Dialectical Behavior Therapy

What is DBT?

DBT in a Nutshell

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.

Components of DBT

Standard, comprehensive DBT (the form provided by the WVU DBT Services Program), includes four components:

  1. Individual DBT (weekly)
  2. Skills training groups (weekly)
  3. Skills coaching by phone (on an as needed basis)
  4. Therapist participation in a consultation team (weekly)

Programs and clinicians who do not provide all of these components are not conducting DBT.

Scientific Evidence for DBT

Research on DBT: DBT is considered an “evidence-based practice”. An evidence-based practice is one that adheres to a specific scientifically 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.

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 (for a 3 minute video on meta-analysis click here; to read brief overviews on meta-analysis, click here or here). DBT has been evaluated in multiple meta-analyses, which have found that DBT has a reliable and moderately strong effect on reducing emotional dysregulation and behavioral dysregulation, including life-threatening behaviors such as suicide attempts and and non-suicidal self-injury (for examples of these meta-analyses, click the following: 1, 2, 3, 4, 5, 6 and 7)

Therefore, there is increasing evidence that DBT is an effective treatment for:

  • Symptoms of BPD
  • Suicidal behavior in emotionally dysregulated adults and adolescents
  • Non-suicidal self-injury in emotionally dysregulated adults and adolescents
  • Substance Use Disorders
  • Disordered eating


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 pervasive emotional dysregulation across different types of psychiatric disorders.

If you would like to read some of the scientific research published on DBT, click here for the Google Scholar list of publications: DBT on Google Scholar