Dialectical behavior therapy (DBT)

There are multiple key elements to dialectical behavior therapy. Because the aim of DBT was to help people who were more likely to experience suicidal ideation, it was important to focus on managing and tolerating distress, rather than trying to find solutions to it. As such, DBT is based on mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. DBT sessions work on each module over the course of an entire treatment program, rather than all at once:

Mindfulness: Clients learn to be present in the moment and observe their thoughts and feelings without judgment.

Distress Tolerance: Techniques to manage and survive crises without making them worse.

Emotion Regulation: Strategies to understand, label, and change emotions.

Interpersonal Effectiveness: Skills to assert needs, manage conflict, and maintain relationships.

To achieve progress with someone who might not respond to other forms of talk therapy, DBT therapists utilize specific tools as prescribed by the protocol to steer clients towards learning to accept themselves and their experiences, rather than asking them to make immediate changes. While change is important, the first step is to tolerate the way things are – and accept that change is possible. A dialectic approach aims to highlight the inconsistencies that pop up when experiencing negative thinking, and using them as a stepping stone towards considering other, more positive lines of thinking through behavioral changes, skills training, and therapy itself.