Dialectical-Behaviour Therapy

Dialectical Behaviour Therapy (DBT) is an evidence-based psychotherapy originally developed to treat individuals with borderline personality disorder (BPD) and chronic suicidal ideation. It has since been adapted for a wide range of mental health conditions involving emotional dysregulation and self-destructive behaviours.

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Core features of DBT

DBT combines cognitive-behavioural techniques with mindfulness and acceptance-based strategies. It aims to help people build a “life worth living” by balancing acceptance and change.

 

The "Dialectic"

• The central dialectic in DBT is the balance between accepting yourself as you are and committing to change.

 

Key components of DBT

1. Individual Therapy – One-on-one sessions to address personal challenges and apply skills.

2. Skills Training Group – Teaches behavioural skills across four modules:

   • Mindfulness

   • Distress Tolerance

   • Emotion Regulation

   • Interpersonal Effectiveness

3. Phone Coaching – Real-time support to apply skills in daily life.

4. Therapist Consultation Team – Ensures therapists receive support and maintain fidelity to DBT principles.

 

Who DBT is suitable for:

DBT has strong empirical support for treating:

• Borderline personality disorder (BPD)

• Chronic suicidality or self-harm

• Emotion dysregulation

• Eating disorders (e.g. binge eating, bulimia)

• Post-traumatic stress disorder (PTSD)

• Substance use disorders

• Adolescents and adults with impulse control issues and intense emotional reactions

 

It is particularly effective for people who:

• Struggle with extreme emotional sensitivity

• Experience frequent relationship conflicts

• Have difficulty tolerating distress or regulating intense emotions

 

Who DBT may not be suitable for:

While DBT can be adapted, it may not be suitable for people who:

• Are unwilling or unable to engage in regular, structured therapy (e.g., weekly sessions and skills training)

• Prefer therapies that are less intensive or shorter-term

• Have severe cognitive impairments that make it difficult to understand or apply skills

DBT requires a high level of commitment and active participation, making it less suitable for individuals who are not yet ready for behavioural change or have low therapy motivation.

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References

• Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

• Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). Guilford Press.

• Lynch, T. R., Trost, W. T., Salsman, N., & Linehan, M. M. (2007). Dialectical behavior therapy for borderline personality disorder. Annual Review of Clinical Psychology, 3, 181–205. https://doi.org/10.1146/annurev.clinpsy.2.022305.095229

• Behavioral Tech. (n.d.). What is DBT? Retrieved from https://behavioraltech.org