Dialectical Behavior Therapy

*Permission was received from Dr. Marsha M. Linehan and associates, to post DBT information on this web site.

Dialectical Behavior Therapy (DBT) developed by Dr. Marsha M. Linehan, is a combination of Cognitive Behavioral Therapy and Zen Buddhism, originally designed for use with clients with Borderline Personality Disorder. Currently, DBT is primarily offered by DBT trained psychotherapists and is used with a wider variety of psychiatric diagnoses, with very good effects.

Understanding the DBT philosophy and theoretical underpinnings is essential before use, because both the therapist’s attitude and the therapeutic relationship are central to effective DBT treatment. Involvement in DBT often requires a considerable commitment of at least one year by the client and their DBT trained therapist - with individual, group sessions, and homework assignments being the most common form of treatment delivery.

Occupational therapists working in mental health must recognize and respect the importance of these therapeutic relationships and receive proper training when utilizing DBT materials, or engaging in treatment with clients who are receiving DBT. When engaging in treatment with these individuals we are becoming a part of this structured therapeutic process. Formal DBT training or taking DBT courses, if offered at your local DBT mental health clinic, is strongly encouraged for OT’s practicing in mental health.

With a focus on skills training, the structure of treatment is generally as follows:

  • Core Mindfulness training – focuses on learning, through practice, to be in control of your mind and in the moment by observing, describing, and participating.
  • Interpersonal Effectiveness training – focuses on learning to deal with conflict situations, to get what one wants and needs, and to say no to unwanted requests and demands. It focuses specifically on doing this in a manner that maintains self-respect and others’ liking and/or respect.
  • Emotion Regulation training – focuses on enhancing the control and modulation of emotions, recognizing that complete emotional control cannot be achieved.
  • Distress Tolerance training – focuses on learning to tolerate distress, surviving crises, and accepting life as it is in the moment. Generally, these skills are ways of surviving and getting through terrible situations, without resorting to behaviors that will make the situation worse.

The DBT web address is available on our links page.

The OT Innovations for Psychosocial Practice conference will be giving a general DBT overview and information to help occupational therapists understand their role with DBT training and reinforcement, when appropriate.


Linehan, M. M. (1993). Skills Training Manual for Treating Borderline Personality Disorder. New York, NY: Guilford Press.

Skills Training Manual for Treating Borderline
Personality Disorder

Cognitive-Behavioral Treatment of Borderline
Personality Disorder