What is DBT?
Dialectical Behavior Therapy (DBT) is a treatment for high-risk and life-threatening behaviors in people with complex psychiatric disorders. This treatment was originally developed for the treatment of suicidal behavior and non-suicidal self-injury, and was initially applied to treating these behaviors in people with Borderline Personality Disorder (BPD).
DBT is a cognitive-behavior therapy that strongly emphasizes the use of behavioral principles to facilitate change. This treatment blends an emphasis on acceptance (of oneself, of reality) with an emphasis on changing behavior. The overarching goal of DBT is to help people build a life worth living as they define it.
Standard, comprehensive DBT (the form provided by the WVU DBT Services Program), includes four components:
- Individual DBT (weekly)
- Skills training groups (weekly)
- Skills coaching by phone (on an as needed basis)
- Therapist participation in a consultation team (weekly)
Programs and clinicians who do not provide all of these components are not conducting DBT.
Research on DBT (see the WVU DBT Science Database for a list of and links to scientific studies on and relevant to Dialectical Behavior Therapy)
DBT is considered an “evidence-based practice”. An evidence-based practice is one that ahderes to a specific scientificallly validated theory, has specific procedures, and has been:
- Researched in multiple, well-designed scientific studies (called randomized controlled trials); AND
- Found through scientific research to be effective for treating a particular condition by performing better than no treatment at all; AND
- Found to be equal to or better than other treatments for the same condition.
DBT is an evidence-based practice and treatment that research has found decreases the following:
- Symptoms of BPD
- Suicidal behavior in emotionally dysregulated adults and adolescents
- Non-suicidal self-injury in emotionally dysregulated adults and adolescents
- Substance abuse
- Disordered eating
In research, the highest level of scientific evidence is a meta-analysis, which evaluates the effects of a treatment across the best research studies available. DBT has been subjected to 2 meta-analyses (see here and here) that have found that DBT has a reliable and moderately strong effect on reducing life-threatening behaviors (suicide and self-injury). An additional meta-analysis on DBT for disordered eating (see here) found that DBT had a strong effect across multiple studies for reducing eating disorder behaviors, primarily bingeing and purging.
At this time, DBT has been researched more than any other outpatient treatment for self-injury, suicidal behavior, and emotional dysregulation in people with BPD, and has the strongest level of scientific evidence supporting its use for treating these behaviors. DBT has the strongest level of scientific evidence supporting its use for the treatment of BPD in general. There is also an expanding range of clinical problems for which DBT is being studied as a treatment. While DBT cannot be all things to all people, research continues to indicate this is an effective treatment for emotional dysregulation across different types of psychopathology.