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Dialectical Behavioral Therapy was developed by Marsha M. Linehan to treat borderline personality disorder, and has since been applied more widely to other types of mental health concerns.  It typically consists of two components: individual psychotherapy (usually weekly) and a psychoeducational skills group.

DBT is influenced by the philosophical perspective of dialectics: the synthesis of two opposite ideas. DBT therapy works to find ways to hold two seemingly opposite perspectives at the same time, avoiding all-or-nothing thinking.  The central dialectic of DBT is acceptance and change: We accept that things are the way they are, and also work to change them.  Acceptance is not necessarily approval.

DBT skills are separated into four modules:

  • mindfulness: learning to observe, describe, and participate in moments in our lives in a nonjudgmental way.
  • emotion regulation: learning to understand the function of emotions, use and/or change them, and reduce vulnerability to making purely emotional decisions
  • distress tolerance: learning how to accept and withstand painful and difficult situations
  • interpersonal effectiveness: learning to assert/ask for changes, resist unwanted changes (say no), and balance gaining one’s objective with self-respect, without harming or sacrificing the relationship