Practical steps in Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) is a cognitivebehavioral therapy (CBT) originally developed to treat women with a history of chronic suicidal behavior who meet criteria for borderline
personality disorder (M Linehan, 1993). According to Marsha Linehan, Standard DBT includes multiple modes of treatment, including weekly individual therapy, weekly group skills training, and asneeded phone coaching to address skill and motivational problems common in people diagnosed with BPD.

The original manualized DBT program consists of four group skills training modules

a) Group skill training of mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance modules,

b) individual counseling,

c) telephone crisis coaching, and

d) a therapist consultation team

The DBT components became popular because it address skills deficits (via group skills training modules and phone coaching), in addition to issues related to motivation for change through individual therapy.

Typically, DBT skills training aims to teach skills to reduce dysfunctional behavior and facilitate the adoption of new behavioral, emotional, and thinking patterns through (but not exclusively delivered in) a group format(Linehan, 1993).

Four modules address skills deficits associated with BPD:

(a) core mindfulness skills center on ways to strategically deploy attentional control;

(b) emotion regulation skills teach clients to identify and influence emotions elicited by the
environment;

(c) interpersonal effectiveness skills help clients to learn to respond effectively to
interpersonal demands and conflicts; and

(d) distress tolerance skills teach clients to identify crisis situations and experience strong negative emotions while inhibiting dysfunctional behaviors that could serve to make the situation worse (Linehan, 1993)