The term “dialectical” comes from the idea that bringing together two opposites in therapy – acceptance and change – brings better results than either one alone.

Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, Ph.D., ABPP, at the University of Washington, is a comprehensive cognitive-behavioral treatment that was originally developed to treat chronically suicidal individuals suffering from borderline personality disorder (BPD). DBT has been found especially effective for those with suicidal and other multiple occurring dysfunctional behaviors. Research has shown DBT to be effective in reducing suicidal behavior, anger, psychiatric hospitalization, treatment dropout, substance abuse, and interpersonal difficulties.

Borderline personality disorder is a disorder that leads to acute emotional distress. Patients may have intense bursts of anger and aggression, moods that shift rapidly, and extreme sensitivity to rejection. With this difficulty in regulating emotions, they experience instability in:

  • – moods
  • – relationships
  • – behavior
  • – thinking
  • – self-image

Impulsive behavior, such as substance abuse, self injury, risky sex, and repeated life crises (legal trouble and homelessness) are common.

The American Psychiatric Association has endorsed DBT as effective in treating borderline personality disorder. Patients who undergo DBT have seen improvements such as:

  • – less anger
  • – less likely to drop out of treatment
  • – improved social functioning
  • – less frequent and less severe suicidal behavior
  • – shorter hospitalizations

A unique aspect of DBT is its focus on acceptance of a patient’s experience as a way for therapists to reassure them — and balance the work needed to change negative behaviors.

What can DBT accomplish? As a comprehensive treatment, DBT can:

  • – Increase the motivation to change by providing positive reinforcement
  • – Decrease the frequency and severity of self-destructive behaviors
  • – Teach new skills on “coping” that generalize to a person’s natural environment
  • – Provide a treatment environment that emphasizes the strengths of both individuals and their treatments

For individuals actively involved in DBT, family members and friends can be most helpful in providing nonjudgmental support of their loved one and by encouraging their loved one to continue with treatment.




Contributed by Guest Blogger Jill Erickson