1. Skill training group
2. Individual psychotherapy 
3. Telephone consultation/coaching
4. Therapist consultation team

4 Components of Traditional DBT

A dialectical dilemma refers to the conflicting internal psychological states commonly experienced by individuals diagnosed with Borderline Personality Disorder. In this state, conflicting thoughts, emotions, or motivations coexist in awareness, causing substantial inner turmoil, emotional distress, and challenges in arriving at a single decision or action. 

Dialectical Dilemma in the Context of Dialectical Behavioral Therapy (DBT) for BPD

In Dialectical Behavioral Therapy (DBT), therapists endeavor to assist clients in developing a synergistic and cooperative cognitive dynamic. This dynamic enables individuals to critically examine ostensibly contradicting personal experiences or phenomena and integrate them harmoniously to construct a holistic worldview.

Dialectical Thinking in Dialectical Behavioral Therapy (DBT)

DBT facilitates one to practice self-acceptance and initiate self-change through obtaining relevant skills and cultivating dialectical thinking. 

New York University

University of Pittsburgh

1. Dialectical behavior therapy (DBT)
2. Mentalization-based therapy (MBT)
3. Transference-focused therapy (TFP)
4. System training for emotional predictability and problem-solving (STEPPS)
5. Schema-focused therapy 
6. Standard cognitive therapy 
7. Good psychiatric management
8. Rogerian supportive therapy 

Evidence-based Treatments for BPD

Evidence-based psychotherapy originally developed to treat individuals with borderline personality disorder and chronically suicidal individuals. Treatment focuses on mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness.

Dialectical Behavior Therapy 

Dialectical thinking refers to a cognitive pattern characterized by people' capacity to tolerate contradictions without experiencing the need to resolve them by outrightly rejecting one perspective in favor of another. 

Dialectical Thinking

O'connell, B., & Dowling, M. (2014). Dialectical behaviour therapy (DBT) in the treatment of borderline personality disorder. Journal of psychiatric and mental health nursing, 21(6), 518-525.

DBT in the Treatment of BPD

Schema-focused therapy identifies five major modes BPD patients frequently exhibit when reacting to the external world; this therapy aims to foster the growth and strength of one mode named 'healthy adult' to exert over the rest of the four less constructive modes. 

Schema-focused Therapy for BPD

TFP focuses on repairing patients' dysfunctional object-relations and helping them to integrate their fragmented identities to maintain the succinctness of their internal world despite the chaotic external world. 

Transference-focused Therapy (TFP) for BPD

MBT aims to enhance patients' social cognition by fostering the ability to comprehend and interpret their own and others' mental states in a systematic and logical manner.

Mentalization-based Treatment (MBT) for BPD

The STEEPS program aims to enhance BPD patients' ability to regulate their emotions by teaching them emotion regulation skills and empowering significant others (e.g., family member, caregiver) to support BPD patients.

System training for emotional predictability and problem-solving (STEPPS) for BPD

Dialectical Behavior Therapy (DBT)  for BPD

Though dialectical behavior therapy (DBT) was initially developed as a treatment for chronically suicidal individuals and was first validated with women who have borderline personality disorder (BPD), it has shown to be effective for a variety of populations. These populations include:

•Individuals with BPD

•Individuals with drug or alcohol addictions

•Individuals with eating disorders


 Populations that Benefit from Dialectical Behavior Therapy

- Radically open dialectical behavior therapy

Variations of Dialectical Behavior Therapy

- Enhancing capabilities
- Generalizing capabilities
- Improving motivation and reducing dysfunctional behaviors
- Enhancing and maintaining therapist capabilities and motivation
- Structuring the environment

Five Functions of Dialectical Behavior Therapy

- GIVE exercise
- Opposite action
- Distraction
- Improving the moment
- Self-soothing
- Thinking of the pros and cons of not tolerating distress
- Radical acceptance

Dialectical Behavior Therapy Exercises

One goal of dialectical behavior therapy (DBT) is to enhance the capabilities of the patient receiving treatment. This is achieved through the teaching of skills within each of the 4 modules or groups outlined below.
- Mindfulness 
- Emotional regulation
- Distress Tolerance
- Interpersonal effectiveness

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