What is Dialectical Behavioral Therapy (DBT)?
Updated: May 23
DBT is an evidence-based psychotherapy treatment created by Marsha Linehan that has its foundations in Cognitive Behavioral Therapy. Originally designed for people with Borderline Personality Disorder, it has now been shown to be effective treatment for people with a wide variety of mental illnesses and mood disorders, including depression and anxiety symptoms. “Dialectical” simply means combining two opposing ideas - in DBT, we learn how to “change what is and how to accept what is” in order to “increase resilience and build a life worth living” (Linehan, 2015). Traditionally, a DBT program includes individual counseling, a skills group, and telephone crisis coaching; however, some counselors simply integrate the skills and lessons into their individual counseling sessions. DBT focuses on 4 main areas of skills training: Mindfulness, Emotional Regulation, Distress Tolerance, and Interpersonal Effectiveness.
Mindfulness is the central aspect of DBT. This is where the client learns “how to observe and experience reality as it is, to be less judgmental, and to live in the moment with effectiveness” (Linehan, 2015). This section includes skills on how to be present, how to access your “wise mind” and how to find balance by “walking the middle path.”
Interpersonal effectiveness skills teach you how to find friends, maintain positive relationships, and end destructive ones. This is where you learn how to communicate effectively and set boundaries.
The next set of skills are for distress tolerance. These skills are simply aimed at surviving moments of crisis, including managing unsafe urges, intense emotions, and painful events.
Finally, there are the emotional regulation skills. With these skills, one learns how to recognize and name emotions, change emotional responses, reduce vulnerability to intense emotionality, and manage extremely difficult emotions.
DBT is a very practical and skills based therapy, and can be a helpful addition to your healing journey.
Mikayla Bugh, LPC
Linehan, M. (2015). Dbt skills training handouts and worksheets. The Guilford Press.