Dialectical Behavioral Therapy (DBT)

What is the approach?

Dialectical behavior therapy (DBT) is a form of cognitive behavioral therapy, specifically developed for borderline personality disorder (BPD), in which the clinician attempts to motivate the client towards change in behavior while simultaneously validating existing thoughts and feelings. (DeVylder) The goal of dialectical behavior therapy is to minimize maladaptive behaviors related to impulse control and emotion regulation, especially those that may result in self-injury or death. (DeVylder) The desired outcome of DBT is a resolution of maladaptive behaviors related to impulse control and emotion regulation, especially those behaviors that may result in self-injury or death. (DeVylder)

According to the Lineman Institute,

When clients first start DBT treatment, they often describe their experience of their mental illness as "being in hell." The goal of Stage 1 is for the client to move from being out of control to achieving behavioral control. In Stage 2, they're living a life of quiet desperation: their behavior is under control but they continue to suffer, often due to past trauma and invalidation. Their emotional experience is inhibited. The goal of Stage 2 is to help the client move from a state of quiet desperation to one of full emotional experiencing. This is the stage in which post-traumatic stress disorder (PTSD) would be treated. In Stage 3, the challenge is to learn to live: to define life goals, build self-respect, and find peace and happiness. The goal is that the client leads a life of ordinary happiness and unhappiness. In stage 4, which is not needed for all clients, clients find a deeper meaning through a spiritual existence. In this stage, the goal of treatment is for the client to move from a sense of incompleteness towards a life that involves an ongoing capacity for experiences of joy and

Due to the structure of the therapy, dialectical behavior therapy is more likely to be covered by insurances, which allows more people access to the therapy. Dialectical behavior therapy is generally used more among women, because of how they are diagnosed. Women are more likely than men to be diagnosed with borderline personality disorder, thus resulting in more women using dialectical behavior therapy to treat their symptoms. Dialectical behavior therapy would be a good approach for someone who is African American because according to Aponte, 1994; Exum and Moore, 1993; Paniagua, 1994, a therapist should use a time-limited, problem-solving approach and directive techniques. In the Asian community, a directive, structured, goal-oriented, problem-solving approach that focuses on alleviating specific symptoms is usually preferred. Asian clients expect therapists to give concrete advice and view the therapist as a knowledgeable expert and authority figure. (Paniagua,