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Dialectical Behavior Therapy

National Institute of Mental Health (NIMH)

Dialectical behavior therapy (DBT), a form of CBT, was developed by Marsha Linehan, Ph.D. At first, it was developed to treat people with suicidal thoughts and actions. It is now also used to treat people with borderline personality disorder (BPD). BPD is an illness in which suicidal thinking and actions are more common.

The term "dialectical" refers to a philosophic exercise in which two opposing views are discussed until a logical blending or balance of the two extremes—the middle way—is found. In keeping with that philosophy, the therapist assures the patient that the patient's behavior and feelings are valid and understandable. At the same time, the therapist coaches the patient to understand that it is his or her personal responsibility to change unhealthy or disruptive behavior.

DBT emphasizes the value of a strong and equal relationship between patient and therapist. The therapist consistently reminds the patient when his or her behavior is unhealthy or disruptive—when boundaries are overstepped—and then teaches the skills needed to better deal with future similar situations. DBT involves both individual and group therapy. Individual sessions are used to teach new skills, while group sessions provide the opportunity to practice these skills.

Research suggests that DBT is an effective treatment for people with BPD. A recent NIMH-funded study found that DBT reduced suicide attempts by half compared to other types of treatment for patients with BPD.