What is DBT?

____Dialectical Behavior Therapy (DBT) is an evidence-based treatment for borderline personality disorder, developed by Dr. Marsha Linehan and colleagues at the University of Washington.  DBT has also shown promise in treating suicidal adolescents, depressed older adults, persons with binge-eating disorder and persons with personality disorders and substance use disorders.  Standard DBT is an outpatient treatment that consists, at minimum, of once weekly individual therapy and once weekly skills training, usually done in a group.  DBT is provided by a team of therapists who meet weekly for consultation on how to improve their skills as therapists and to remain adherent to the treatment principles and protocols. 

            The overarching goal of DBT is to obtain “a life worth living.” DBT has been shown to be effective in reducing suicidal behaviors, hospitalizations, and problems with anger, depression, and hopelessness.  The key problem that DBT treats is emotion dysregulation, defined as a combination of extreme emotional vulnerability with difficulty in regulating emotions once they are aroused.  DBT clients learn an array of skills to manage their emotions and the impulsive and almost automatic behaviors that often accompany strong emotions.  In individual therapy each client works on a highly personalized plan to reduce the behaviors getting in the way of attaining their goals and to increase their use of skillful behaviors.  DBT also includes between-sessions coaching by phone and email on how to use skills in specific situations to achieve improved functioning.  Most clients who enter DBT are asked to make a year commitment to attend both individual therapy and skills training.  In one year of treatment and with hard work from both the client and the therapist, most clients can see significant improvement in their overall functioning.