For instance, inpatient and partial hospitalization day programs may offer shortened skills training schedules. In all, it takes around six months to complete the skills training modules following the standard DBT schedule. The modules are often repeated, however, meaning that many people spend a year or longer in a DBT program. DBT was initially developed to help improve symptoms of BPD and persistent thoughts of suicide. DBT involves a skills training group, which is similar to a group therapy session.

At present, eight published, well-controlled, randomized, clinical trials (RCTs) have demonstrated that DBT is an efficacious and specific2 treatment for BPD and related problems. In addition, research has shown that it is effective in treating a wide range of other disorders such as substance dependence, depression, post-traumatic stress disorder (PTSD), and eating disorders. In summary, DBT is a comprehensive, cognitive-behavioral treatment originally designed to help suicidal women. Persons interested in learning more about DBT might begin with Linehan’s1 comprehensive treatment manual.


A DBT therapist is a licensed mental health professional who has additional training and experience in DBT. Several organizations provide certification in DBT to qualified therapists who have completed advanced academic and clinical work. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors. DBT may be combined with the use of medication, counseling, and support group meetings, and used as part of a comprehensive addiction treatment program. In some instances, a person may need to attend a detox program before entering an alcohol addiction treatment program to reach a stable physical level first. DBT has also been shown to be beneficial in helping those who struggle both with bipolar disorder and substance abuse, the journal Psychiatry further publishes.

Dialectical Behavioral Therapy

Due to this, a consultation team is considered essential for DBT providers. It can offer support, motivation, and therapy to the therapists working with difficult issues. Currently, DBT is used to treat people with chronic or severe mental health issues.

When to Apply DBT: Using the Research Evidence as a Guide

By Michelle C. Brooten-Brooks, LMFT

Michelle C. Brooten-Brooks is a licensed marriage and family therapist, health reporter and medical writer with over twenty years of experience in journalism. She has a degree in journalism Dialectical Behavioral Therapy from The University of Florida and a Master’s in Marriage and Family Therapy from Valdosta State University. The practice of mindfulness is to be aware and focused on the present moment instead of the past.

The cost effectiveness of DBT also extends past the treatment year as evidenced by a recent examination in a VA hospital setting. Meyers and colleagues (2014) found that veterans who received DBT treatment had significantly decreased the use of outpatient mental health services in the following year by 48%. Perhaps more importantly, the study demonstrated that utilization of high-cost inpatient services decreased by 50% and length of stay by 69%.

DBT Treatment Targets

Two of these trials (carried out in our research clinic) specifically targeted highly suicidal women with BPD, and we are in the midst of a third trial targeting the same population. In our first study, results favoring DBT were found in each DBT target area. In our second study, we compared DBT to a much stronger control condition, treatment by non-behavioral community experts (TBE). In comparison to TBE, DBT reduced suicide attempts by half, had less medically severe self-injurious episodes, lower rates of treatment drop-out, and fewer admissions to both emergency departments and inpatient units due to suicidality. In studies of substance dependent BPD patients conducted at our research clinic as well as at other sites, DBT has been found to be superior to control treatments in reducing substance use.

Although 86 percent of DBT participants had stopped bingeing by the end of treatment, this number declined to 56 percent during the six-month follow-up period. A second study compared a modified version of individual DBT that included skills training to a wait list condition. DBT patients had greater reductions in bingeing and purging.14 No follow-up data are currently available for this latter study. DBT has also been described in terms of its functional goals, which include giving patients new skills and abilities, improving patients’ motivation to make changes in their lives, and helping patients to apply their skills and abilities to real-life situations. DBT programs also aim to manage the types of contacts between patients and therapists and to ensure the quality of patient care through regular meetings between therapists and teams of consultants.

DBT Cost Effectiveness

The National Survey on Drug Use and Health (NSDUH) publishes that more than 15 million Americans (aged 12 and older) struggled with alcohol addiction in 2016. Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that nearly 8 million adults in the United States struggled with co-occurring disorders in 2014. DBT may be highly beneficial for people who suffer from both a mental disorder and alcoholism at the same time, as it helps to manage extreme emotions and potentially self-destructive behaviors, which can include substance abuse. The word “dialectical” means combining opposite ideas, notes the University of Washington. DBT embraces this concept by pairing opposing strategies of acceptance and change.

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