What is DBT?

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Overview

Dialectical Behavior Therapy (DBT) is a cognitive behavioral treatment that was originally developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD) and it is now recognized as the gold standard psychological treatment for this population. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders.

DBT Skills

DBT skills training group is just one component of standard DBT treatment. DBT skills training group is focused on enhancing clients’ capabilities by teaching them behavioral skills. The group is run like a class where the group leader teaches the skills and assigns homework for clients to practice using the skills in their everyday lives. Groups meet on a weekly basis for approximately 2.5 hours and it takes 24 weeks to get through the full skills curriculum, which is often repeated to create a 1-year program. Briefer schedules that teach only a subset of the skills have also been developed for particular populations and settings.

The DBT Skills are:

  1. Mindfulness: the practice of being fully aware and present in this one moment
  2. Distress Tolerance: how to tolerate pain in difficult situations, not change it
  3. Interpersonal Effectiveness: how to ask for what you want and say no while maintaining self-respect and relationships with others
  4. Emotion Regulation: how to change emotions that you want to change

The majority of the data on the effectiveness of DBT focuses on using the entirety of standard DBT for people with complex, severe mental illnesses. There is increasing evidence that DBT skills training alone is a promising intervention for a wide variety of both clinical and nonclinical populations and across settings.

For more information about standard treatment components, treatment targets, and stages of DBT, read more about DBT on the Behavioral Tech website. Behavioral Tech is a training organization of The Linehan Institute and is fully owned by The Linehan Institute.

Who does DBT help?

To date, more than 30 randomized controlled trials (RCTs) produced by nearly 20 independent research groups in nine countries have demonstrated the effectiveness of DBT for certain populations. RCTs are the gold standard for health intervention research, and meta-analyses of this extensive research have found moderate to large significant effects indicating DBT is more effective than treatment as usual in reducing suicide attempts, non-suicidal self-injury, and anger, and improving general functioning among people with borderline personality disorder (Stoffers et al., 2012; Kliem et al., 2010).

Although the strongest evidence exists for DBT as a treatment for people with borderline personality disorder, DBT has been found to be effective for a wide variety of mental health conditions. Conditions for which standard or adapted versions of DBT have been found to be effective in at least one randomized controlled trial are listed below (Note: DBT has been evaluated for many other conditions in non-RCT research).

  • Borderline personality disorder, including those with co-occurring:
    • Suicidal and self-harming behavior
    • Substance use disorder
    • Posttraumatic stress disorder
    • High irritability
  • Cluster B personality disorders
  • Self-harming individuals with personality disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Posttraumatic stress disorder (PTSD) related to childhood sexual abuse
  • Major depression, including:
    • Treatment resistant major depression
    • Older adults with chronic depression and one or more personality disorders
  • Bipolar disorder
  • Transdiagnostic emotion dysregulation
  • Suicidal and self-harming adolescents
  • Pre-adolescent children with severe emotional and behavioral dysregulation
  • Binge eating disorder
  • Bulimia nervosa

DBT has been evaluated and found to be effective among individuals from diverse backgrounds in terms of age, gender, sexual orientation, and race/ethnicity. Specifically, the demographic groups listed below have made up a sizeable proportion (25-100%) of the sample in at least one study of DBT.

Ages:
  • Children (ages 7-12 years)
  • Adolescents (ages 12-18 years)
  • Young Adults (ages 18-25)
  • Adults (ages 25-60)
  • Older Adults (ages 60+)
Genders:
  • Female
  • Male
Sexual orientations:
  • Lesbian, gay, and bisexual
  • Heterosexual
Races/Ethnicities:
  • American Indian/Alaska Native
  • Black or African American
  • Hispanic or Latino
  • Multi-racial
  • White or Caucasian

 

You can review the DBT research information that the Linehan Institute has collected and summarized. You can also search for DBT research articles through sites like Google Scholar or other professional search engines to review the research for yourself.