What Everyone Should Know About Dialectical Behavior Therapy

If you’re considering Dialectical Behavior Therapy (DBT) for you or a loved one, you probably already know the basics: DBT was developed in the late 1980s by Dr. Marsha Linehan specifically for patients with Borderline Personality Disorder (BPD). DBT is a highly beneficial treatment for many individuals for various mental health disorders and conditions, and traditionally follows the same path or protocol of treatment through 4 key modules to achieve success. 

The 4 main stages of DBT are: 

  • Stage 1: This is where therapists identify and target the most self-destructive behavior types for the patient (such as suicidal ideations, self-harm, or harm to others) and target them accordingly to mitigate distress/risk of harm. 
  • Stage 2: Here the therapist will address quality of life issues such as emotional regulation, distress tolerance and interpersonal effectiveness to improve the mental health and wellbeing of the patient. 
  • Stage 3: In stage 3 the therapist will focus on building healthy relationships and addressing self-esteem problems to create a better sense of identity. 
  • Stage 4: Final DBT treatment sessions target big picture objectives such as helping patients discover greater happiness and fulfillment in their lives, and the purposeful establishment and pursuit of goals. 

DBT Uses

DBT starts with the perspective that all emotional dysregulation, instability and impulsivity is based in internal chaos, and that shifting your core thoughts and beliefs from negative self-doubt, impulse, and obsession can contribute to resolving chaos in relationships, and protect you from self-harm or suicidal ideation. DBT teaches patients to learn to look at problems in new ways and to replace existing patterns and habits that are toxic with healthier, more effective self-analysis and decisionmaking skills. 

While DBT was initially developed to treat a specific condition - Borderline Personality Disorder (BPD) - it’s also been successful in the treatment of other conditions such as substance abuse, eating disorders, self-harm, and even PTSD. 

Most DBT takes place in one or both of the following settings:

  • Group Therapy: In this setting, members are taught DBT skills with a group of their peers and are able to practice DBT application in a safe, controlled environment led by a licensed mental health professional.
  • Individual Therapy: For one-on-one therapy, DBT can be leveraged by a trained mental health specialist to identify the patient’s destructive behaviors in order to replace them with healthy behavioral skills. 

DBT Benefits 

The primary goal of DBT treatment is for the patient to work with their therapist synchronistically to bring them greater peace of mind and improve their emotional regulation through healthy self-acceptance and respect. They’ll learn to practice mindfulness, increase distress tolerance, and improve interpersonal effectiveness. 

Stepping through the techniques taught throughout all states of DBT can bring immense value and validation to a patient’s journey as they learn to acknowledge their experiences and emotions while balancing them with rational thought and “wise mind” activation. 

For those who pursue DBT treatment, they’ll discover new ways to accept, tolerate, and embrace their innermost thoughts and feelings, and their external challenges and circumstances. They’ll develop heightened self-awareness and greater self-love, and should adapt a specific set of skills that bring satisfaction and positivity to relationships and daily life. 

At the end of your DBT training journey you should be communicating better with other people, able to identify your emotions and calm their intensity on your own, and leverage your existing strengths for a more positive outcome of every interaction. 

DBT Concerns

Anyone going into or considering DBT treatment should know that this treatment protocol takes a significant amount of time. For most people, they’ll plan to work through all four of the stages of DBT in a combination of group and individual therapy for about a year in order to see the improvement they need. For some individuals it might even be necessary to go back and repeat certain modules for the sake of mastering those specific skill sets according to their symptom needs. 

The time and energy invested in DBT treatment over a long period of time can be taxing for some, and costly for others. Adapting to the coping mechanisms you’ll need to achieve mastery over your current symptoms can be a long road, but is highly likely to bring you a much better quality of life. 

The good news? You don’t have to do this journey alone!

Mental health experts across the world highly recommend joining group therapy as a way to begin your DBT journey and to practice the skills you’ll learn each week in a healthy, safe, controlled environment with your peers. 


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