Dialectical Behavior Therapy (DBT) is an evidence-based therapy that uses dialectical strategies and mindfulness techniques to help change behaviors that prevent people from leading a "life worth living."  DBT combines both the principles and practices of Western cognitive-behavioral therapy (CBT) and Eastern mindfulness approaches to help people understand, accept, and change the patterns of living that are causing them suffering. DBT aids in learning adaptive skills to increase self-awareness, regulate emotions, improve interpersonal relationships, and tolerate very stressful situations and emotional responses to life's events. 

DBT was  developed at the University of Washington by Marsha M. Linehan, Ph.D (1993) to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). DBT is now recognized as the "gold standard" psychological treatment for this population. In addition, research has shown that DBT is effective in treating a wide range of disorders in adults and adolescents, including substance dependence, depression, anxiety, bipolar disorder, post-traumatic stress disorder, and eating disorders. Most recently (2017) DBT for children (DBT-C) demonstrated feasibility in the treatment of disruptive mood dysregulation disorder (DMDD) in childhood. (Perepletchikova, et al 2017).

When emotional dysregulation occurs, it can result in behaviors such as: 

  • Extreme emotional intensity that feels all-consuming and difficult to contain

  • Rapid and/or extreme mood shifts

  • Experiencing real or imagined feelings of abandonment

  • Heightened sensitivity and reactivity to criticism

  • Difficulty establishing or maintaining healthy relationships

  • Shame

  • A chronic sense of emptiness or confusion about self

  • Having mixed or alternating feelings of anxiety and depression

To cope with such symptoms, people often engage in behaviors that may make things feel better in the moment but lead to serious consequences such as:

  • Impulsive behaviors

  • Self-harm behaviors

  • Drug and/or alcohol abuse

  • Eating too much or too little

  • Suicide ideation

  • Relationship instability

  • Addictions

  • Avoiding people or places that are painful or upsetting

  • Isolation

DBT  targets such behaviors and help people feel more in control of their emotions and actions.

DBT includes four sets of behavioral skills:

  • Mindfulness: the practice of being fully aware and present in this one moment

  • Distress Tolerance: how to tolerate pain in difficult situations, and not change them

  • Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others

  • Emotion Regulation: how to change emotions that you want to change

DBT has been shown to:

  • Enhance motivation and desire to live fully in your life

  • Improve overall quality of life and create a life worth living

  • Regulate emotions and increase focus

  • Improve emotion management

  • Decrease impulsive reactivity

  • Improve interpersonal relating and communicating

  • Decrease self-destructive behaviors

  • Enhance your ability to get through crises

  • Reduce behaviors that cause harm to self and others

  • Manage life crises more effectively

  • Decrease suicidal behaviors and hospitalizations

DBT can help you:

  • Improve problem solving in the moment

  • Ask for what you want and say “no” effectively

  • Be in a difficult situation without making it worse

  • Reduce suffering and increase happiness by managing the intensity and reactivity of emotions