How Dialectical Behavior Therapy (DBT) Works
What is DBT?
Dialectical Behavioral Therapy or DBT is a cognitive behavioral treatment that focuses on helping people create a life worth living. As a therapy DBT usually involves both individual psychotherapy and group skills training. DBT skills include emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness.
How can DBT benefit me?
DBT is an extremely effective treatment with evidence for several disorders and issues that are challenging to treat with other techniques including suicidal behaviors, borderline personality disorder (Linehan et al., 2006), binge eating disorder (Telch, Agras, & Linehan, 2001), and substance use (Linehan et al., 2002). DBT’s focus on creating a life worth living helps focus on building skills that allow people to cope with life stresses and challenging emotions.
Can I get the same benefits from practicing DBT online?
DBT, similar to other cognitive behavioral treatments, focuses on skills-based training. There is promising evidence that these skills can be delivered, taught, and practiced online (Wilks et al., 2018). Web-based DBT has been shown to be effective in the treatment of of specific disorders as well, including suicidality and substance use (Wilks et al., 2018).
…and on my smartphone?
There have been several demonstrations of mobile apps that either encompass principles from DBT or deliver DBT skills. The majority of research evaluating these apps have explored their use to extend training and practice of DBT skills in combination with traditional DBT treatment (Rizvi et al., 2011; Rivzi et al., 2016; Suñol et al., 2017). Therefore although it is possible that emotion regulation, distress tolerance, mindfulness, and interpersonal effectiveness can be supported through apps, the state of the research in DBT apps themselves suggest their benefit mostly in combination with traditional care.
Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., … & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of general psychiatry, 63(7), 757-766.
Linehan, M. M., Dimeff, L. A., Reynolds, S. K., Comtois, K. A., Welch, S. S., Heagerty, P., & Kivlahan, D. R. (2002). Dialectical behavior therapy versus comprehensive validation therapy plus 12-step for the treatment of opioid dependent women meeting criteria for borderline personality disorder. Drug & Alcohol Dependence, 67(1), 13-26.
Rizvi, S. L., Dimeff, L. A., Skutch, J., Carroll, D., & Linehan, M. M. (2011). A pilot study of the DBT coach: an interactive mobile phone application for individuals with borderline personality disorder and substance use disorder. Behavior therapy, 42(4), 589-600.
Rizvi, S. L., Hughes, C. D., & Thomas, M. C. (2016). The DBT Coach mobile application as an adjunct to treatment for suicidal and self-injuring individuals with borderline personality disorder: A preliminary evaluation and challenges to client utilization. Psychological services, 13(4), 380.
Suñol, J., Panisello, J. M., Castell, E., Tárraga, J. P., Sánchez, C., & Pérez, V. (2017). Medtep DBT”: A dialectical behavior therapy native app and web platform for borderline personality disorder patients and their therapists. Universal Journal of Public Health, 5(3), 110-118.
Telch, C. F., Agras, W. S., & Linehan, M. M. (2001). Dialectical behavior therapy for binge eating disorder. Journal of consulting and clinical psychology, 69(6), 1061.
Wilks, C. R., Lungu, A., Ang, S. Y., Matsuyama, B., Yin, Q., & Linehan, M. M. (2018). A randomized controlled trial of an Internet delivered dialectical behavior therapy skills training for suicidal and heavy episodic drinkers. Journal of affective disorders.