Dialectical behavior therapy: What you need to know

Dialectical behavior therapy, or DBT, is a therapy that helps people who struggle with managing emotions and who may be self-destructive. It’s a type of cognitive behavioral therapy (CBT).

DBT isn’t a treatment for learning and thinking differences. But it can sometimes help teens and adults with mental health issues that often co-occur with those issues. Learn more about DBT.

What is DBT?

DBT is an evidence-based treatment that’s been around since the 1970s. It’s a form of CBT, but it takes a different approach to problem-solving.

CBT helps people look at their negative ways of thinking and assess whether those thoughts are accurate. The goal is to change actions and behaviors that are getting in the way of healthy functioning. CBT therapy focuses on reducing those behaviors and increasing ones that promote mental health.

DBT also aims to change behavior. But it helps people recognize and accept their feelings in the moment. It also gives them tools to improve skills in four main areas:

• Being mindful

• Regulating emotions

• Having better relationships

• Tolerating distress

Unlike CBT, DBT is a very structured treatment program. It has four main components:

• Weekly individual therapy sessions

• Weekly group therapy sessions for building DBT-related skills, like regulating emotions

• As-needed consultations with the therapist

• Weekly meetings where therapists consult each other on cases

What sets DBT apart from other approaches is that it focuses on two things that might seem opposed: acceptance and change. DBT helps patients accept themselves and their feelings in the present. At the same time, it teaches them how to use thinking to change negative feelings and behaviors.

DBT gives people concrete skills they can use to soothe themselves, redirect their thinking, and handle tough emotions. Group skills-training sessions may involve special worksheets. Patients do written exercises to help identify their trouble spots and brainstorm better ways to handle them.

Those are the aspects of a complete DBT program. But people can also benefit from having individual sessions with a DBT therapist.

Who DBT can help

DBT was created to help people with borderline personality disorder who are suicidal. Over the years, it’s been adapted to help with a range of mental health issues, some of which may co-occur with learning and thinking differences.

Researchers are looking into whether DBT might be an effective treatment for ADHD and two other conditions that often co-occur with it: mood disorders (like depression) and binge-eating disorder.

DBT doesn’t work for everyone. But if your child struggles with extreme emotions, you might want to consider it. Talk to your child’s doctor or therapist about whether DBT might be a good treatment option and whether they can recommend a DBT therapist in your area. Keep in mind that DBT isn’t for young kids.

If you suspect your child is struggling with mental health issues, it’s a good idea to seek help early. Know how to spot the signs of anxiety and depression. And read about when to seek help for your child.

Where to find DBT therapy

DBT is becoming more widespread. To find a therapist, you can ask your child’s pediatrician for a referral to a local DBT therapist. Or if your child is in another type of therapy, you can ask that professional if anyone in your area does DBT.

In some places, however, a complete DBT treatment program may be hard to find. But even without a full program, some therapists will use DBT techniques in their sessions. You can look into local therapists who might use a DBT approach.

Find out where to look for a therapist. You can also learn more about DBT at the Child Mind Institute, an Understood founding partner.