Dialectical Behavioral Therapy



Dialectical Behavioral Therapy is a derivative of cognitive behavioral therapies.  This therapy is used to teach patients skills to learn how to deal with stress, improve relationships with other people, and to regulate their emotions.  It is a philosophical process that is known as dialectics.  It comes from the concept that everything has an opposite.  It is believed that change only can occur when one force is much stronger than another.  It is of paramount importance of overall health and well being improvement that people learn how to deal with their emotions and to not bottle them up or to lash out at others, but to act properly and to learn to act not to react.

Goals of Dialectical Behavioral Therapy

Dialectical Behavioral Therapy is made up of three different types of assumptions.  One is that all things are generally connected in one way or another.  The second is that change is not only inevitable but it is also constant, and third to form closer approximations within the truth opposites can really be integrated.  With Dialectical Behavioral Therapy the therapist and the patient work closely together in order to resolve the contradiction of self-acceptance and what comes along with change so that the outcome for the patient can be a positive one.

When is Dialectical Behavioral Therapy Used?

Dialectical Behavioral Therapy is primarily designed for use in patients who could cause potential harm to themselves, such as patients who are cutters or who ultimately have thoughts of suicide that plague their minds and emotions.  Originally Dialectical Behavioral Therapy was intended for people who had personality disorders.  Since then it has been adapted for conditions where patients exhibit behavior that is very self destructive.  It is common with eating disorders or those who participate in substance abuse.

How Dialectical Behavioral Therapy Works

The process of Dialectical Behavioral Therapy is to primarily learn behaviors that are new.  It can affect the way we think and what actions we participate in emotionally.   This is crucial for Dialectical Behavioral Therapy to work properly.  There are many strategies that are used in teaching patients how to change their behaviors.  These include training for new skills, therapy exposure, therapies in cognitive training, and management of contingencies.  With skill training, patients will attend skill building groups; they will participate in assignments at home, and role play to learn how to interact with people in new and more positive ways.  Through exposure therapies, people have to be open to exposing new types of feelings, especially those that are uncomfortable in nature and have been previously avoided.  With cognitive therapies, patients will then recognize the patterns that contain negative thoughts and to implement thoughts that are more positive which is a closer reflection to reality.  Contingency management is when a patient learns how to identify behavior that is manipulative and how to learn skills for adapting and how to avoid bad behaviors to live life in a more positive fashion.  The goal is to help patients learn a deep respect for what is right and wrong and how to access their moral code to guide them through many situations and to avoid negativity at all costs.  This type of learning will be helpful to patients to develop relationships that are more positive and will help them gravitate toward more positive people in their life and how to cope with those that are negative and to keep them at arm’s length.  Dialectical Behavioral Therapy is very beneficial to patients, especially those who have severe mental disorders and psychological problems.  It gives them the coping skills necessary to be able to deal with life and to take on new challenges instead of ducking their head in the sand to avoid them.  It teaches them to be strong and to hold their head up high and how not to internalize pain but to face it head on.

Criticisms of Dialectical Behavioral Therapy

Dialectical Behavioral Therapy was designed to work alongside cognitive behavioral therapies.  It was developed by Dr. Marsha Linehan in the late 70’s.  Techniques were added to further develop the treatment so that the needs of patients could be met.  At the current time there is not a lot of criticism with regard to this type of treatment.  It helps to reach patients and help them develop certain emotional skills.


Linehan, M. M.; Armstrong, H. E.; Suarez, A.; Allmon, D.; Heard, H. L. (1991). "Cognitive-behavioral treatments of chronically borderline patients". Archives of General Psychiatry.

Verheul, R., Schippers, G.M., van den Brink, W. (2002). Dialectical Behavior Therapy of borderline patients with and without substance use problems: Implementation and long-term effects. Addictive Behaviors.

Linehan et al. (2006) NIMH 3 Two-Year Randomized Control Trial and Follow up of DBT.

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