Dialectical Behavior Therapy, DBT, is a type of cognitive-behavioral psychotherapy. DBT was originally developed to help better treat individuals with suicidal behaviors and borderline personality disorder (BPD). DBT is a modification of standard cognitive behavioral therapy (CBT). DBT utilizes a cognitive-behavioral approach while placing greater emphasis on the psychosocial aspects of treatment. A psychologist named, Marsha M. Linehan, developed DBT in the late 1980s after the result of her own transformation that occurred in 1967, according to Psych Central. Interestingly, at the time of its development, Linehan was a suicide researcher, with negligible knowledge of borderline personality disorder. Although DBT was initially developed as a means to be used primarily in the treatment of individuals with BPD, it is now recognized as an effective treatment method for individuals diagnosed with a variety of mental health illnesses, particularly those that involve serious emotion dysregulation such as depression, eating disorders, post traumatic stress disorder (PTSD), substance use disorder (SUD), and more. Furthermore, DBT has been evaluated and found to be effective among individuals from diverse backgrounds.
Marsha M. Linehan
Marsha M. Linehan is a pioneer in the treatment of mental health ailments, with extensive notoriety. She retired from serving as a Professor Emeritus of Psychology in the Department of Psychology at the University of Washington in 2019. She served as president of both the Association for the Advancement of Behavior Therapy and the Society of Clinical Psychology, Division 12, American Psychology Association. Linehan was also a fellow of the American Psychological Association and the American Psychopathological Association and was a diplomat of the American Board of Behavioral Psychology. Linehan has written the following four books, including two manuals:
- Cognitive-Behavioral Treatment for Borderline Personality Disorder
- Skills Training Manual for Treating Borderline Personality Disorder
- DBT Skills Training
- Building a Life Worth Living: A Memoir
Additionally, Linehan has published extensively in scientific journals, as well as served on a plethora of editorial boards. Some of the many awards Linehan received recognizing her clinical and research contributions to the study and treatment of suicidal behaviors include the following:
- The Distinguished Research in Suicide Award (American Foundation of Suicide Prevention
- The Louis I. Dublin Award for Lifetime Achievement in the Field of Suicide
- The creation of the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior established by the American Association of Suicidology
- The Distinguished Scientist Award from the Society for a Science of Clinical Psychology
She is the co-founder of DBT-Linehan Board of Certification (DBT-LBC), which is an organization that identifies providers and programs that offer reliable DBT services, which conform to the evidence-based research for treatment. Linehan is the founder of Behavioral Tech LLC, which is an origination that provides DBT training to mental health professionals and healthcare systems.
Dialectical behavior therapy is comprised of one-on-one psychotherapeutic sessions and DBT skills group training sessions. The individual therapy sessions are used to assure the individual in treatment can focus on all of his or her nuanced mental health needs, as well as to provide support and encouragement to integrate the skills learned in group sessions into his or her daily life. One-on-one therapy sessions emphasize problem-solving behaviors, and provide the individual with an emotionally safe environment to process and address any problems that arise in the individual’s life. The DBT skills group sessions are conducted by a qualified mental health professional that teaches the DBT skills as well as provides relevant exercises for participants to practice the skills learned. DBT specifically focuses on providing therapeutic skills in the following four key areas, as provided by the Linehan Institute:
- Mindfulness: integrating the practice of being fully aware and present in the moment
- Distress Tolerance: learning how to tolerate pain in difficult situation instead of attempting to change it
- Interpersonal Effectiveness: learning how to advocate for and assert one’s wants, including the ability to say no, while simultaneously maintaining self-respect and relationships with others
- Emotion regulation: learning how to change unwanted emotions.
DBT skills group sessions generally last about two hours, and are often held on a weekly basis. After each DBT skills group session the facilitator will assign homework to the participants to help reinforce the information taught during the session. The combination of one-on-one therapy sessions and the DBT skills group sessions help an individual in treatment learn, apply and master the DBT skills. DBT usually lasts about six months long, though depending on the needs of the participants the process can last a shorter or longer length of time.