Dialectical behavior therapy (DBT) is an evidence-based form of talk therapy, and it's used in individual sessions with a therapist, group therapy, or the increasingly popular "Dialectical Behavior Therapy App." It was originally developed to treat borderline personality disorder, but research shows that it can help anyone who struggles with intense emotions and emotional dysregulation. It can also be useful in treating co-occurring disorders, such as bulimia nervosa, binge eating disorder, depression, post-traumatic stress disorder, or substance abuse.
What's unique about dialectical behavior therapy is that it aims to balance acceptance of a patient's experience with the push for change. A major part of DBT is teaching patients new skills that can improve their ability to tolerate distressing emotions and manage negative situations and relationships.
The most well-known aspect of DBT is its mindfulness practice, which teaches patients to become more aware of their feelings, thoughts, and impulses. However, DBT has many other skills that can help patients cope with distressing or unhelpful behaviors. For instance, in one study, patients were taught a set of skills that allowed them to respond to their emotions differently. This included learning to accept their emotions as normal and focusing on the here and now rather than dwelling on painful experiences in the past or future. In addition, skills taught in DBT can help reduce emotion dysregulation and increase emotion regulation.
During DBT sessions, the therapist guides the client through behavioral analysis, which is used to identify problem areas and determine how best to address them. This is particularly important for people who struggle with emotions that are intense and difficult to control. The therapist helps the patient to understand what causes and maintains problematic behaviors, including any underlying beliefs that surreptitiously support them. The therapist and client then work together to decrease the target behaviors by reviewing problem-situation analyses, conducting a thorough behavior assessment, and celebrating skillful behavior.
This goal-focused approach is what makes dialectical behavior therapy so effective, and it's why it has such a high success rate. Research has shown that DBT can significantly decrease suicidal thinking and behavior, and it's even been used to treat other conditions such as bulimia nervosa, depression, bipolar disorder, and PTSD.
A comprehensive DBT treatment program typically involves a weekly session with the therapist and participation in an ongoing DBT group. The group consists of other individuals who are going through the same therapy and can offer support. The group leader is a therapist trained in DBT and acts as the coach for the participants.
A wide variety of DBT skills can be incorporated into other therapies, and there are also some standalone DBT books that can provide a general overview and more advanced chapters on specific skills. This book from author Marsha Linehan has a 4.5-star rating on Amazon and can be found here.