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  • Writer's pictureKiki Fehling

What is DBT?

Updated: Oct 18, 2023

Dialectical Behavior Therapy (DBT) is a unique and powerful therapy. It's changed my life, and it's changed (and even saved) the lives of thousands of people. That's why I love telling people about it. Consider this post your DBT 101.

(tl;dr: DBT is a research-backed gold standard treatment for BPD, (c)PTSD, and other diagnoses, and DBT skills can improve mental health and be life-changing for anyone.)

DBT Helps People Cope with Their Emotions

DBT was designed to help people dealing with intense emotions and impulsive behaviors (e.g., self-harm, disordered eating, substance abuse). It was originally studied as a treatment for borderline personality disorder (BPD), but it's now considered much more than that.

A large majority of DBT focuses on improving emotional intelligence and emotion regulation: how someone understands, uses, copes with, and lives in balance with their emotions. DBT can be particularly helpful for highly sensitive people who feel emotions easily or intensely. It can also help people (like those with BPD) who feel like they're totally at the mercy of their emotions; like emotions are driving the car of their life, and they're just along for the ride. DBT helps put people back in the driver's seat. It does that, in part, through DBT skills.

DBT Teaches Skills

A key feature of DBT is DBT skills. Throughout the therapy, we teach and practice skills in four main modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. By covering a wide array of topics and areas, DBT skills offer guidance in almost all areas of life. They offer small, tangible steps you can take to feel grounded when your world feels chaotic, unstable, or uncertain. In my experience, when life gets tough, it can be incredibly comforting to have the DBT skills in your back pocket.

DBT Focuses on Building a Meaningful Life

By teaching concrete tools, DBT helps people eliminate emotional suffering and cultivate more joy and meaning. DBT does not guarantee a life without pain, certainly. And, it is not a suicide prevention program. Rather, it offers a pathway to building a "Life Worth Living" (the ultimate goal of DBT as a therapy). Each person gets to define their own personal Life Worth Living, by identifying what makes them feel the most pleasure, fulfillment, and peace.

DBT is Evidence-Based

DBT definitely helps many people. Decades of research show that comprehensive DBT can successfully reduce the difficulties associated with BPD. And, while DBT was originally created to treat BPD and self-harm, research now demonstrates that DBT can effectively help treat major depressive depression, (c)PTSD, substance use disorders, ADHD, some eating disorders, and other psychiatric diagnoses. At this point, there's even significant evidence that DBT skills alone can be beneficial for many people's mental health, regardless of specific diagnoses or struggles.

OK sure, sound great. But what actually is it?

Adherent, comprehensive DBT always includes four main parts: weekly individual DBT therapy, weekly DBT skills group (or some other form of dedicated skills learning), as-needed phone coaching between sessions, and weekly consultation team (for the therapist). There are a ton of different guidelines, principles, structures, and techniques that make each of these individual components "real" DBT. (To find our more, see this post on adherence.)

Traditional DBT takes at least six months. That's because it usually takes six months for a weekly DBT skills group to make it through one "round" of covering all of the skills in all four skills modules. To participate in comprehensive DBT, clients need to commit to engaging in all parts of DBT for at least one full round of skills group. Many clients end up committing to multiple rounds, staying in DBT for 12 or 18 months (or sometimes even longer)

Whoa. Do I really need all that?

It's understandable if you read the above and feel intimidated. All in all, DBT requires a pretty hefty commitment in time, energy, and (possibly) money. While some people see the most benefit from adherent DBT, many people don't need the comprehensive treatment.

Research shows that just learning DBT skills can improve mental health for a lot of people! Luckily, there are a ton of books, videos, and other resources where you can learn the DBT skills in ways that are cheaper and easier to access than comprehensive DBT.

Please note: if you struggle with BPD, self-harm, heavy substance use, frequent dissociation, or impulsive behaviors that cause you harm, you are likely to benefit more from comprehensive DBT than self-learning DBT skills alone. But, DBT self-help could still support you as you wait to find/receive adherent DBT.

More Resources to Learn about DBT

Check out this post from the University of Washington (where Dr. Marsha Linehan worked and where most of the original research on DBT was conducted).

If you're an audio/visual learner, I love this video. While it's specifically about DBT for adolescents, it provides a bunch of information relevant to traditional DBT for adults. This podcast with Dr. Shireen Rizvi (my mentor!) explains a lot of about DBT.

To find a DBT therapist, check out the "I'm trying to find a therapist" section of my resources page.




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