What Is Dialectical Behavior Therapy?

Developed in the 1980s by Marsha Linehan, a psychology researcher out of the University of Washington, dialectical behavior therapy (DBT) was initially invented to treat borderline personality disorder (BPD). Marsha Linehan herself claimed a diagnosis of BPD.

However, since its inception, DBT has shown to be effective for various mental health conditions. The original DBT manual was published in 1993, and the most recent edition was released in 2015. The DBT manual provides instruction for the administration of DBT groups and individual therapy.

The skills developed through DBT include mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

The Skill of Mindfulness

Drawing on concepts from classical Buddhism and meditation, DBT introduces mindfulness as a skill to attune oneself to their environment. The client can engage with the present moment by paying attention to the external environment using all senses.

By focusing on the taste, touch, sound, smell, and sight of one’s immediate surroundings, one can find calmness in an inanimate object, an aspect of nature, or something as simple as the introduction of water or light. Linehan, a zen master herself, suggests clients approach this task non-judgmentally, from a wise mind.

A Wise Mind

A wise mind represents a mental state that draws on both emotion and logic. Through the use of knowledge, experience, and common sense, wise-mind decisions bring balance into the decision-maker’s life.

The Important of Non-Judgement

Another critical component of DBT is the incorporation of a nonjudgemental stance to your person and your surroundings. This can be accomplished through observation and asking “what” questions followed by “how” questions.

By approaching life through a lens of curiosity instead of judgment, we can rid ourselves of intense negative emotions. Another approach to take to reach a nonjudgemental stance is to practice “radical acceptance.”

Radical Acceptance

By accepting the lived realities that cannot be changed, clients engaging with DBT can reach a place of inner calmness. However, they are also taught interpersonal effectiveness skills to harness assertiveness in a variety of different situations.

Another crucial aspect of radical acceptance is the understanding that dialectics exist. By dialectics, Linehan means two seemingly opposing truths, which have applications in a variety of settings.

Accepting that two contradictory scenarios can both carry weight at the same time allows DBT clients to navigate more unsettling experiences with greater effectiveness. This is the tangle aspect of understanding grayness in life instead of approaching decision-making with black and white, judgemental perspectives.

Emotional Regulation

The ability to regulate emotions hinges on practices of mindfulness and radical acceptance through observation of emotion. In DBT, the feeling wheel helps the client identify their intense emotions and then seek to engage the opposite of that emotion to find a balanced middle ground. This practice is termed “opposite emotion.”

Chain Analysis

During DBT sessions, clients can conduct a chain analysis of different situations in their lives that might lead to the need to practice emotional regulation. Chain analysis focuses on a prompting event that can lead to problem behavior through chains or a series of other events (i.e., ineffective coping skills like self-harm or substance use). By underpinning the prompting event, clients can better understand the origin of their problems.

Distress Tolerance

Distress tolerance refers to the capability of an individual to take on stressful situations. The bandwidth to handle stress increases as clients learn to engage with and practice the skills of DBT.

For example, approaching a situation with a wise mind non-judgmentally means achieving greater equilibrium in life. Regardless, there are times when an individual succumbs to stressful emotions. When this occurs, it is time to practice “opposite emotion” and “chain analysis” to identify the core trigger and respond calmly to that stimulus.

Interpersonal Effectiveness

DBT clients seek to amplify their interpersonal effectiveness. This can be accomplished through Walking the Middle Path. In other words, this refers to making decisions not based solely on emotional responses or logical musings but rather from a place of observation and subsequent application. Two skills from this part of DBT include DEAR MAN and GIVE FAST.


This acronym stands for Describe, Express, Assert, Reinforce, (Stay) Mindful, Appear Confident, and Negotiate. It serves as a mantra for leveraging yourself to get what you want in an assertive manner.


The GIVE acronym stands for (Be) Gentle, (Act) Interested, Validate, (Use an) Easy manner as a subsequent negotiation tactic. Following suit, FAST stands for (Be) Fair, (No) Apologies, Stick to Values, and (Be) Truthful so as clients can practice self respect in scenarios where what they want is not immediately following their initial request.

Developed in the 1980s by Marsha Linehan, DBT incorporates a variety of skills to help impart to young women and adolescents in general that they can achieve calmness in their lives despite past chaos. Marsha Linehan published the first DBT manual in 1993. At Havenwood Academy, we use the most updated version of the DBT manual: the second edition. By teaching mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness at Havenwood Academy, we equip our clients with the tools to succeed when they leave our facility. At Havenwood Academy, every treatment plan is precisely and carefully designed to best respond to and treat each young woman’s struggles and address her needs. We believe that “treatment” is an integrated approach combining therapy with academics and life skills designed to promote future success and personal empowerment. For more information on our program and how we can help an adolescent in your life, call us today at (435) 586-2500


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