What is Dialectical Behavior Therapy and How Does it Work?

Dialectical Behavior Therapy, or DBT, combines talk therapy and behavioral therapy to help patients manage negative emotions, and learn interpersonal and communication skills. Unlike CBT which takes a more holistic approach to a patient’s belief system, DBT is focused on four main areas.

Negative rumination patterns and excessive worry can trigger depressive episodes or anxiety in vulnerable patients. In this area of DBT, patients can overcome this habit and improve their emotional state. In DBT, the patient is encouraged to accept their circumstances and learn how to be present in the moment. Being mindful keeps the patient from ruminating over the past, which they can’t change, or the future, which they can’t predict.

Failing to increase their distress tolerance can cause patients to self-soothe with harmful substances or behaviors. In this area of DBT, a trained therapist gives patients the tools they need to increase their tolerance to negative emotions, instead of trying to escape from their negative feelings.

Intense, unregulated emotions will harm a person in many facets of their life. Unchecked emotions can hurt their relationships, and their ability to hold or keep a steady job. They may find themselves financially harmed as a result of emotional outbursts. What DBT aims to do here is to give patients skills and strategies for recognizing their emotions, tolerating their distressing emotions, and learning how to change and manage those emotions.

Not knowing how to communicate with others effectively can cause all sorts of strife. A vulnerable individual may be taken advantage of, or they may have a difficult time forging and strengthening relationships if they are poor communicators. In DBT, a patient will learn how to communicate with others in a way that is assertive and effective. DBT will teach the patient techniques for strengthening their bonds with others, and how to maintain their self-respect and personal boundaries in relationships.

Who can benefit from DBT?

Psychiatrist Marsha Linehan invented DBT in the 1980s. Initially, the therapy was used to treat borderline personality disorder, of which Dr. Linehan suffered herself. But since the treatment was first used more than thirty years ago, research has indicated that a multitude of other mental health disorders and behavioral disorders can be successfully treated with DBT.

  • Depression
  • Eating disorders
  • Bipolar disorder
  • PTSD

DBT can help patients who suffer from emotional distress and communication issues regulate their emotions and learn how to tolerate negative feelings and situations effectively. Patients who have problems with communication and learning how to live in the present can also benefit from DBT with an experienced therapist.

How does DBT work?

DBT is most useful for patients who have problems regulating their emotions and communicating with others. Although DBT is not the same as CBT, it definitely is closely related to CBT and shares its roots with the method.

Dialectical Behavioral Therapy

At its core, DBT is about the idea of balancing opposites. During sessions, the therapist must work with the patient to find a way to balance two opposite perspectives at the same time, which helps promote emotional regulation, and encourages the patient to avoid problematic black-and-white thinking. Thinking in extremes severely harms relationships and interactions, and can also distort the patient’s acceptance of themselves.

For example, borderline patients will often fall into extremes of “I’m all bad” or “I’m all good,” and those beliefs can drastically change on a dime. With DBT, the therapy promotes a both-and outlook, instead of either-or thinking. The overarching goal of the treatment is to encourage radical self-acceptance and change in the patient.

DBT is often administered in group settings, one-on-one settings, or a mix of both methods. Sessions usually last about two hours, and groups or individual patients will meet once a week for up to six months. Sessions can be shorter or longer, and DBT can have a longer or shorter duration than six months, but it depends on the patient’s needs and progress.

What are the success rates of DBT?

Statistics show that up to 30% of mental health disorder patients also have a personality disorder. For personality disorders, DBT is the most effective treatment method. There is no cure for a personality disorder, but with therapy, patients can find relief from distressing symptoms. Like CBT, DBT therapy is designed to have an end-date and is not necessarily an ongoing therapy method. But the number of DBT sessions a patient will need will vary depending on the severity of their condition. After DBT is completed, patients can benefit from ongoing talk or group therapy that centers around coping methods and support for the patient’s current circumstances.

Studies have found that up to 86% of DBT patients experience a remission of their symptoms after treatment is completed. Six-month follow-ups reveal that 56% of DBT patients were still in remission. DBT is often used to treat emotional disorders where other methods of therapy have failed. It is therefore critical that patients receive ongoing treatment for their disorder, even after DBT has been completed and they’ve experienced remission of symptoms.

Who is most qualified to administer Dialectical behavior therapy?

A trained psychiatrist or a therapist who has undergone DBT certification can treat patients with DBT. For patients, it’s important to be aware that DBT sessions are intense and can last more than one hour. It may take some time for patients to find a therapist they can trust who is trained to treat their disorder. For DBT to be most effective, patients need to find a therapist they can build a working relationship with and trust.

How Does Dialectical Behavioral Therapy (DBT) Work?

Managing emotions may be very difficult for some people. DBT, or Dialectical Behavioral Therapy is a combination of talk and behavioral therapy; it helps patients manage their negative emotions through a number of methods. Our southern California rehab center utilizes DBT for addiction treatment as one of its therapies.

What is DBT?

Is DBT related to CBT, Cognitive Behavioral Therapy? The answer is yes; however, it is different in that it focuses on providing clients with new skills to address conflicts in relationships and painful emotional situations. It has a focus on four different aspects:

  • Mindfulness
  • Tolerance for distress
  • Emotional regulation
  • Interpersonal effectiveness

An example of mindfulness is paying attention to your own breath, taking note of the inhaling and exhaling. Watching the stomach rise and fall while breathing, may also be an action of the state of being mindful.

Some actions for tolerance towards distress include learning how to distract yourself, learning how to self-soothe, and learning to improve the moment. What are your pros and cons of being distressed? That is an important question that you may ask yourself.


For What is DBT Effectively Used?

It was originally developed as a treatment for personality disorders. However, recently, DBT has been used to treat a number of other psychological issues, including the following:

  • Substance abuse
  • Bulimia
  • Depression
  • Binge eating
  • Bi-polar disorder
  • PTSD

Regulating emotions is one of the goals of DBT. Behaviors that are self-destructive are the target of this type of cognitive behavioral therapy.

DBT As A Solution

DBT for addiction treatment is an evidenced-based therapy. People often wonder how DBT works. One way that it benefits those with a substance abuse or eating disorder is that the patient begins to accept him or herself as well as others. Mindfulness keeps you in the present, not constantly judging experience. By doing things mindfully, one at a time, chaos is replaced by focused behavior.


Knowing how DBT works is realizing that acceptance and change go hand and hand. Tolerating distress and being mindful works in tandem with solutions, such as changing behavior, changing environments, solving the problems and more.


Treatment Settings

DBT for addiction treatment can be done in many settings, including group, individual or phone coaching. Group therapy allows for role-playing, homework, and learning new ways of behaving and interacting with other people. In individual therapy, a highly trained counselor helps patients adapt newly learned behaviors to their own lives and its challenges. Phone coaching allows for the patient to call the therapist between sessions to attain guidance and help with coping skills for their life situation. This is done mainly between DBT sessions.

If you or a loved one are struggling with a substance abuse problem, our southern California rehab can help. Our trained therapists use DBT and other evidence-based therapies and more to address substance abuse and addiction. Contact us at Mission Harbor Behavioral Health to begin the path to wellness and freedom from addiction.

Updated content on 05/20/21

The facilities at Mission Harbor are staffed with trained experts to best assist patients with their mental health issues. We are capable of dealing with any and all cases with a licensed staff, equipment, and approved techniques. Our mission is to help those who want to help themselves, and we support your decision in seeking help.

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