Dialectical Behavioral Therapy (DBT)

Facts to Know

• DBT is an evidence-based treatment for Borderline Personality Disorder and other conditions where emotional dysregulation is causing distress.
• DBT is a therapy-based intervention that can consist of individual therapy, group therapy, and even short phone coaching calls.
• DBT has 4 key skill components: mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.

What is DBT?

Dialectical Behavioral Therapy (DBT) is a treatment developed by psychologist Marsha Linehan to help patients who suffer from emotional dysregulation which results in self-destructive behaviors. It was originally designed to treat patients with suicidal behaviors and borderline personality disorder, and it has since proven to be an effective in the treatment of depression, bipolar disorder, substance use disorders, eating disorders, other personality disorders, and impulse control disorders. 

Dialectical Behavioral Therapy is aimed at helping individuals understand the triggers that lead to destructive and impulsive behaviors and develop new skills to cope with emotion dysregulation. The treatment also focuses on developing a capacity to hold onto seemingly contradictory truths like the need for both acceptance and change.  

A complete DBT treatment generally starts with a commitment to at least 6 months of treatment to learn the skills and apply them, but often requires longer to improve understanding and generalization of the skills to everyday life. The four components of comprehensive DBT treatment are:

• Individual structured DBT therapy
• DBT skills group
• Skills coaching via telephone contact outside of session
• Participation of the DBT therapist in a treatment team consultation group.

How does DBT work?

DBT treatment itself has four categories of skills taught to improve emotion regulation.

1. Mindfulness

Mindfulness focuses on increasing experiential attention and awareness into the here and now.Mindfulness is practiced throughout the course of treatment and aids in utilization of the other skills.

2. Distress Tolerance

Distress tolerance focuses on developing skills to manage and tolerate suffering and crisis situations without acting on impulses that could have long term negative consequences, such as self-harm or suicidal behaviors, problematic substance use, or anger outbursts.

3. Interpersonal Effectiveness

Interpersonal effectiveness skills focus on aiding patients in creating and maintaining healthy relationships with others by offering skills for developing appropriate boundaries, making requests, and saying no. These skills help patients enhance and improve relationships, build new relationships, maintain self-respect, and manage problematic interpersonal relationships effectively.

4. Emotion Regulation

Emotion regulation focuses on developing skills to use one’s emotions to guide internal, interpersonal and behavioral choices. The focus is on learning to understand, validate and integrate emotional experience to create a deeper connection with life and to make it more meaningful.

How can I receive DBT at Columbia?

At ColumbiaDoctors, we provide comprehensive programming for DBT which includes individual providers who specialize in DBT as well as DBT skills groups. In addition, the Columbia Day Program and the Lieber Recovery Clinic both incorporate DBT into their comprehensive programs.

Search our providers for a therapist or psychiatrist with expertise in DBT.