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dialectical behavioral therapy

Dialectical behavioral therapy (DBT) is a kind of cognitive behavioral psychotherapy (CBT) developed in the late 1980s to help treat borderline personality disorder. It has since been used to treat other kinds of mental health illnesses including borderline personality disordered patients with co-existing substance abuse problems. As a CBT analogue, DBT is a skills training therapy specifically designed to treat borderline personality disorder and includes 4 behavioral components:

  1. Core mindfulness
  2. Distress tolerance
  3. Emotion regulation
  4. Interpersonal effectiveness.

Together, the four skills-therapy components are designed to specifically assist guests in managing behaviors, emotions and thoughts, a difficult task to be sure with patients that almost inevitably have “control” issues.

The strongest evidence for DBT as a useful treatment is for individuals with borderline personality disorder.


Core mindfulness centers around the concept of being mindful, or present in the moment. This skill is vital to being an active part of your own reality, being in-touch with yourself and your surroundings. Mindfulness lends itself to a state-of-mind that is ever-present, giving the guest the opportunity to truly experience life.

Distress Tolerance

Distress tolerance offers a skill-set of tools to be used as coping mechanisms. Through out life, there will be times of distress— the object of distress tolerance skills are to effectively tolerate the distress in a healthy way, protecting your sense of self and sanity in the process. Distress tolerance is especially helpful for those who seem to feel emotions strongly.

Emotion Regulation

Emotion regulation is a module that represents emotional actions and reactions. Emotion regulation skills give guests a sense of control when they are experiencing emotions intensely. Within emotion regulation, guests will learn how to discern their emotion and their response to it. Guests will be able to understand their experience of emotions and ask themselves questions like “is my emotion matching the situation that caused it?”

Interpersonal Effectiveness

Interpersonal effectiveness is one of the most helpful modules for guests who participate in Dialectical Behavioral Therapy. Interpersonal effectiveness is essentially how we communicate with others. Through learning interpersonal effectiveness skills, guests will learn the most effective ways to communicate with others, whether it be for something they feel, need, think, or want.

Mindfulness, emotion regulation, and interpersonal effectiveness skills therapy usually raise less questions than “distress tolerance” skills therapy. DBT distress tolerance skills work on the tendency of some patients to experience negative emotions as unbearable and overwhelming. People with a low threshold for things not going their way (i.e. people with control issues) can become overwhelmed when faced with mild levels of usual and customary day-to-day stress, and sometimes react with not very well thought-out behaviors.


Dialectical behavioral therapy allows guests to be in control of their actions and reactions, in a well thought-out and understanding way. DBT offers up multiple perspectives and many different ways to look at one single situation, which is especially helpful for those in early recovery.


Pottash ALC, Jonas JM, Gold MS, Cocores JA, Phenomenological Link Between Substance Abuse and Eating Disorders. Society For Neuroscience 1986.p

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