DBT: Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a therapy that helps people manage strong emotions, cope with stress, and build healthier relationships. It was originally developed as a treatment for individuals diagnosed with borderline personality disorder. The therapy is now applied to a broad range of issues, including depression, anxiety, trauma, and substance use. 

DBT provides skills training in mindfulness, coping, and interpersonal effectiveness. In this blog, we will examine how DBT functions, its central skills, and the positive impact it can have on mental health and well-being.

Overview of DBT

Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment for borderline personality disorder (BPD) [1]. Psychologist Dr. Marsha Linehan developed it to treat people who struggled with emotional regulation and engaged in self-destructive behaviors beginning in the late 1980s. 

The term “dialectical” refers to balancing two opposing forces, entering into the premise of DBT. This therapy involves teaching practical skills that help individuals cope with stress, regulate their emotions, and improve communication. DBT is now used effectively to treat many mental health conditions in hospitals, clinics, and private practices.

Who Can Benefit from DBT?

DBT can benefit all who struggle with intense feelings or unhelpful coping. It can be beneficial to individuals who experience certain psychological conditions. Others who may benefit from DBT are individuals who struggle with interpersonal relationships, experience mood swings, or self-cut. It provides people with concrete coping tools, rendering life more stable and manageable. 

Conditions DBT is often used for include:

• Borderline Personality Disorder (BPD)

• Depression and anxiety

• Post-traumatic stress disorder (PTSD)

• Substance use and addiction

• Eating disorders

• Self-harm and suicidal thoughts

DBT Core Skills

A significant part of Dialectical Behavior Therapy (DBT) is learning core skills that help people handle everyday challenges in healthier ways. All skills are designed to balance emotional coping, relationships, and reflective decision-making. Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness are four areas of focus in DBT. 

Each DBT skill, like taking a break when stressed, improving communication with others, and becoming more aware of feelings, has real-life uses that make daily life easier. Practicing these skills can lead to real change in mental health and daily life over the long term.

Mindfulness

Mindfulness can be defined as “awareness in the present moment, nonjudgmentally.” Emotion-focused DBT focuses on using the present moment to assist the individual in feeling their emotions rather than emoting. Moreover, increased awareness of emotion allows for a more measured and reasonable response. Mindfulness fosters a feeling of agency and identifies the feeling as less consuming.

Ways mindfulness improves emotional awareness include:

• Assisting individuals in identifying emotions at an early stage, before they escalate

• Space for pausing and responding.

• Decreasing automatic or negative responses to stress

• Promoting nonjudgmental acceptance of one’s feelings

• Improving the mind-body connection

Distress Tolerance

Distress tolerance is a DBT skill that focuses on managing painful emotions and stressful situations without making them worse. This skill teaches people how to cope with discomfort in better ways rather than reacting quickly or badly. It stresses coping, resigning, and soothing oneself to survive difficult moments. Tolerating distress allows people to better manage crises and minimize regrettable rash actions.

Emotion Regulation

Emotion regulation is a crucial DBT skill because it helps people understand, manage, and respond to their feelings healthily. For many mental health concerns, one source of emotional pain is that feelings are excessively intense or overwhelming. Emotionally, one can learn to control one’s emotions, resulting in more stable moods, less acting on impulses, and overall increased happiness. It provides the ability to stay centered and feel in control in stressful or difficult situations.

Interpersonal Effectiveness

DBT interpersonal effectiveness skills are all about having and keeping healthy relationships while respecting your needs. It teaches them to articulate their needs and feelings, to negotiate boundaries, and to engage in peaceful and respectful conflict resolution. The capacity to do this allows one to integrate self-respect while having compassion for others and thus have a healthier interaction. Interpersonal effectiveness practice enhances relationships in personal and professional spheres and reduces confusion.

DBT Strategies for Better Communication

One big focus in DBT is on learning how to find and use one’s voice, explicitly and respectfully discussing challenging, sensitive topics. These approaches help people to request what they require, to refuse when necessary, and to handle conflict without destroying relationships. Better communication also helps build trust and reduce misunderstandings, making for a better day-to-day interaction.

Some DBT strategies for better communication include:

• Using “I” statements to express feelings without blame

• Practicing active listening to fully understand the other person

• Being assertive while still respecting others’ boundaries

• Balancing honesty with kindness during conversations

• Staying calm and mindful in stressful discussions

How Does DBT Work?

Dialectical Behavior Therapy (DBT) combines individual therapy sessions with group skills training [2]. In individual sessions, people work one-on-one with a therapist to set goals, talk through challenges, and apply DBT skills to their daily lives. 

Groups focus on teaching and practicing the four skills of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Therapists also coach patients between sessions on utilizing these skills in the real world. DBT is structured, supportive, and incrementally builds progress, and thus, very effective when looking to make long-term emotional and behavioral change.

