DBT INTRODUCTION
Dialectical Behavior Therapy (DBT) is a research-supported treatment which combines cognitive-behavioral theory and methods with Eastern meditative principles and practices. Developed by Dr. Marsha Linehan and her colleagues at the University of Washington, DBT addresses problems in regulating emotions, behavior, and thinking.

Emotions
• Heightened emotional sensitivity
• Quick and intense emotional reactions
• Slow return to normal mood
• Chronic problems with depression, anxiety, anger or anger expression

Behavior
• Repeated suicide threats or attempts
• Self-harm behavior such as cutting and burning
• Relationship difficulties including hypersensitivity to criticism, disapproval,
rejection or abandonment
• Impulsive and potentially self-damaging behavior in areas such as binge eating
and purging, alcohol or drug abuse, sexual promiscuity, and gambling or
spending sprees

Thinking
• Extreme (black or white) thinking
• Difficulty with problem-solving and decision making
• Unstable self-image or sense of self
• “Detached” thinking, ranging from mild problems with inattention to episodes of
complete dissociation

The DBT Program lasts approximately six months and is organized into three stages. Each stage is designed to achieve a set of clearly defined treatment goals.

Stage One:  Addresses assessment and preparation.  Goals of this stage are to 1) conduct a thorough assessment, 2) provide an orientation to treatment, and 3) establish treatment goals and build commitment to working on them.

Stage Two:  Specific behaviors are targeted to increase or decrease. Behaviors to decrease include 1) life-threatening behaviors, 2) behaviors that interfere with progress in treatment, and 3) behaviors that interfere with living a reasonably good quality of life.

Behaviors to increase include 1) dialectical (balanced, as opposed to dichotomous and extreme) thinking and behavior patterns, and 2) adaptive skills in living and relating to others.

Stage Three:  Focuses on generalizing and maintaining treatment gains. Specific goals are to 1) refine skills use and encourage application across time and settings, 2) solidify environmental changes to support new behaviors, and 3) improve problem-solving and relapse prevention skills.

For more information on DBT, we refer you to the following review articles:

Dialectical Behavior Therapy (DBT) for Borderline Personality Disorder, by Marsha Linehan, Ph.D.

Treatment of Borderline Personality Disorder Using Dialectical Behavior Therapy, by Thomas Lynch, Ph.D. and Clive Robins, Ph.D.

The Mystery of Borderline Personality Disorder, by John Cloud