What is DBT?
Updated: Apr 8
DBT is the acronym for Dialectical Behavioural Therapy, which is a cognitive therapy based on the concept that the way we think about things affects our emotional experience and our quality of life. Cognitive therapies focus on current thinking and behaviour, rather than on past history, and are oriented toward problem-solving. DBT has traditionally been used for people with a diagnosis of Borderline Personality Disorder, but can be used for addictions and many other challenges, as will be discussed below.
DBT was founded by a psychologist named Marsha Linehan who had significant struggles of her own as a young woman, which shaped her approach to this therapy. It was first used with young women who were suicidal and self-harming, however its value for a much broader population was identified, and now it is frequently used in venues as common as elementary schools and high schools. As DBT has 4 distinct components, it can either be delivered as a comprehensive program such as in a group setting, or the different elements can be applied to an individual based on their needs.
DBT is usually carried out with the original handouts and worksheets to be found in Linehan's books, and best outcomes involve the use of a weekly “diary card” where the client can track their struggles and their use of skills.
The components of DBT are as follows:
Mindfulness (becoming more mindful and self-aware in your daily life)
Interpersonal Effectiveness (learning ways to communicate with others in order to have your needs met, to maintain your relationships, and to keep your self-respect)
Emotional Regulation (learning to better manage your emotions)
Distress Tolerance (learning to better handle distress)
Clearly, some of these skills would benefit many of us.
These elements are taught in a manner that would best meet the unique needs of the client. For example, Distress Tolerance would be prioritized for someone frequently in distress. Or, a client may only seem to need help with Interpersonal Effectiveness, and their DBT-specific work would end after their interpersonal struggles had been addressed.
Because DBT is considered effective with people who are self-harming or suicidal, it is often sought out for this reason. However, it is generally not ideal for private counsellors to work on DBT with clients who are regularly hurting themselves or actively wanting to kill themselves, because there is not enough professional support available between settings to do this safely. It is important to seek hospital treatment or outpatient and community mental health services in these cases.
That being said, most clients are able to benefit significantly from DBT, or its parts, within a private counselling setting.