Dialectical Behavior Therapy

What does the word dialectical even mean?  The term “dialectical” means a synthesis or integration of opposites. This form of therapy is a balance between acceptance and change.

DBT is a cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). This form of therapy is now recognized as the gold standard psychological treatment for this population. Studies have shown that it is effective in treating a wide range of other disorders including substance dependence, post-traumatic stress disorder (PTSD), eating disorders, and chronic pain.

DBT is often taught in groups. These groups focus on helping strengthen a client’s coping ability by teaching skills.  This form of counseling is more of a teaching format.  The counselor teaches skills to the clients, gives the client homework, and asks the client to use these skills throughout the week.

Clients also can receive individual DBT counseling. This format is focused on enhancing client motivation and helping clients to apply the skills learned in group to specific life challenges.  In the standard DBT model, individual therapy takes place once a week for as long as the client is in therapy and runs in connection with skills groups.

There are four main skills that are taught within DBT; mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation.  Mindfulness has a client be fully present in the current moment.  This can help with dealing with a current distress instead of focussing on the past or the future.  Distress tolerance teaches a client to cope with current pain instead of changing it.  Not all pain, especially physical pain is avoidable.  Interpersonal Effectiveness teaches a client to reach out for help and learn to say no while still maintaining quality relationships with other.  The last piece is emotional regulation. The emotional regulation allows a client to change the emotions.

DBT has become a more popular theory in the past decade.  With a focus on skill development, DBT quickly gives a client tangible skills to help make a quick impact on the pain a client brings to counseling.

Scroll to Top