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Dialectical Behavior Therapy: An Overview

Dialectical Behavioral Therapy is a type of psychotherapy that uses a range of cognitive (thought) and behavior therapy strategies. Created in the early 1990's by Marsha Linehan, a professor in the Department of Psychology at the University of Washington, Dialectical Behavior Therapy was designed specifically to treat individuals with Borderline Personality Disorder, especially for those who struggle with self-harm behaviors such as self-mutilating and suicide attempts.

Dialectical Behavior Therapy maintains that some individuals – especially those with Borderline Personality Disorder – due to biological and environmental factors, react abnormally to emotional stimulation. DBT is a method whereby teaching skills help the patient to cope with these intense, sudden surges of emotion.

Dialectical Behavior Therapy typically includes two components: regularly scheduled individual therapy sessions, and a regular group session which usually lasts for ninety minutes.

Skills Training is an integral part of Dialectical Behavior Therapy, and is usually carried out in a group context, ideally by someone other than the individual therapist. In the Skills Training group sessions, patients are taught skills considered relevant to the particular problems experienced by people who have Borderline Personality Disorder. There are four modules, which focus on four groups of skills:

1. Core Mindfulness Skills
2. Interpersonal Effectiveness Skills
3. Emotion Modulation Skills
4. Distress Tolerance Skills

The “Core Mindfulness Skills” are derived from certain techniques of Buddhist meditation, although they are, essentially, psychological techniques, and no religious affiliation is involved in the application of these concepts. These are techniques that enable the patient to become more clearly aware of the contents of experience, and to develop the ability to stay with that experience in the present moment.

The “Interpersonal Effectiveness Skills” focus on effective ways of achieving the patient’s objectives with other people: to ask for what he/she wants effectively, to say “No,” and to have it taken seriously, to maintain relationships, and to maintain his/her self-esteem in interactions with others.

“Emotion Modulation Skills” are ways of changing distressing emotional states, and “Distress Tolerance Skills” include techniques for putting up with these emotional states if they cannot be changed in the meantime.

The course of therapy over time is organized into a number of stages, and is structured in terms of hierarchies of targets at each stage.

About the Author

David Oliver is the founder of BorderlineCentral.com a one stop source of information on how to cope and deal with borderline personality disorder.

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