What is the role of dialectic behavior therapy (DBT) in the treatment of borderline personality disorder (BPD)?

Updated: Nov 05, 2018
  • Author: Roy H Lubit, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Answer

Dialectic behavior therapy (DBT) is a modification of standard cognitive-behavioral techniques designed specifically for the treatment of BPD. [6, 28] Currently, DBT is the only data-supported therapy for BPD. Although DBT was developed as an outpatient program, it has been modified for use in hospital settings and among more diverse populations. Its focus is on teaching patients the following 4 skills:

  • Mindfulness (attention to one’s experience)

  • Interpersonal effectiveness (predominantly assertiveness)

  • Emotional regulation

  • Distress tolerance without impulsivity

In randomized clinical trials, DBT was more effective than usual treatment in reducing suicidal and self-injurious behaviors, treatment dropout, hospitalizations, and self-reports of anger and anxious ruminations. [1, 2, 29] Increased rates of global adjustment were observed after 1 year of treatment, and these gains were maintained over the subsequent year.


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