Dialectical behavioral therapy (DBT) is a type of cognitive-behavioral therapy. Cognitive-behavioral therapy tries to identify and change negative thinking patterns and pushes for positive behavioral changes. DBT may be used to treat suicidal and other destructive behaviors as well as to treat clients with Borderline Personality Disorder.

Four key elements are focused on in DBT:

• Mindfulness, which focuses on improving the ability to accept and be present within the moment
• Distress tolerance: this is geared towards increasing the tolerance for negative emotion, rather than trying to escape this
• Emotional regulation: a means and strategy used to manage and change the emotions that are super intense and creating a problem in a person’s life
• Interpersonal effectiveness: techniques that allow someone to communicate with others in a way that’s assertive, allows for self-respect to be maintained, and strengthen the relationship of a person

DBT is a psychotherapy technique that is used to treat:

1. Borderline Personality Disorder
2. Eating Disorders
3. Bipolar Disorder
4. Depression

The focus of DBT is to teach coping skills. This is because certain negative or destructive behaviors are formed in order to cope with a situation. For example, binge-eating may be a form of a coping mechanism for anxiety. After many instances of binge-eating, a habit forms in a person. This habit is unhealthy and a person feels powerless to come out of it. DBT is designed to build skills to form different and more positive habits so that the new habits will replace the old.

There is quite a bit of homework involved for the client. The skills taught at the session need to be practiced and sometimes the counselor might need to call up during the week to motivate the client to stay with the plan. The counselor will always agree beforehand on the times that such calls will come through so as not to intrude on the day-to-day lives of the client.

DBT is used in group therapy. However, in Sri Lanka, we don’t see many clients agreeing to come for group sessions due to privacy and other issues.