Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy (DBT) is an evidence-based cognitive-behavioral treatment designed to help individuals regulate intense emotions, improve interpersonal effectiveness, and reduce self-destructive behaviors. Originally developed for borderline personality disorder, DBT is now widely used to treat a range of conditions including mood disorders, substance use disorders, post-traumatic stress disorder (PTSD), and suicidal ideation, particularly when traditional therapies have been insufficient^1,2.

DBT combines individual therapy, skills training groups, phone coaching, and a therapist consultation team to provide comprehensive support. Core skills taught include mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. These skills help patients build resilience, reduce impulsivity, and improve relationships, making DBT especially effective for patients with complex emotional and behavioral challenges².

For primary care providers (PCPs) and behavioral health clinicians, early identification of patients who may benefit from DBT, such as those with recurrent self-harm, chronic emotional dysregulation, or treatment-resistant mood disorders, is critical. Referrals to DBT programs or therapists trained in this modality should be prioritized. Integrated care models that include DBT can enhance engagement, improve clinical outcomes, and reduce hospitalizations or emergency visits³.

Best practices in DBT implementation emphasize cultural awareness, individualized treatment planning, and coordination between behavioral health and medical providers. Ongoing provider training, adherence to DBT fidelity standards, and family involvement can further optimize patient outcomes. While DBT requires significant clinician expertise and resource commitment, its structured, skills-based approach offers a durable and scalable model for managing complex behavioral health needs.