Dialectical Behavioral Therapy
What is Dialectical Behavioral Therapy (DBT)?
Dialectical Behavioral Therapy (DBT) helps clients who feel overwhelmed by intense emotions, experience difficulty in their relationships, and are looking for greater stability in their lives. DBT helps reduce behaviors that leads to distress and disruption and increase helpful behaviors, resulting in a calmer, more fulfilled life.
DBT was developed by Dr. Marsha Linehan and has been proven successful in improving the lives of people with a variety of struggles. DBT skills include mindfulness, effective communication, radical acceptance, problem solving, and more.
Is DBT right for me?
If the intensity of your emotions sometimes makes it hard to act and speak in ways that line up with your values, DBT can be incredibly helpful.
DBT skills help you:
Regulate emotions (help you deal when things get really overwhelming)
Be in the moment (not try to escape the moment with overthinking, overworking, or excessive substances)
Handle tough conversations (say what you mean in a way you won’t regret later)
DBT was originally developed as a treatment for borderline personality disorder. It has since been shown to be effective in treating clients with a history of trauma, anxiety, and depression.
As many DBT clients say, “I wish everyone could learn DBT.” This is because anyone can benefit from the skills practiced.
Different Kinds of DBT
There is a wide spectrum of DBT offerings. Finding out which type of DBT is right for you is key. If you are interested in DBT, the general guide below can help you find the right fit. When a therapist says they offer DBT, be sure to ask exactly what that looks like. This will ensure you or your loved one gets treatment that meets your personal needs.
Traditional or Adherent DBT – This is the original DBT. It was created for individuals living with borderline personality disorder. Fully adherent or traditional DBT (meaning adhering closely or exactly to the original manual created by Dr. Linehan) usually consists of one 50-minute individual session per week in addition to one hour-and-a-half skills class per week. It also includes phone-based coaching with a therapist outside of scheduled sessions when needed.
Traditional DBT is best when an individual is really struggling to find stability in big aspects of life like work and relationships. There may be some level of crisis fairly regularly. In this mode of DBT, clinicians and clients work together to create highly targeted plans to address specific behaviors (for example: self-harming or binge eating) that are interrupting their lives.
All forms of DBT come with some level of practice outside of sessions. Adherent DBT has very specific homework and can require a substantial time and energy commitment to be effective.
Radically Open DBT – If the original DBT was created for people who get stuck in “emotion brain,” radically open DBT (RO-DBT) was created to help those who get stuck in “reason brain.” This form of DBT is set up similarly to traditional DBT. However, it differs in its goals.
RO-DBT is for individuals who have trouble expressing emotions, who are likely to attempt to control whatever aspects of their lives they can, and who struggle to be open. Whereas traditional DBT helps individuals who feel and express emotions very intensely, RO-DBT helps those who avoid feeling or expressing their emotions at all.
Non-Adherent DBT – There are a variety of ways to incorporate DBT into other types of therapy. It can range from using DBT skills as-needed with individual clients to having a DBT skills group that’s a little less structured than adherent DBT, or that doesn’t require participants to have individual DBT as well.
As stated above, almost anyone can benefit from DBT skills. If you’re not in a crisis or at high risk of harming yourself, therapy that includes some DBT skills may be right for you.
Whatever form of DBT you seek, ask the therapist about their DBT training and experience and how they use DBT in sessions. It’s also important to share a bit about yourself and what you want help with. An ethical therapist will let you know if they’re not be the best fit and will help you find someone who is.