Dialectical Behavior Therapy (DBT) is an empirically supported treatment designed for individuals exhibiting self-harm behaviors, such as thoughts of suicide, often associated with borderline personality disorder and other mental health issues. DBT comprises three treatment modalities: individual therapy, skills training in groups, and phone coaching, focusing on skill development in areas like mindfulness, emotional regulation, and distress tolerance. The therapy progresses through four stages aimed at enhancing emotional control, fostering connections, and facilitating ordinary life problem-solving.

1. Dialectical
Behavior
Therapy
(DBT)
By Allyson Lindsey
Campbell University
Psych 491
Intro to Counseling
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2.  DBT is a modification of cognitive behavior
therapy (CBT) and a variety of other research
techniques.
 Of note: DBT is empirically supported treatment.
 DBT is designed to treat “individuals with self-
harm behaviors, such as self-cutting, suicide
thoughts, urges to suicide, and suicide
attempts.” Click
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Empirical- DBT was researched and developed in clinical trials due to the therapy’s initial ineffectiveness and rejection by clients.
Treatment: Typically those with the listed behaviors tend to also meet criteria for Borderline Personality Disorder (BPD) and
subsequently also struggle with depression, bipolar disorder, post-traumatic stress disorder (PTSD), anxiety, eating disorders, or
dependency on drugs and alcohol.

3.  Specifically designed as a year long “outpatient”
therapy (length of therapy is dependent on patient)
 In DBT therapy, the therapist could be compared to a
patient’s life coach, sponsor, and firewall
 No one gets to the patient without going through the
individual therapist – who is “in charge” of the patient
 Three modes of treatment: Individual therapy, skills
group and phone coaching
 In addition to the 3 modes of treatment, DBT is often
a combined therapy
 Some patients with severe disorders require
pharmacological therapy
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4.  Skill groups are designed to arm patients with
effective tools for working through their
issues
 Groups are set up as classroom-type skill
builder sessions
 Learn one skill set thoroughly before moving on to the
next
 Groups focus on 4 sets of skills
 Mindfulness – eyes wide open
 Interpersonal effectiveness
 Emotional regulation
 Distress tolerance
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5. Discussion of Skillsets:
 Mindfulness – you can’t learn if you fail to really see what’s around you
 Interpersonal Effectiveness – defined but not in great detail as the topic is so large that it could result in a whole other
discussion piece
 Emotional Regulation – learning to understand how emotions work and the skills needed to manage emotions instead of
being managed by them, to reduce vulnerability, and to build positive emotional experiences by validating ALL emotions (not
discounting them) even negative ones will ultimately provide a sense of control
 Distress tolerance – builds on tolerating painful emotions and events when it’s not possible to make things better
immediately broken down into 4 sub-sets: distract, self-soothe, improve the moment, and pros & cons

6.  Stage 1 - Moving from being out of control of one’s
behavior to being in control
 Covers approximately 3 weeks
 Focus is on the problem behavior responsible for treatment
 Stage 2 – Moving from being emotionally shut down to
experiencing emotions fully
 Targets understanding of the disorder or problems
 Acquiring skills for addressing the problems
 Reinforcing desired behaviors following self-injurous or suicidal communication
 Stage 3 – Building an ordinary life, solving ordinary life
problems
 Focus is on working through ordinary problems and stressors, with or without a therapist
 Stage 4 – Moving from incompleteness to completeness
or connection
 Finding a way to fill the void of a life full of therapy treatment, building on skills learned in therapy
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7. Click
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Bohus, M., Haaf, B., Stiglmayr, C., Pohl, U., Bohme, R., & Linehan, M. (1999). Evaluation
of inpatient dialectical-behavioral therapy for borderline personality disorder -
a prospective study. Behavior Research and Therapy, 38(2000), 875-887.
Retrieved from http://depts.washington.edu/brtc/files/Bohus et al 2000.pdf
Dietz, L. (2003-2009). Dbt self help. Retrieved from
http://www.dbtselfhelp.com/html/dbt_skills__defined_.html
Dietz, L. (2003-2009). Dbt self help. Retrieved from
http://www.dbtselfhelp.com/html/flash_cards.html
Linehan, M. (1993). Skills training manual for treating borderline personality disorder.
New York, NY: The Guildford Press.
Linehan, M. (2009). Dialectical behavior therapy [Web]. Retrieved from
http://www.youtube.com/watch?v=ZTperp0Aa8Q
Linehan, M. (2009) Mindfulness & DBT I [Web]. Retrieved from
http://www.youtube.com/watch?v=Eec_SA6oSEA

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Linehan, M. (2009) Mindfulness & DBT II [Web]. Retrieved from
http://www.youtube.com/watch?v=-1ceBmqZnSI
Linehan, M. (2009) Mindfulness & DBT III [Web]. Retrieved from
http://www.youtube.com/watch?v=UTWITUGhDZs
Linehan, M. (2009) Mindfulness & DBT IV [Web]. Retrieved from
http://www.youtube.com/watch?v=yoLKQLvGylQ
Linehan, M. (2009) Mindfulness & DBT V [Web]. Retrieved from
http://www.youtube.com/watch?v=TFYGEbDzjnM
McKay, M., Wood, J., & Brantley, J. (2007). The dialectical behavior therapy skills workbook.
(pp. 1-224). Oakland, CA: New Harbinger Publications, Inc. Retrieved from
http://www.amazon.com/Dialectical-Behavior-Therapy-Skills-
Workbook/dp/1572245131/ref=pd_bxgy_b_img_b
Sanderson, C. (1997). Dialectical behavior therapy frequently asked questions. Retrieved from
www.behavioraltech.org
DBT skills workbook – an AMAZING tool for learning, but more specifically if this is a chosen specialty of interest.