What is Dialectical Behavior Therapy (DBT)?

This video describes dialectical behavior therapy. Dialectical behavior therapy (DBT) is a modality that was created by Marsha Linehan in the 1980s and it was specifically designed to treat individuals with borderline personality disorder. Even more specifically it treats the characteristic of suicidal tendencies that sometimes observed in borderline personality disorder. DBT is a particularly complex modality. It has a number of different components that were borrowed from a number of other theories and modalities. It is generally thought of as a program only modality, although there are versions of it that can be delivered by an individual clinician. From a client's point of view DBT has three main activities: individual therapy (usually about two hours a week), group counseling (an hour and a half to two and a half hours a week) and telephone coaching (available 24/7). From the therapist point of view, you have those three components and a therapist consultation component. There are five functions to DBT. The first is enhancing capabilities and this is really skills training. This skills training has four modules known as the “four modules of DBT.” This includes mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. The second function is generalizing capabilities. The third function is improving motivation and reducing dysfunctional behavior. The fourth function is enhancing and maintaining therapist capabilities and motivation, and this is met through support training and encouragement to the therapist. Dialectical behavior therapy is based on three theories, biosocial theory, dialectical philosophy, and behavior therapy. The biosocial theory has to do with emotional vulnerability, which is related to the invalidating experiences that we believe may lead to or at least may contribute to the development of borderline personality disorder. Dialectical philosophy is about the tension between acceptance and the desire to change. This tension is experienced by the client and by the therapist. Behavior therapy has lot of the techniques from other behavioral modalities including cognitive restructuring, components of exposure therapy, and adaptive responding.