Dialectical Behavioral Therapy

Dialectical behavior therapy (DBT) is a structured, time-limited treatment developed for borderline personality disorder (BPD) that has demonstrated efficacy in reducing self-harm and suicidal behaviors. Despite DBT’s strong evidence base and the high prevalence of BPD among psychiatric patients, few psychiatric training programs have incorporated teaching DBT and many psychiatrists have limited knowledge of and comfort with its principles. In this chapter, an overview of DBT will be provided, including its history, theoretical perspectives, and basic treatment structure as well as a review of its empirical evidence base. Applications in special populations, such as adolescents, and in lower resource settings, will also be discussed. Clinical case examples will be presented to demonstrate applications of DBT to common problems encountered in psychiatric practice, including difficult-to-treat depression, medication non-adherence, and suicidal or self-injurious behaviors. Online resources as well as further reading recommendations will be provided.