DBT Therapy: What Is It and How Can It Help?

Dialectical behavioral therapy (DBT) is a type of psychotherapy, or talk therapy. DBT was originally developed to treat people with borderline personality disorder who have ongoing struggles with suicidal thoughts. However, this type of therapy is now used to treat people with a variety of mental health conditions.

This article discusses the key components of DBT, conditions treated with this type of therapy, and its effectiveness.

What Are the Components of DBT?

Dialectical behavioral therapy often has four main components: individual therapy, skills training group, phone coaching, and the therapist consultation team.

There are also individual therapists who provide DBT-oriented therapy without groups and phone coaching, but they teach and practice the skills within individual sessions.

Individual Therapy

DBT individual therapy sessions are typically once per week for an hour each time. The goal of individual therapy is helping the client apply the skills learned in skills training group to current situations and challenges in daily life.

DBT Skills Training Group

Skills training group is similar to a classroom environment in which clients are taught specific skills to help cope with daily life. Group sessions are often 2.5 hours per week, and the full program and coursework is 24 weeks long. Skills taught in these training groups include:

• Mindfulness: This skill teaches awareness of your surroundings and your body in the present moment.
• Distress tolerance: This skill helps a person learn how to deal with stressful situations and crises, without behaving in ways that will make the situation worse. Distress tolerance also teaches acceptance of circumstances that a person cannot change.
• Interpersonal effectiveness: This skill focuses on communication, setting boundaries, self-respect, and healthy-relationship building.
• Emotion regulation: This skill helps a person recognize and understand their emotions, and learn how to change emotions that are unwanted.

Phone Coaching

DBT provides clients with access to their therapist (typically by phone) between therapy sessions. The purpose of these calls is to allow the therapist to coach a client—in real time—through difficult circumstances in which the client can practice their newly learned skills.

Therapist Consultation Team

DBT therapists are supported by a team of other therapists while providing treatment to clients. This keeps the treating therapist motivated and helps to prevent burnout. Team meetings are typically held weekly. They allow therapists to discuss client cases as a group and to brainstorm treatment strategies.

What Conditions Does DBT Treat and Is It Effective?

DBT is typically used for individuals who have multiple mental health issues. DBT was originally designed for a very specific patient population—women with borderline personality disorder who had ongoing suicidal thoughts and self-harm behaviors. In this population, DBT was found to be very effective.

Use of DBT has expanded to successfully treat borderline personality disorder with substance use issues, binge eating disorder, other personality disorders, and depression.

What to Expect

DBT treatment is often broken down into four stages, as well as a "pretreatment" stage. Clients can work through stages in order, or they may need to return to previous stages to work through specific issues that come up during treatment.

• Pretreatment: This occurs at the beginning of therapy, in which the therapist and client establish a working relationship.
• Stage 1: The focus of this stage is identifying and addressing behaviors that are life-threatening or causing problems in the client's life. Behaviors that interfere with therapy (such as not showing up and chronically being late) will also be addressed. During stage 1, clients begin to learn and practice skills learned in group therapy sessions.
• Stage 2: This stage helps clients process past traumas and other emotional childhood experiences.
• Stage 3: The goal in this stage is to help clients find peace and happiness, build self-respect, and set goals for the future.
• Stage 4: Clients who achieve happiness and satisfaction in stage 3 might not need stage 4 of treatment. Stage 4 focuses on an individual's spiritual development.

Dialectical Behavioral Therapy vs. Cognitive Behavioral Therapy

DBT is different from cognitive behavioral therapy (CBT)—a commonly used type of psychotherapy that focuses on identifying negative thinking patterns and changing unwanted behaviors. The main component of CBT is individual therapy sessions. "Homework" is often assigned to help clients practice new skills outside their treatment sessions.

The primary focus of DBT is learning coping strategies moving forward in life, rather than spending a lot of time discussing past events that led up to current issues.

Summary

Dialectical behavioral therapy (DBT) is a type of psychotherapy that is primarily used to treat individuals with multiple mental health conditions, including borderline personality disorder. DBT has four main components, including individual therapy, skills training group, phone coaching, and a therapist consultation team. DBT has been shown to be an effective therapy, but more research is needed.

A Word From Verywell

It's difficult to know what type of therapy is best for you. Talk to your healthcare provider if you are considering dialectical behavioral therapy and they can help you determine if it's a good fit.

Keep in mind that just because you start a certain mode of therapy doesn't mean you have to stick to that type. You may have to work with multiple therapists and try out a few methods before finding what helps you the most.