What Is Dialectical Behavioral Therapy

*Dialectical Behavioral Therapy in San Jose is a treatment developed by Marsha Lineman, Ph.D. and her colleagues at the University of Washington. Dialectical Behavioral Therapy (DBT) is a cognitive behavioral therapy, meaning it focuses on the role of cognition and actions in the development and treatment of borderline personality disorder. DBT includes some changes to the traditional elements to help reduce the symptoms, with 2 key characteristics: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes.

“Dialectical” refers to the issues involved in treating patients with a variety of disorders, and to the type of thought processes and behavioral styles used in doing so. DBT emphasizes balancing conduct change, problem-solving, and emotional regulation with validation, mindfulness, and acceptance. It has 4 components:

  1. Capability Enhancement
  2. Motivational Enhancement
  3. Generalization (Access to Therapist Outside Clinical Setting, Homework, Including the Family in Treatment)
  4. Structuring of the Environment

About Dialectics

Dialectics are one of the important unifying notions that reflect how the mind understands and perceives most core concepts and ideas. Psychology contains an abundance of such concepts, including:

  • Blameworthiness
  • Courage
  • Guilt
  • Honesty
  • Impulsivity
  • Inhibition
  • Passivity
  • Rage
  • Risk-Taking
  • Self-esteem
  • Trust
  • Withdrawal

Dialectics are based in part on the fact that we cannot understand these concepts without appreciating that they consist of bipolar opposites with a higher level of integration between them. This field breaks down the concepts into their seemingly opposite parts—white, black, and gray. John R. Fishbein Ph.D. is well-versed in this field and applies it to his practice.

*Adapted from SAMHSA’s National Registry of Evidence-based Programs and Practices and Psych Central, Charles H. Elliott, Ph.D.