Dialectical Behavioral Therapy (DBT) is considered one of the most effective treatment options for borderline personality disorder (BPD) and other mental health disorders. As an evidence-based treatment, DBT combines cognitive and behavioral therapists to help people regulate emotions, transform negative thinking patterns, and change unhealthy behaviors.


How did DBT develop?

Dialectical Behavior Therapy (DBT) was created by Marsha Linehan, Ph.D., and colleagues in the late 1980s when they discovered that cognitive-behavioral therapy (CBT) alone did not work as well as expected in patients with BPD. Dr. Linehan, her team, and others have developed a treatment that meets the unique needs of these individuals.


DBT strategies

DBT teaches you four strategies that can help you change your behavior.

  1. Mindfulness. Mindfulness skills help you center yourself in the present moment, whether you are meditating or simply sitting and breathing. It's an essential part of DBT, as it can help you be more aware of and in charge of emotional situations to move through them effectively. 

  2. Distress tolerance. The concept of Distress Tolerance is the ability to accept and endure both emotional and physical distress (e.g., life's inevitable stressful events) without becoming overwhelmed with anxiety or discomfort. By learning how to handle being in a state of emotional distress, people can better control their own lives and not live out their problems through negative behaviors.

  3. Interpersonal effectiveness. In DBT, interpersonal effectiveness is the skill to be able to manage relationships productively. This includes the ability to communicate effectively and identify strategies that will help you maintain desired relationship outcomes, as well as the ability to set boundaries. 

  4. Emotion regulation. Emotion regulation is a set of skills you can learn to help you manage your emotions more effectively. The skills include identifying, naming, and changing emotions, as well as deepening and broadening them.


Aside from individual therapy sessions, DBT is often offered in group settings.  With guidance from experienced professionals, the group can offer an outlet for compassion, self-development, and learning strategies to cope with life stressors.


Is DBT right for you?

Although most DBT research has focused on its effectiveness for people with borderline personality disorder,  it may also be effective in treating: 

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Bipolar disorder
  • Eating disorders (such as anorexia nervosa, binge eating disorder, and bulimia nervosa)
  • Generalized anxiety disorder (GAD)
  • Major depressive disorder (including treatment-resistant major depression and chronic depression)
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorder


The bottom line


Overall, DBT helps clients find healthy ways to cope with problems while building skills that enable them to get the most out of life. If you or a loved one might benefit from DBT, it's essential to talk with a healthcare provider or mental health professional trained in the approach