Dialectical behaviour therapy - summary of chapter 29 of Handbook of personalilty disorders

Handbook of Personality Disorders
Chapter 29
Dialectical behaviour therapy


Dialectial behaviour therapy (DBT) is developed to address the skills deficits of individuals with borderline personality disorder, as well as the issues that lead therapist frequently to get stuck.

DBT is rooted in the principles of behaviour therapy including 1) a strong emphasis on ongoing data collection during treatment 2) clearly defined target behaviours 3) a collaborative therapist-patient relationship 4) the use of standard cognitive and behavioural treatment strategies.

DBT has an emphasis on dialectics. The fundamental dialectic is the need for both acceptance and change. The therapist needs to fully accept the patient as (s)he is and at the same time persistently push for and help the patient to change. The therapist also tries to develop and strengthen an attitude of acceptance toward reality on the part of the patient, as well as the motivation and ability to change what can be changed.

The fundamental treatment dialectic of acceptance and change is expressed through validation and problem solving.

DBT involves a dialectic of communication style between reciprocal, warm interpersonal style and a more irreverent style.

There is a dialectic in case management between consultation to the patient to help manage his or her environment and direct environmental intervention by the therapist.

Scope and focus: Domains of psychopathology

DBT addresses problems associated with pervasive emotion dysregulation.

Treatment stages and targets

DBT consists of five stages: 1) Pretreatment 2) control 3) order 4) synthesis 5) transcendence.

Each session agenda is based on the patient’s behaviour since the last session. It is the therapist’s responsibility to remain mindful of treatment goals and to ensure that patient treatment activities are directed toward creating a life worth living.


The objectives of this stage are 1) To orient patients to the philosophy and structure of

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Summaries & Study Note of SanneA
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