Dialectical Behavior Therapy
for Borderline Personality Disorder
Status: Strong Research Support
Dialectical Behavior Therapy (DBT) was originally developed as an intervention for chronically suicidal individuals. DBT blends behavioral and crises intervention theories with an emphasis on acceptance and tolerance drawn both from Western contemplative and Eastern meditation practice. The theoretical framework emphasizes an exchange and negotiation between therapist and client, between the rational and the emotional, and between acceptance and change (hence the term "dialectical"). Treatment targets are agreed upon, with self-harm taking priority. The learning of new skills is a core component - including mindfulness (e.g., non-judgmental awareness of one’s own feelings and actions), interpersonal effectiveness (e.g. assertiveness and social skills), coping adaptively with distress and crises, and identifying and regulating emotional reactions. DBT involves both individual and group therapy.
Key References (in reverse chronological order)
- Linehan, M.M., Comtois, K.A., Murray, A.M., Brown, M.Z., Gallop, R.J., et al. (2006). Two-Year randomized controlled trial and follow-up of Dialectical Behavior Therapy vs. therapy by experts for suicidal behaviors and Borderline Personality Disorder. Archives of General Psychiatry, 63, 757-766.
- Verheul, R., van den Bosch, L.M.C., Koeter, M.W.J., de Ridder, M.A.J., Stijnen, T., van den Brink, W. (2003). A 12-month randomized clinical trial of Dialectical Behavior Therapy for women with borderline personality disorder in the Netherlands. British Journal of Psychiatry, 182, 135-140.
- Koons, C.R., Robins, C.J., Tweed, J.L., Lynch, T.R., Gonzalez, A.M., Morse, J.Q., Bishop, G.K., Butterfield, M.I., Bastian, L.A. (2001). Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder. Behavior Therapy, 32, 371-390.
- Linehan, M.M., Heard,H.L., Armstrong, H.E. (1993). Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients. Archives of General Psychiatry, 50, 971-974.
- Linehan, M.M., Armstrong, H.E., Suarez, A., Allmon, D., Heard, H.L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48, 1060-1064.
- Linehan, M.M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford press.
- Linehan, M.M. (1993). Skills training manual for treating borderline personality disorder. Guilford press.
- Linehan, M.M., Rathus, J.H., & Miller, A.L. (2006). Dialectical behavior therapy with suicidal adolescents. Guilford press.
- Linehan, M.M. (2006). Treating borderline personality disorder: The dialectical approach. Guilford press. [DVD of therapy sessions and interviews with Marsha Linehan]
The Behavioral Research and Therapy Clinics (BRTC) at the University of Washington is run by Marsha M. Linehan and offers a variety of training opportunities, as well as information about pre- and post-doctoral training opportunities in DBT throughout the United States.