Marsha M. Linehan developed dialectical behavior therapy (DBT) in the late 1980s. It was founded on and includes many of the principals of the cognitive behavioral therapy (CBT) approach. CBT is a short-term psychotherapeutic treatment option that, according to Psychology Today, focuses on “modifying dysfunctional emotions, behaviors, and thoughts by interrogating and uprooting negative or irrational beliefs.” DBT was developed to better treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD). It is considered a longer therapeutic process than CBT, as it lasts between six to twelve months long (depending on if certain modules are repeated). DBT places primary emphasis on the psychosocial aspect of treatment. 

DBT Basics

DBT is comprised of different therapeutic settings: weekly one-on-one therapy session, weekly group DBT skills session, and as-needed phone coaching (i.e. support between sessions). The four main modules that are focused on and taught during the group DBT skills sessions include:

• Core mindfulness: teaches focusing skills to enable an individual to be fully present in any given moment.
• Distress tolerance: teaches survival skills to help an individual learn to increase his or her tolerance of negative emotion, instead of trying to avoid or escape it.  
• Emotion regulation: teaches de-escalation skills to enable a person to identify, understand, fully experience and de-escalate his or her emotions without instinctively reacting to them. 
• Interpersonal effectiveness: teaches social skills to help an individual learn to communicate with others in an assertive, self-respecting way that simultaneously strengthens relationships. 

One-on-one therapy sessions offer an individual an emotionally safe environment to delve further into the DBT skills, clarify any confusion, and dissect personal experiences related to the implementation of the DBT skills that had been applied in one’s own life in and/ or outside of the DBT group skills session. Should crisis arise, and/ or an individual need additional support between session, phone coaching is available twenty-four-hours a day, seven days a week. 

DBT Books

Considering it is a relatively new form of psychotherapy, there is an extensive amount of literature that has been published regarding dialectical behavior therapy. Some of the most notable publications, and DBT workbooks include the following:

• DBT® Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan PhD ABPP, 2014, The Guilford Press, New York
  • This resource includes over 225 user-friendly worksheets and handouts for individuals learning DBT skills.

• Dialectical Behavior Therapy Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, & Distress Tolerance by Matthew McKay, Jeffrey C. Wood, and Jeffrey Brantley, 2007, New Harbinger Publications, Oakland: CA
  • This resource provides practical exercises to effectively practice and build on the four key DBT areas (i.e. core mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness).

• The High Conflict Couple: A Dialectical Behavior Therapy Guide to Finding Peace, Intimacy and Validation by Alan E. Fruzzetti, Ph.D., 2006, New Harbinger Publications, Oakland: CA
  • This book adapts the various techniques of DBT into applicable skills for de-escalating heightened emotions that can arise in relationships. 

• Don’t Let Your Emotions Run Your Life: How Dialectical Behavior Therapy Can Put You in Control by Scott E. Spradlin, 2003, New Harbinger Publications, Oakland: CA
  • This book is comprised of worksheets, exercises, and assessments intended to teach individuals how to pay attention to rising emotions, identify obstacles that interfere with one’s ability to effectively regulate emotions, and how to overcome those obstacles. 

It is important to bear in mind that DBT is an evidence-based form of psychotherapy, and as such new books with more current DBT data as well as alternative DBT workbooks with additional resources, exercises, and/ or worksheets continue to be published.