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IT
Institute of Therapy Clinical Reference
Modalities DBT

Dialectical Behavior Therapy (DBT)

A modified type of cognitive behavioral therapy (CBT) developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD).

Theoretical Foundations

Developed by Marsha M. Linehan, DBT rests on a biosocial theory of borderline personality disorder, conceptualizing the disorder as primarily one of pervasive emotion dysregulation. The "dialectical" aspect refers to the core philosophical tension in the treatment: the simultaneous synthesis of acceptance (validating the client where they are) and change (pushing for behavioral modification).

The Four Modules of Skills Training

  • Mindfulness: The foundation of all other skills, adapted from Zen practices to help clients observe and describe their current experience non-judgmentally.
  • Distress Tolerance: Skills designed to help clients survive crises without making things worse (e.g., TIPP skills, radical acceptance).
  • Emotion Regulation: Strategies to identify emotions, reduce vulnerability to emotion mind, and change emotional responses.
  • Interpersonal Effectiveness: Techniques for asking for what one needs, saying no, and managing interpersonal conflict while maintaining self-respect.