Dialectical behavioral therapy: Definition and techniques

If you decide that DBT is the right therapy for you, they’ll ask you to commit to the treatment and the length of treatment. Most therapists’ websites list the conditions and problems they treat. If you have questions, call or email the therapist’s office before you choose. Dialectical behavior therapy was developed in the 1970s by Marsha Linehan, an American psychologist. This document is prepared and intended for use in the context of the Canadian health care system.

• This isn’t to be confused with group therapy, in which you discuss your problems with others.
• The team helps therapists problem-solve ways to implement effective treatment in the face of specific clinical challenges (e.g., a suicidal patient, a patient who misses sessions).
• Plus, you learn to avoid situations that typically trigger strong emotions and pursue events that boost positive emotions.
• A landmark study, published in 1991 in the Archives of General Psychiatry, was the first to show that DBT could be an effective treatment for BPD.

Therefore, the therapy team typically meets weekly for support, training, and feedback. This skill involves being able to feel intense emotions, such as anger or grief, without reacting impulsively or using maladaptive coping techniques, such as substance abuse or self-harm. (No talk therapy can do that.) It will work best for you if you’re committed to change, ready to practice the skills you learn, and comfortable sometimes being in a group, as well as in one-on-one sessions. Depending on where you live, you may have trouble finding a complete DBT program that includes individual sessions, group skills classes, and phone coaching. If so, you can look for a therapist who uses DBT techniques in their practice. DBT was first designed to treat people with borderline personality disorder.

Table 1Characteristics of Included Publications

Lorandini notes that all patients are encouraged to fill out a weekly “diary card,” which is a self-monitoring chart used to document urges, behaviors, emotions, and skills. DBT is a form of cognitive behavioral therapy (CBT) that was first developed in the 1980s by psychologist Dialectical Behavioral Therapy Marsha Linehan, PhD, at the University of Washington in Seattle, according to the Association for Behavioral and Cognitive Therapies (ABCT). Because supporting people with life-threatening behaviors can be challenging, DBT therapists work with consultation teams.

While there is no “right” answer to this question, potential clients should know upfront whether phone calls and other forms of communication are accepted during the week. If the therapist states that he or she does not accept these forms of communication, it is important to inquire how skills generalization may occur (i.e., how the client might receive skills coaching at times other than the therapy hour). To that end, at both Adult and Adolescent Services, Yale offers high quality DBT treatment across levels of care, allowing patients and their families to be matched to treatments that best fit their needs. Additionally, offering DBT services across levels of care also supports patients in maintaining their treatment gains and meeting individualized goals. For instance, inpatient and partial hospitalization day programs may offer shortened skills training schedules.

What Does Dialectical Mean?

Outcome measures of interest in the RCT by Elices et al.1 were time to relapse or recurrence of major depression, and changes in depression, general psychiatric symptoms, and dispositional mindfulness. Accumulating evidence indicates that DBT reduces the cost of treatment. For example, the American Psychiatric Association (1998) estimated that DBT decreased costs by 56% – when comparing the treatment year with the year prior to treatment – in a community-based program. In particular, reductions were evident by decreased face-to-face emergency services contact (80%), hospital days (77%), partial hospitalizations (76%), and crises bed days (56%).

Individuals will learn to recognize and accept their emotions without judgment. If you have been diagnosed with borderline personality disorder, your treatment may last longer than that. In deciding whether to use DBT or other treatments for a particular patient, one key deciding factor is the research data on the treatment with patients that are similar in terms of problem areas, diagnoses, or characteristics to the patient in question.