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Reviewed by Jill Johnson, FNP
Written by Our Editorial Team
If you’ve been diagnosed with a mental health disorder, your healthcare provider may suggest taking part in psychotherapy or talk therapy.
One form of psychotherapy is dialectical behavior therapy, or DBT. It’s an evidence-based type of treatment for conditions such as borderline personality disorder (BPD) that involves thinking in new ways to find acceptance and solve problems.
DBT therapy can offer real advantages for people with certain mental health conditions, but it’s not always the best treatment method for everyone.
Below, we’ve explained what dialectical behavior therapy is, as well as how it works to manage certain mental disorders. We’ve also discussed its potential benefits if you have a condition like borderline personality disorder.
Finally, we’ve shared some other treatment methods that may help you to think, feel and behave differently if you’ve been diagnosed with a mental health disorder.
Dialectical behavior therapy is a style of psychotherapy. It shares numerous key similarities with cognitive behavioral therapy (CBT), a widely-used form of therapy that involves identifying, then changing, problematic thoughts and behavior.
DBT emphasizes learning skills in areas like emotional regulation, relationships with others and mindfulness.
Originally, DBT therapy was developed to treat borderline personality disorder — a mental health disorder in which a person may experience mood swings, extreme black and white thinking and uncertainty about their perception of themselves and their role in life.
Many people with borderline personality disorder lack adequate coping skills and can engage in dangerous behaviors in response to their feelings and thoughts.
Marsha Linehan, an American psychologist, developed DBT as a potential form of treatment for suicidal, multiproblematic women. As a form of therapy, it was designed specifically to target the factors that contribute to suicidal behavior.
Today, DBT is still widely used as a form of psychotherapy for borderline personality disorder in women and men.
Like other forms of psychotherapy, DBT usually takes place in private sessions with a licensed mental health provider. A therapy session typically lasts for an hour and may occur on a weekly basis, with additional group skills training sessions.
The idea behind DBT is simple: to help people at risk of self-harm, substance abuse or physical and verbal aggression to avoid negative thought patterns, impulsive behavior and other forms of harmful behavior, and instead learn ways to cope safely and appropriately.
The term “dialectics” refers to the discourse between two or more people with contrasting points of view, with the aim of using questions, answers and understanding to find meaningful solutions.
In simple terms, dialectical behavior therapy involves a therapist helping their patients progress toward acceptance. This often means acceptance of themselves, their emotions, thoughts and the world as a whole.
Using DBT, therapists aim to help their patients to find acceptance, develop new skills to handle intense emotions and make meaningful and effective changes to their thoughts and behavior.
As part of dialectical behavior therapy, people learn the following four skills:
Mindfulness, or the practice of remaining fully aware of what’s going on in any specific moment and accepting it without judgment.
Distress tolerance, or the ability to tolerate pain and difficulty in challenging situations, not attempting to change it.
Interpersonal effectiveness, or learning how to request what you want and deny what you don’t want while preserving relationships and maintaining respect for yourself.
Emotional regulation, or learning how to manage your emotional sensitivity and change emotions that affect your wellbeing or interfere with your life goals.
Beyond simply developing skills, DBT often involves using exercises to put these thinking skills to use as part of everyday life.
Although DBT therapy was originally developed to treat borderline personality disorder, it’s also used to treat other mental health conditions. Research suggests that DBT may offer benefits for the following behaviors and disorders:
Post-traumatic stress disorder (PTSD)
Generalized anxiety disorder (GAD)
Substance use disorder (SUD)
Eating disorders, such as binge eating disorder and bulimia nervosa
Non-suicidal self-injury (NSSI)
Like other forms of therapy, dialectical behavior therapy isn’t always used on its own. In some cases, your mental health provider may also recommend using medication to treat symptoms involved in BPD and other disorders, including mood swings and depression.
Like other common forms of cognitive behavioral therapy, DBT is backed up by a large amount of scientific research on its effectiveness.
In general, research suggests that DBT therapy is an effective treatment for certain aspects of borderline personality disorder.
