Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan specifically for borderline personality disorder but has expanded uses. DBT therapy explained covers the structure, modules, and how it differs from CBT.
DBT origins and approach
Developed in the 1980s for chronically suicidal patients with borderline personality disorder. Core insight: balance between acceptance and change.
DBT is more intensive than standard CBT and traditionally includes:
- Individual therapy
- Skills group
- Phone coaching
- Therapist consultation team
The four modules
Mindfulness: Foundational skills for present-moment awareness.
Distress tolerance: Crisis survival skills, accepting reality.
Emotion regulation: Understanding and managing intense emotions.
Interpersonal effectiveness: Communication, boundaries, relationships.
Conditions with DBT evidence
- Borderline personality disorder (strongest evidence)
- Suicidal behavior and self-harm
- Eating disorders (especially binge eating)
- Substance use disorders
- PTSD
- Treatment-resistant depression
DBT vs CBT
- DBT more focused on emotional dysregulation
- DBT incorporates mindfulness and acceptance
- DBT typically more intensive (multiple components)
- Both share behavioral elements
- DBT specifically developed for severe/complex cases
DBT-informed vs full DBT
“DBT-informed” therapy uses some skills without full program structure. Full DBT includes all four components and is more intensive.
Frequently Asked Questions
Is DBT only for borderline personality disorder?
Originally yes, now used broader. Most evidence still BPD.
How long does DBT take?
Standard program is 6+ months. Some patients participate longer.
Can I do DBT online?
Yes, with some adaptations. Group component sometimes harder online.
Is DBT covered by insurance?
Generally yes for indicated conditions.
What if I don’t have BPD?
DBT skills can help many conditions involving emotion regulation.
The bottom line on DBT
Intensive evidence-based therapy with strongest support for BPD but expanding uses. Skills useful broader than the formal program. Discuss with mental health provider.