Individual Therapy vs. Group Skills Training

Group skills training and individual therapy both have central roles in DBT. Individual therapy provides one-on-one assistance in addressing personal issues, setting individual goals, and applying DBT skills to the individual’s life. Group skills training, in contrast, is more akin to a course where skills are taught and practiced collectively in core skills groups. The individual sessions allow for personal-centering of the process, while group sessions offer reinforcement, common experiences, and a safe place to rehearse new skills and coping mechanisms.

What is DBT Used For?

DBT has been adapted to treat a range of mental health conditions in which high emotions and high coping behaviors are prevalent. Originally created for those with borderline personality disorder, it has subsequently been adapted for a wide array of concerns. 

Today, DBT is often used for depression, anxiety disorders, trauma, substance use problems, and eating disorders [3]. It is also very useful to those who self-injure, have suicidal thoughts, or are often in relationship conflicts. The skills that DBT teaches people enable them to better cope with emotions, make more skillful choices, and learn to create healthier patterns of behavior in all areas of life.

Substance Use and Addiction

DBT can be very helpful for people struggling with substance use and addiction. While drugs or alcohol may provide an escape from painful emotions or a stressful situation, they often make matters worse in the long run. 

In addition, DBT offers more functional coping mechanisms that diminish cravings, increase self-control, and promote a lasting recovery. It prepares people for a substance-free life by addressing emotional triggers and teaching practical techniques.

How DBT supports recovery from addiction:

• Teaching distress tolerance to manage cravings safely

• Using mindfulness to stay focused on recovery goals

• Building healthier daily routines and habits

• Improving emotional regulation to reduce relapse risk

• Strengthening relationships and support systems

Benefits and Effectiveness of DBT

What makes DBT work is that it shows people how to cope with feelings, manage stress, and have healthier relationships. It has been shown to decrease self-harm, suicidal ideation, and psychiatric admissions. It is also helpful in dealing with depression, anxiety, trauma, and addiction by providing practical coping tools. DBT participants report feeling more in control of their emotions, better decision-making, and overall improvements in quality of life.

Key benefits of DBT include:

• Lower self-harm and suicidal behaviors

• Better control over emotions and mood swings

• Healthier ways to cope with stress

• Improved communication and relationships

• Greater self-confidence and stability

FAQs

Can DBT be used in group therapy?

Yes, DBT can also be provided in a group setting. Group skills training provides people with support, a shared experience, and a safe space to develop together as it emphasizes learning and practicing DBT skills.

How much does DBT therapy cost?

The cost of DBT therapy varies depending on location, therapist experience, and program structure. On average, it can range from $100 to $250 per session in many psychiatric clinics.

Is DBT effective for treating BPD?

Yes, DBT is highly effective for treating borderline personality disorder (BPD). It focuses on providing skills training and therapy sessions that can reduce self-injurious behavior, gain control over emotions, and develop new interpersonal skills and healthier relationships.

In what order should DBT skills be learned?

DBT is usually taught in a specific order. People first learn mindfulness, followed by distress tolerance, emotion regulation, and then interpersonal effectiveness. This order builds stronger skills step by step.

Who created DBT?

DBT was developed in the late 1980s by Dr Marsha Linehan. She created it as a way for individuals with borderline personality disorder to cope more effectively with overwhelming emotions and destructive behaviors.

How long does a session of DBT therapy last in the Psychiatric Clinic?

Sessions are usually 45-60 minutes in length, and common practice occurs in a psychiatric clinic. Therapy groups tend to be longer, usually from 90 minutes to two hours.

Get Support with Dialectical Behavior Therapy (DBT) at District Behavioral Health

At District Behavioral Health Group, we provide evidence-based Dialectical Behavior Therapy (DBT) programs designed to help individuals manage emotions, cope with stress, and build healthier relationships. Our nationwide recovery network ensures a supportive, structured path to healing, with care tailored to each person’s unique needs.

Our comprehensive DBT programs include:

• Individual Therapy: One-on-one sessions to work on personal struggles and apply DBT skills in daily life.

• Group Skills Training: A supportive setting to learn and practice DBT skills with peers.

• Crisis Coaching: On-call guidance to manage overwhelming emotions or stressful situations.

• Outpatient Programs: Flexible therapy sessions designed to fit around daily responsibilities.

• Specialized Programs: Focused care for conditions such as BPD, depression, anxiety, PTSD, addiction, and more.

To learn more about how DBT can support your mental health and recovery, call our compassionate team today at (888) 707-6073.

Sources:

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC2963469/

[2] https://preventionservices.acf.hhs.gov/programs/782/show

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC6007584/