Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan, Ph.D. as an outpatient cognitive-behavioral intervention for adults diagnosed with Borderline Personality Disorder. The term “dialectical” describes the tension of polarity between profound acceptance of the person and the agenda to change (i.e., to grow, develop, and get on with life). Another example of polarity is the tension between giving up a lifestyle organized around self-hurt and the stresses of gain associated with successful performance.

From this perspective, the struggles experienced by individuals with BPD — emotional turmoil, a diffuse sense of self, chaotic relationships, and “all-or-none” thinking, behaving, and feeling — are examples of a person stuck in polarities and unable to move toward integration.

A dialectical approach includes cognitive and behavioral strategies that are realistic and practical. One of the primary goals is to continually reframe self-destructive and other difficult behaviors as part of the person’s best shot at problem solving, rather than as a character fault or personal weakness. Balanced with the staff members’ validation of the persons, the focus is on active problem solving. DBT principles and strategies are featured in two weekly groups for PT members with Borderline Personality Disorder. In most of our programs, DBT principles and strategies are featured in weekly groups. A few of our programs feature a strong DBT focus with additional DBT program elements:

• Validation strategies
• Behavioral analysis
• Helping the person to explore the “how’s and why’s” of progress, impasses, and setbacks
• Figuring out practical solutions.
• Learning and applying skills that support the solutions.
• Testing out (and evaluating) the solutions.

A typical week at Project Transition is described on our Program page.