Dialectical Behavior Therapy: A General Overview


Dialectical behavior therapy: A general overview. In the late 1970s when Dr. Marsha M. Linehan worked as a psychology researcher specializing in suicide at the University of Washington, it quickly became evident that many of the patients she had contact with did not benefit from existing therapeutic approaches.


Patients with personality disorders who,

in particular, suffered with emotional dysregulation were at high risk of committing suicide. This was due to a lack of efficacious treatments. It was a recurring issue for therapists all across the world, and, unfortunately, at the time there was no solution.


Dr. Linehan took it upon herself to come up with a solution and proceeded to research certain therapeutic approaching es, such as Cognitive Behavior Therapy (CBT) and the Humanistic approach, to see which parts of these psychotherapies worked best on her patients.Then she took those techniques and adapted them to the needs of patients with personality disorders, which resulted in the formation of Dialectical Behavior Therapy (DBT).


Today, the psychotherapy is used to treat a plethora of mental disorders. Research shows that DBT can be beneficial in the treatment of mood disorders, anxiety, and substance use disorder, among many others.


The Goals Of DBT


One of the good things about DBT is that it allows the patient the freedom to choose what exactly they are expecting to get out of the therapy. Some of the main goals when it comes to learning the skills are as follows:


  • The ability to understand difficult feelings and analyze the root of the problem
  • Learning to use the skills to handle different situations and people
  • Eliminating behaviors that are harmful to yourself or other people in your life
  • Becoming mindful of your feelings
  • Learning strategies to cope with interpersonal conflict and stress


Dialectical Behavior Therapy: A General Overview

The Structure Of DBT


One of the main beliefs in DBT is that each individual has three states of mind:


  • Emotional mind: This is when an individual is overwhelmed by emotions. It is difficult to think rationally; therefore, it is very hard to make well thought-out decisions


  • Rational/Reasonable mind: This is the state of mind we associate with thinking. It’s purely based on logical thinking and does not include emotional responses.


  • Wise mind: This is a healthy balance between Emotion mind and Reasonable mind. Emotions no longer control the individual, and they’re capable of making decisions based on a combination of emotion and rationality.


DBT combines aspects of CBT with mindfulness and distress tolerance techniques. Four core skill sets are as follows:


  • Mindfulness: This is a foundation for the other skills in the DBT program because it allows individuals to identify, understand, and accept powerful emotions as they come. The origin of the mindfulness skill set lies in traditional contemplative religious practice; however, the DBT version does not include any religious components.


  • Interpersonal effectiveness: This skill set teaches patients how to treat others and themselves with care, respect and validation.


  • Emotional Regulation:This skill set helps the individual identify emotions and reduce emotional vulnerability. It also provides techniques that may prove useful when an individual is stuck in emotional mind and feels they are not in control of their emotions.


  • Distress tolerance: This is exactly what it sounds like, a skill set to aid the individual in coping with distress. There are valuable techniques in this skill set allowing the individual to occupy their mind with something other than the overwhelming anger/sadness they may be feeling in the moment.

Some of the popular DBT skills include the T.I.P.P skill, the S.T.O.P skill and the DEARMAN skill. It is worth looking into them all if you are struggling with self-harm, substance abuse, or eating disorders.


DBT is beneficial to people from all walks of life. It can reduce incredibly destructive behaviors and in some cases, even eradicate them.


In December 2014, a study called “Effectiveness Of Dialectic Behavioral Therapy In Routine Outpatient Care: The Berlin Borderline Study” found that 77% of people no longer met the criteria for BPD after a year of treatment with dialectical behavior therapy. This is a major, groundbreaking statistic as BPD seemed to be treatment resistant prior to the development of DBT.


There are many success stories when it comes to this psychotherapy. Of course, the treatment may not work for everybody, and not everyone will benefit from ALL the skills.  It cannot be denied that DBT has been a major step forward in the treatment of personality disorders.

Give us a call at High Expectations Counseling today 407-967-1327. Meet the team and choose from one of our many talented therapist. Start the road to self awareness and true healing.