been proven to help people with their mental health conditions in several studies. For people with borderline personality disorder, in particular, DBT results in:

• Less self-harm behavior and anger.
• Fewer days of inpatient hospitalization.
• Less drug and alcohol misuse.
• Improved depressive symptoms.

However, DBT isn’t for everyone, and it can be very difficult. DBT is more likely to work for you if you:

• Are committed to making positive changes.
• Are ready to fully commit to therapy and do homework assignments.
• Are ready to focus mostly on your present and future, rather than your past.
• Feel able to do some sessions in a group with others.

Dialectical behavior therapy (DBT) usually takes at least six months to a year. However, each person is unique, and mental health conditions are complex. You shouldn’t expect to be completely free of symptoms or no longer have problematic behaviors after one year of DBT.

Many therapists believe that the treatment for borderline personality disorder, in particular, can often take several years.

Try not to get discouraged by how long it may take to be able to better manage your emotions and have a better quality of life. The important thing is that you’re seeking help. Any progress is good progress.

DBT was developed by Marsha M. Linehan, a psychologist who initially used it to treat her own BPD. Since then, DBT has become a widely recognized and evidence-based therapy approach.

Benefits and Effectiveness of DBT

DBT has become one of the most studied forms of therapy and has picked up popularity among therapists as evidence of its clinical effectiveness has continued to accumulate. There have been 15 significant trials of DBT to date. The evidence shows effectiveness in reducing self-harm, more treatment adherence, less time in treatment, fewer serious episodes, and patients have reported feeling better.