Procedure

Dialectical Behavior Therapy

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Dialectical Behavior Therapy, DBT

  • See Also
  1. Cognitive Behavioral Therapy
  • Definitions
  1. Dialectical Behavior Therapy (DBT)
    1. Subtype of Cognitive Behavioral Therapy (CBT) which focuses on emotion acceptance and behavior change
    2. Teaches emotional regulation, distress tolerance, interpersonal relationship building and mindful decision making
  • Indications
  1. Borderline Personality Disorder
    1. Original indication for Dialectical Behavior Therapy
  2. Broad range of mental health conditions with emotional dysregulation
    1. Intense emotions
    2. Self-destructive behavior
    3. Difficult relationships
  3. Other mental health conditions
    1. Suicidality
    2. Post-Traumatic Stress Disorder (PTSD)
    3. Eating Disorders
    4. Substance Use Disorder
    5. Bipolar Disorder
  • Background
  1. Clinicians should consider teaching focused DBT techniques at clinic visits (e.g. a 5 minute MindfulnessExercise)
  • Management Mindfulness
  1. Goals
    1. Focus on the present moment (instead of future fears or past worries)
    2. Accept difficult emotions
    3. Dispose of unhelpful thoughts
  2. Techniques
    1. See Mindfulness (e.g. box breathing)
    2. Wise mind balances the logical/rational mind with the emotional mind
  • Management
  • Distress Tolerance
  1. Goals
    1. Intense emotion management (e.g. anger, sadness, anxiety)
  2. Techniques
    1. Distraction techniques
    2. Live in the moment (e.g. Mindfulness techniques)
    3. Self soothing techniques to experience relaxation and comfort (e.g. five senses to explore places of relaxation)
    4. Radical acceptance of reality and setbacks without perseverating over what may have been instead
    5. Embrace the privelege to decide what gives life meaning
  • Management
  • Emotional Regulation
  1. Goals
    1. Develop skills to cope with overwhelming situations
    2. Avoid self harm
  2. Techniques
    1. Perform the opposite actions related to negative emotions
      1. Anger: Perform a kind task
      2. Unmotivated: Exercise or perform an activity
    2. Positive self-talk
      1. Although I sometimes fail, I also sometimes succeed
  • Management
  • Interpersonal Effectiveness
  1. Goals
    1. Maintain healthy relationships with improved communication and boundary setting
  2. Techniques (Mnemonic: DEAR MAN)
    1. Describe
      1. Review the facts of a negative event with the person involved (e.g. failed commitment)
    2. Express
      1. Share the emotion of how this negative event made you feel (e.g. ignored, sad, lonely)
    3. Assert
      1. Ask for your want (and decline what you don't want)
    4. Reinforce
      1. Explain the positive effects on the relationship of met needs
    5. Mindful
      1. Summarize goals and needs
    6. Appear
      1. Be confident when expressing what you need
    7. Negotiate
      1. Find solutions that meet your own needs, as well as the needs of everyone involved
  • Resources
  1. Dialectical Behavior Therapy
    1. https://dialecticalbehaviortherapy.com/
  2. Simple DBT Skills Diary Card (free)
    1. https://apps.apple.com/us/app/simple-dbt-skills-diary-card/id666921665
  3. DBT Coach
    1. https://apps.apple.com/us/app/dbt-coach/id1452264969
  • References
  1. Bylotas (2025) Am Fam Physician 112(1): 88-90 [PubMed]