What is Dialectical Behavior Therapy (DBT)?

Although as few as ten years ago it was commonly thought Borderline Personality Disorder was untreatable, a flood of new research indicates it can be effectively treated with a special form of Cognitive Behavioral Therapy (CBT), called Dialectical Behavior Therapy (DBT). DBT was developed by a psychologist by the name of Marsha Linehan. Since the intial research about DBT and borderline personality disorder, subsequent studies have shown DBT to be highly effective for a number of other problems including intense anxiety, anger problems, substance abuse, and depression.

In the development of Dialectical behavior therapy (DBT), Marsha Linehan focuses on the concept of mindfulness, or being aware of and attentive to the current situation. DBT teaches skills to control intense emotions, reduce self-destructive behaviors, and improve relationships. DBT differs from traditional CBT in that it seeks a balance between changing and accepting beliefs and behaviors.

DBT can be provided one-on-one between the therapist and the patient and in a group setting. Therapist-led DBT group sessions may help teach people with Borderline Personality Disorder how to interact with others and how to express themselves effectively. Families of people with Borderline Personality Disorder may also benefit from therapy. The challenges of dealing with an ill relative on a daily basis can be very stressful, and family members may unknowingly act in ways that worsen their relative's symptoms.

Some therapies, such as DBT-family skills training (DBT-FST), also developed by Marsha Linehan, include family members of people with Borderline Personality Disorder in treatment sessions. These types of programs help families develop skills to better understand and support a relative with Borderline Personality Disorder.  Other therapies, such as Family Connections, focus on the needs of family members. More research is needed to determine the effectiveness of family therapy in Borderline Personality Disorder. Studies with other mental disorders suggest that including family members can help in a person's treatment.

Some symptoms of Borderline Personality Disorder may come and go, but the core symptoms of highly changeable moods, intense anger, and impulsiveness tend to be more persistent. People whose symptoms improve may continue to face issues related to co-occurring disorders, such as depression or post-traumatic stress disorder. However, encouraging research suggests that relapse, or the recurrence of full-blown symptoms after remission, is rare. In one study, only six percent of people with Borderline Personality Disorder had a relapse after remission.


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