DBT was designed to treat borderline personality disorder, but it can be used for many other conditions.
The world is filled with contrasts — up and down, happy and sad, stillness and movement.
Dialectical behavior therapy (DBT) embraces this dichotomy and helps individuals strike a balance between accepting themselves as they are while acknowledging that change is necessary.
During DBT, individuals learn to manage their emotions and relationships through mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.
Techniques like individual and group therapy, homework, and skill building guide them to embrace their reality.
Treating a wide variety of mental health conditions, DBT builds on cognitive behavioral therapy to address the needs of people with a higher sensitivity to emotional situations.
Dialectical philosophy finds truth in multi-perspectives. It tells you that you’re OK just as you are in this moment. At the same time, it helps you build skills that will change the way you think, feel, and behave.
First developed by Dr. Marsha Linehan in the late 1980s, DBT was intended for people living with borderline personality disorder. She found that previous treatments focused solely on change wasn’t helpful for people living with this condition — but neither was only acknowledging their pain.
Dialectical behavior therapy takes into consideration that some people react more intensely to emotional situations within interpersonal relationships and teaches skills to help manage emotions, like:
- emotional regulation
- distress tolerance
- interpersonal effectiveness
Borderline personality disorder is characterized by intense emotions, lack of stability in relationships, black and white thinking, and an unstable self-image. People with borderline personality disorder tend to have higher rates of self-injury and suicide.
Research suggests that DBT helps reduce suicide behaviors and lowers hospitalizations for people living with borderline personality disorder.
But DBT doesn’t only help there. It can help no matter if you’ve been diagnosed with a mental health condition or not, and it can also help with other conditions.
Post-traumatic stress disorder (PTSD) can develop after experiencing a traumatic event, such as an accident, war, natural disaster, or violent assault.
Similar to people with borderline personality disorder, individuals with PTSD can have trouble managing their emotions. Sometimes they have issues with depression, panic attacks, and anxiety — all of which might put them at higher likelihood for suicide or self-harming behaviors.
In DBT, you’re taught skills to help regulate your emotional responses and reduce self-harming behaviors.
Symptoms improved more in those who received DBT (58%) versus those who received CPT (41%).
People with depression often experience changes in mood, and similar to borderline personality disorder, have an increased chance of suicide or self-harm behaviors.
A 2020 study found that adolescents who received inpatient DBT had a significant decrease in their symptoms over a short amount of time compared with the usual treatment of group therapy, individual therapy, and medication, if needed.
Anxiety disorders involve strong feelings of fear, anxiety, or worry that at times can interfere with day-to-day life. This can sometimes lead to issues at home, at work, and in relationships.
DBT for anxiety focuses on teaching skills to cope with these feelings and manage emotions.
One goal in treating eating disorders, such as anorexia nervosa, binge eating disorder, and bulimia nervosa, is to limit the frequency of episodes. DBT may help do that.
DBT has been shown to be particularly helpful for treating binge eating disorder. Research suggests it can help reduce binge eating behaviors for a short period.
A 2017 review pointed out that though 89% of participants stopped binge eating by the end of a 20-week treatment with DBT, only 56% of them continued to not binge eat 6 months after the end of treatment.
DBT was originally intended to treat chronically suicidal behaviors and thoughts in people with borderline personality disorder.
Research has found that DBT helps to reduce suicidal behavior in adults.
In a 2019 long-term effectiveness study, researchers looked at treatments for adolescents with repeated suicidal and self-harming behaviors. At the 3-year follow-up, adolescents who received DBT reported a more significant and larger long-term reduction in self-harm behaviors than those who didn’t receive DBT.
DBT has shown promise as a stand-alone treatment for substance use disorder.
In a 3-month study, more than 100 individuals with substance use disorder and co-occurring substance use disorder with another mental health condition received only DBT in an outpatient program. Participants in the study showed improvements in the number of consecutive days of abstinence.
A study in 2015 showed that 98% of the American Indian/Alaska native adolescents who had substance use disorder self-reported they were either “recovered” or “improved” after treatment with DBT.
People with bipolar disorder experience changes in mood, behaviors, and thoughts. Suicidal thoughts are common in people living with bipolar disorder, especially during depressive episodes.
Though DBT isn’t one of the firstline therapies for bipolar disorder, experts are exploring how to adapt DBT skills for treating bipolar disorder.
Older research suggests that DBT improves symptoms of bipolar disorder I or II in people ages 18 or older. However, the improvements weren’t significant enough to recommend DBT as a standard treatment.
Newer research suggests that DBT using adapted materials for bipolar disorder might be a helpful intervention. Five experts interviewed in the study reported using DBT to treat bipolar disorder, but more research is needed to confirm this therapy is effective.
Through skills like mindfulness, emotional regulation, and distress tolerance, DBT offers the tools you need to manage intense emotions and cope with stress.
In DBT, you can learn to embrace the present while welcoming change.
You can also reach out to your primary doctor or a mental health professional for recommendations.