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DBT: What Is Dialectical Behavior Therapy?

June 26, 2018

An in-depth look at Dialectical Behavior Therapy

Dialectical Behavioral Therapy (DBT) is a highly structured program used to provide teens with tools to regulate emotions. This approach has been proven to work for many adolescents suffering from extreme emotional stability, including suicidal ideation and self-harm. The word “dialectical” in DBT refers to the program’s combination of the tenets and methods of mindfulness and of Cognitive Behavioral Therapy.

A short history of Dialectical Behavioral Therapy

DBT was developed in the 1970s by Dr. Marsha Linehan to treat patients suffering from Borderline Personality Disorder (BPD), a mental condition characterized by serious symptoms such as an inability to retain interpersonal relationships, self-harm, depression, anxiety, and suicidal thoughts. Before the development of Dialectical Behavioral Therapy, patients with BPD were considered to be difficult or impossible to treat. Rather than accepting this as fact, Dr. Linehan took a different approach to the disorder and searched for an effective treatment. She did this by reframing the disorder as a specific problem that affects the emotion regulation system, and thus would be treatable with a systematic approach.

How does DBT work?

DBT has been designed to assist patients suffering from extreme emotional instability that is commonly referred to as “emotional dysregulation.” Dysregulation can lead to self-destructive behaviors. The main goal of DBT is to educate patients about emotions without judgment, teaching them to practice mindfulness. This component, along with the identification of harmful cognitive and behavioral patterns gleaned from CBT, helps patients learn skills and techniques to handle their emotions and stop self-destructive behavior.

DBT skills training consists of 5 modules that are well structured to help adolescents deal with mental-health problems. These modules include:

- Mindfulness: Understanding the common signs of unregulated emotions.

- Interpersonal effectiveness: Learning to have positive social interactions by dealing with a negative stimulus in the moment, rather than allowing it to trigger a negative reaction.

- Emotional regulation: Coping with difficult situations by encouraging the building of pleasant and soothing experiences, often through a focus on taking proper care of the physical body.

- Distress tolerance: Recognizing and impeding the drive toward self-destructive behavior.

- Walking the middle path: Teaching parents and children to validate, negotiate, and compromise.

For more information on Dialectical Behavioral Therapy for adolescents, see this thorough article from the Child Mind Institute:

At Casa Pacifica Centers for Children and Families, we have seen time and again the effectiveness of well-administered Dialectical Behavioral Therapy. If you believe your child is in need of intensive therapeutic intervention, reach out today for a free and confidential screening to see if Dialectical Behavioral Therapy is the right approach for your child: