When it comes to figuring out the type of therapy best suited for your needs, you may find yourself in murky waters when trying to decipher different therapeutic styles. Each post in this series serves as a primer on a major therapeutic approach to guide you in the right direction. It is important to note that many clinicians identify as integrative rather than adhering to a single school of thought, though there are some that stick to one orientation over others. Even within one school of thought, however, the individual therapist inevitably brings their own unique style to the work, so nothing here is cut and dry. Additionally, on the whole, research has shown support for success with all major schools of thought! So even if you feel unsure about what style is suited for you, with a good therapy relationship you should be positioned for success.
Dialectical Behavior Therapy (DBT) is a specialized type of Cognitive Behavioral Therapy (CBT) that maintains a focus on interpersonal dynamics and relational distress. It was created in the 1980s by psychologist Marsha Linehan as a specialized treatment for those grappling with Borderline Personality Disorder (BPD). Growing up, Linehan was given a range of inaccurate psychiatric diagnoses and extreme forms of "treatment" to try to cure what she now believes was BPD. BPD only became an official diagnosis in 1980, though references to it in psychological literature are present decades prior. Linehan's own struggles with mental illness and eventual success in managing her mental state to become a thriving and high-functioning professor of psychology served as her inspiration for developing the DBT approach.
DBT is a great treatment approach for those who have intense reactions to emotional situations, especially situations related to interpersonal relationships. For some, changes in relationships, whether it be movement towards OR away from intimacy with another, can elicit very strong and overwhelming emotional responses. DBT is especially designed to aid in managing strong emotional reactions through building skills for mood regulation, distress tolerance, mindfulness (e.g., meditation, staying present), and strategies to improve interpersonal effectiveness and relationships. It is designed to help people find balance between dialectics (e.g., opposites), and practice sitting in grey areas rather than black-and-white thinking (e.g., recognizing and tolerating ebbs and flows in relationships vs. believing that getting in an argument with a partner means the relationship is doomed).
DBT capitalizes on the individual's strengths to aid in symptom reduction and progress. It utilizes similar components of CBT, with an effort towards identifying and challenging unhelpful thinking patterns, as well as relaxation training and mindfulness practices to re-learn how it feels to be at peace. DBT sessions are typically structured, time-limited, and present-focused. It is administered in individual, group, or a combination of group and individual modalities. While it was developed originally for and remains the top choice treatment for BPD, it has also been successful in treating post-traumatic stress disorder, some eating disorders, depression, and substance abuse.
Interested in finding a DBT therapist for yourself? Check this post for ways to get connected with a therapist.
Some other helpful resources on DBT:
Overview and Applications of DBT Therapy
DBT Skills and Worksheets
DBT Skills Workbook
Dr. Bethany Detwiler is a psychologist practicing in Allentown, PA. She specializes in mood and relationship struggles. She also is an adjunct professor of counseling at Lehigh University.