Dialectical Behavioral Therapy

Dialectical behavior therapy (DBT) is an evidence-based[1] psychotherapy that began with efforts to treat multiproblematic, suicidal women.[2]

DBT has been proven useful in treating mood disorders, suicidal ideation, and for change in behavioral patterns such as self-harm, and substance abuse.[3] DBT evolved into process in which the therapist and client work with acceptance and change-oriented strategies, and ultimately balance and synthesize them, in a comparable to the philosophical dialectical process of hypothesis and antithesis, followed by synthesis.[4]

This approach is designed to help people increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviors to help avoid undesired reactions. A modified form of cognitive behavioral therapy (CBT), DBT was developed in the late 1980s by Marsha M. Linehan,[5] a psychology researcher at the University of Washington, to treat people with borderline personality disorder and chronically suicidal individuals. Research on its effectiveness in treating other conditions has been fruitful;[6] DBT has been used to treat people with depression, drug and alcohol problems,[7] post-traumatic stress disorder (PTSD),[8] traumatic brain injuries (TBI), binge-eating disorder,[1] and mood disorders.[9][10]

Research indicates DBT might help patients with symptoms and behaviors associated with spectrum mood disorders, including self-injury.[11] Recent work also suggests its effectiveness with sexual abuse survivors[12] and chemical dependency.[13] DBT combines standard cognitive behavioral techniques for emotion regulation and reality-testing with concepts of distress tolerance, acceptance, and mindful awareness largely derived from Buddhist meditative practice.

DBT is based upon the biosocial theory of mental illness and is the first therapy that has been experimentally demonstrated to be generally effective in treating BPD.[14][15] The first randomized clinical trial of DBT showed reduced rates of suicidal gestures, psychiatric hospitalizations, and treatment drop-outs when compared to treatment as usual.[10] A meta-analysis found that DBT reached moderate effects in individuals with borderline personality disorder.[16]

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