DBT: an Overview

An overview of Dialectical Behavior Therapy (DBT)Do you struggle with explosive anger, self-destructive and impulsive behaviors, substance abuse, and other emotional problems, such as depression and anxiety?

Do emotional and behavioral problems consistently interfere with your life?

Dialectical Behavior Therapy (DBT) is a cognitive- behavioral therapy for people diagnosed with Borderline Personality Disorder, as well as people who have emotion regulation problems and impulse control problems. 

DBT was developed by Marsha Linehan as a comprehensive intervention package.  In controlled outcome trials, DBT has been shown to be effective in reducing self-injurious behavior and inpatient psychiatric days.  It has also been shown to be helpful in reducing anger and improving social adjustment.  DBT’s approach balances a focus on behavioral change with acceptance, compassion, and validation.

DBT Treatment

Comprehensive DBT services include:


Weekly or biweekly groups for a total of 2 to 2 1/2 hours per week.  Half of the group is devoted to presenting new skills to teach you how to better manage your emotions.  The remainder is spent reviewing homework practice for the skills currently being taught.

The group is highly structured with an agenda set by the DBT manual developed by Marsha Linehan.


The rationale is that people often need help in applying the behavioral skills they are learning in group to problems in daily life.  The focus of this interaction is on applying skills.  Over time the frequency and duration of crisis interventions will decrease you become more effective in managing crisis. 


Diary cards are used as signals of problems that need tracking and assessment.  The cards are used to assist in recalling details surrounding stressful behaviors and teaching you to organize and recall events surrounding these behaviors.


DBT assumes that effective treatment must pay as much attention to the therapist’s and treatment providers behavior as it does to the clients.  Treating people with intense emotions and high risk behaviors requires ongoing consultation to ensure that treatment stays within the DBT therapeutic frame.


Individual therapy sessions are usually once a week, 50 minutes, sometimes twice per week during crises or at the beginning of treatment.  Therapy is structured around specific target behaviors.  The therapist uses a chain analysis to help you get a better understanding of problem behaviors and what leads up to them.  The therapist also uses specific strategies focused on maintaining motivation and commitment to improving behavior.

Photo by "redmuse_poet," available under a Creative Commons attribution, non-commercial license.

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