For example, a thorough review published in the Indian Journal of Psychological Medicine in 2017 found that DBT offers specific utility in addressing suicide attempts among people with BPD.
However, the same scientific review concluded that DBT might not be an effective therapy for managing personality symptoms associated with BPD.
A study published in the journal Borderline Personality Disorder and Emotional Dysregulation also looked at the effectiveness of dialectical behavior therapy skills for people with borderline personality disorder in Germany.
The researchers found that after one year of treatment with DBT, 77 percent of the people that took part in the study no longer met the diagnostic criteria for borderline personality disorder.
Other research has found that DBT therapy helps lower parasuicidal behavior (behavior that involves serious, deliberate self-harm that isn’t fatal). It might also help reduce the need for psychotropic medication in people with parasuicidal behaviors.
Because DBT is a form of therapy rather than a medication, and because exact symptoms and their severity can differ greatly between people with BPD, there’s very little X vs. Y comparison data on the effectiveness of DBT like there is for some psychiatric medications.
However, research generally shows that DBT can offer real benefits for people affected by BPD and certain other mental health conditions.
Just like with other types of therapy, there are numerous different techniques and approaches that are used in dialectical behavior therapy.
For most people, dialectical behavior therapy takes place on a weekly basis in private sessions with a licensed mental health provider. During each session, you’ll talk with your therapist about any ongoing issues you’re facing, including your mental health symptoms.
For example, a session might involve talking to your mental health provider about feeling sad or frustrated when someone hurts your feelings. Or, you may spend your time role-playing a tough or awkward discussion with someone you care about.
You and your therapist will problem solve and work on helpful strategies to develop your distress tolerance and help you cope with your feelings.
The goal of this type of therapy is to help you enhance your capabilities, including skills that are related to regulating your emotions, navigating interpersonal situations, focusing on the present and learning how to use distress tolerance techniques.
You may take part in individual therapy at your mental health provider’s office or from home via online counseling. Your therapist may make themselves available between sessions to help you continue learning new life skills on an ongoing basis.
Dialectical behavior therapy can involve weekly skills group sessions, during which you’ll work with a DBT group of four to 10 other people to discuss new skills, participate in active practice and receive at-home assignments to foster continual learning.
Group sessions offer a distinct and unique environment from individual therapy sessions, allowing you the opportunity to practice more closely with other people.
Dialectical behavior therapy can offer real benefits, including improving distress tolerance skills and making it easier to maintain interpersonal relationships. However, it’s far from the only form of mental health treatment that can improve thinking, behavior and quality of life.
Other treatment options for mental health disorders include:
Different forms of therapy. Many people affected by mental health conditions benefit from other forms of therapy, such as exposure therapy, interpersonal therapy (IPT) and other variations of cognitive-behavioral treatment.
Medication. Many mental health conditions can be treated using medication, including antidepressants, antipsychotics, anti-anxiety medications and other drugs that manage common mental health symptoms.
Lifestyle changes. Some habits, such as exercising frequently, getting sufficient sleep, eating a balanced diet and avoiding alcohol and other harmful substances may help to reduce the severity of some mental health conditions.
If you suffer from a mental health condition that could benefit from dialectical behavior therapy, your mental health professional may suggest using DBT in combination with one or several of the options above.
Dialectical behavior therapy is a modern form of therapy that’s effective for certain mental health conditions, particularly borderline personality disorder.
If you have BPD, your mental health provider may recommend dialectical behavior therapy as a part of your treatment approach. DBT might also be used to treat other mental conditions, either on its own or in combination with other techniques.
Used effectively, dialectical behavior therapy can help you to develop healthy coping skills, learn how to regulate negative emotions and gain more control in difficult situations.
If you’re worried about your mental health, it’s important to seek help. We offer a range of online mental health services that you can use to access expert assistance, including online psychiatry and individual therapy.
You can also learn more about treating mental health issues, developing new behavior skills and overcoming negative thinking patterns with our free mental health resources and content.