What is Dialectical Behavior Therapy (DBT)?

By Christine Benvenuto, MFT, Co-Founder of the Oakland DBT and Mindfulness Center in Oakland, CA

Dialectical Behavior Therapy (DBT) is a research-supported evidence-based treatment model that combines cognitive-behavioral theory (CBT) and methods with principles of mindfulness and Eastern meditation practices. Developed by Dr. Marsha Linehan and her colleagues at the University of Washington, DBT addresses problems with regulating emotion and managing behavior by challenging and changing problematic thought patterns that can lead to emotional reactivity, interfere with relationships, and ultimately rob us of the life we want to lead.

DBT maintains that some people, due to the interaction between their environments during upbringing as well as biological factors as yet unknown, react intensely to stimuli, experience high levels of arousal, and need more time to return to baseline after events that stimulate emotion. This can lead to the appearance of having constant “crises,” and/or extreme emotions that shift from one to another rapidly. As a result, interpersonal and relationship problems can develop, as well as difficulties establishing a sense of identity outside of the “highs and lows” of emotions.

The dialectical (i.e., integration of opposing forces) nature of this approach means that treatment will include combining validation and acceptance while teaching you, step by step, to make changes so that you can have the life that you want. DBT treatment involves a multi-pronged approach that includes individual therapy, skills group and phone coaching.

1.) Individual therapy combines strategies for change with validation, with the underlying assumption that you can’t change a problem without deep appreciation for all that factors that caused the problem(s) to occur.

2.) Skills classes focus on the following:

• Mindfulness – learning to pay attention to the present moment with a sense of acceptance and self-compassion
• Distress Tolerance – learning how to tolerate stress without making things worse
• Emotion Regulation – understanding how they work and how to make effective decisions based on what they are communicating
• Interpersonal Effectiveness – improving the ability to establish and maintain healthy relationships

3.) Phone coaching: individual therapists make themselves available to their clients 24 hours/7 days per week for the purpose of “phone coaching” or supporting clients to use skills to manage stress and problem solve in the moment in a way that supports long term goals. All therapists who provide adherent DBT are part of a consultation team that meets weekly and aim to follow the same principals and guidelines that we teach our clients.

While DBT was initially developed for people with Borderline Personality Disorder, this style of treatment and the associated skills have been helpful for people who struggle with all kinds of life challenges, including Depression, Anxiety, Bipolar disorder, or simply want a more structured and pragmatic approach to therapy than they have had in the past.

Simply put, the goal of DBT treatment is to help you suffer less and build a life worth living.

About this Contributor: Christine Benvenuto, is a Marriage and Family Therapist and Co-Founder of the Oakland DBT and Mindfulness Center, where she oversees the Adolescent/Family and Young Adult program and provides both long-term and brief psychotherapy to adolescents, adults and couples. She received her undergraduate degree from Boston University and her Masters in Psychology with a focus on Somatic Psychotherapy from the California Institute of Integral Studies (CIIS) and has worked in mental health since 1993. Since 1996 she has maintained a mindfulness practice (yoga and meditation), which she integrates into her clinical work, as she is inspired by the profound impact it has had on her life. For more information about her work, please visit: oaklanddbtcenter.com.