Dialectical Behavior Therapy (DBT)

DBT treatment typically consists of individual therapy sessions and DBT skills groups. Individual therapy sessions consist of one-on-one contact with a trained therapist, ensuring that all therapeutic needs are being addressed. The individual therapist will help the patient stay motivated, apply the DBT skills within daily life, and address obstacles that might arise over the course of treatment.

DBT skills group participants learn and practice skills alongside others. Members of the group are encouraged to share their experiences and provide mutual support. Groups are led by one trained therapist teaching skills and leading exercises. The group members are then assigned homework, such as practicing mindfulness exercises. Each group session lasts approximately two hours, and groups typically meet weekly for six months. Groups can be shorter or longer, depending on the needs of the group members. DBT can be delivered by therapists in many ways. For instance, some people complete the one-on-one therapy sessions without attending the weekly skills group. Others might choose the group without regular one-on-one sessions.

DBT is a cognitive-behavioral treatment developed by Marsha Linehan, Ph.D., in the 1980s to treat people with a borderline personality disorder. Those diagnosed with BPD often experience extremely intense negative emotions that are difficult to manage. These intense and seemingly uncontrollable negative emotions are often experienced when the individual is interacting with others—friends, romantic partners, family members. People with borderline often experience a great deal of conflict in their relationships.

As its name suggests, DBT is influenced by the philosophical perspective of dialectics: balancing opposites. The therapist consistently works with the individual to find ways to hold two seemingly opposite perspectives at once, promoting balance and avoiding black and white—the all-or-nothing styles of thinking. In service of this balance, DBT promotes a both-and rather than an either-or outlook. The dialectic at the heart of DBT is acceptance and change.