DBT is a comprehensive treatment developed by Marsha Linehan at the University of Washington in the 1980s.
DBT was originally developed to treat people struggling with multiple, self-destructive problems.
DBT is effective for a wide range of emotional difficulties, including:
suicidality, self-injury, impulsivity, relationship difficulties, depression, anxiety, problematic substance use, disordered eating, unstable sense of self, and post traumatic stress.
DBT involves several components:
Skills training classes, which teach new ways of managing emotions.
There are five types or “modules” of DBT skills: Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and middle path skills.
Therapy, which focuses on working toward individualized goals and building motivation to do so.
Regular support for staff providing DBT, or “therapy for the therapists,” in a DBT consultation team.
Skills coaching to help generalize new skills to “real life” settings.
DBT is based on the theory of dialectics
According to the Oxford English Dictionary, 2023, a dialectic is “the existence or operation of opposing (abstract) forces, tendencies, etc.; the tension produced by these”.
A dialectical worldview holds that two opposing things can be true at the same time, and indeed can often be combined to create a greater truth.
When big emotions lead to “black and white” thinking, dialectics help us find the gray area.
While some might view acceptance and change as contradictory positions, DBT synthesizes them. It’s not just that acceptance and change can coexist, but that implemented effectively, acceptance leads to change, and change leads to acceptance.
Other key dialectics in DBT include: problem solving and validation, reason and emotion, flexibility and stability, and nurturing and challenging.
DBT uses a dialectical worldview because emotion dysregulation so often leads to extreme patterns of thinking, feeling, and acting. Dialectics provide a useful way to find balance.
The central dialectic of DBT is that of acceptance and change: in DBT we believe that everyone is doing the best they can with what they have in the moment (complete and total acceptance) and they can and must do better with new tools, skills, and supports (strong push for change).
DBT leverages the tools of acceptance-based therapies (e.g., warmth, acceptance, support, validation, mindfulness) and those of change-based therapies (e.g., problem solving, skills training, behaviorism, exposure, behavioral activation).
Part of a dialectical worldview is the idea that there is no single, absolute truth. Instead of being certain that our idea is the right idea, we ask, “what is being left out?”
DBT is a behavioral treatment
The “B” and “T” in DBT refer to “behavior therapy.” Behavior therapies use the scientific principles of behavior change to help clients achieve their goals. Behavioral science underpins a wide range of many effective therapies (e.g., cognitive behavioral therapy (CBT), exposure for anxiety and OCD, and parent management training (PMT) and parent child interaction therapy (PCIT) for disruptive behavior in young children).
DBT uses the scientific principles of behavior change to help clients build new skills, stop destructive behaviors, and build lives they experience as worth living.
You will learn more about the principles of behaviorism, and how to use them to achieve your goals, in the program.