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Addictions

Dialectical Behavioral Therapy

A. Tom Horvath, Ph.D., ABPP, Kaushik Misra, Ph.D., Amy K. Epner, Ph.D., and Galen Morgan Cooper, Ph.D.

Dialectical Behavioral Therapy (DBT) is a hybrid form of cognitive-behavioral therapy (CBT). Like CBT, Dialectical Behavioral Therapy an evidence-based practice.

Marsha Linehan, Ph.D. (Linehan, 1993) developed DBT. Linehan noticed that some of her therapy participants were highly reactive to the change emphasis of CBT. Their sensitivity to requests for change made it difficult for them to benefit from CBT. Linehan concluded that the change emphasis of CBT was profoundly invalidating to certain highly sensitive patients. Therefore, Linehan added an acceptance component to her treatment approach. She began to encourage therapy participants to both accept themselves, and to change their behavior. DBT is "dialectical" because acceptance and change are seemingly incompatible agendas. However, it is clear that some therapy participants can only begin to change once they truly accept themselves and their current situation. To promote such acceptance, DBT teaches mindfulness. Mindfulness refers to the non-judgmental observation of moment-to-moment awareness. Mindfulness techniques borrow heavily from Eastern meditative practices. Research suggests that DBT may be particularly effective in addiction treatment for individuals with borderline personality disorders.

 

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