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Dialectical behavior therapy (DBT) is a comprehensive, evidence-based psychological treatment that combines cognitive-behavioral techniques with mindfulness practices and acceptance strategies. Originally developed by Dr. Marsha Linehan in the 1970s for individuals with borderline personality disorder and chronic suicidal behaviors, DBT has evolved into one of the most effective treatments for a wide range of complex mental health conditions involving emotion dysregulation.

This structured treatment approach operates within a framework of dialectical philosophy—the concept of holding two seemingly opposite truths simultaneously. The core dialectic in DBT involves balancing radical acceptance of one's current situation while simultaneously working toward meaningful change. This both-and approach distinguishes DBT from traditional cognitive-behavioral therapies and makes it particularly effective for individuals who have not responded well to other treatment modalities.

Table of Contents

  • What Is Dialectical Behavior Therapy?
  • Development and History
  • DBT Theory and Core Principles
  • Components of Comprehensive DBT
  • Four Skills Modules
  • Stages and Goals in DBT
  • How Effective Is DBT?
  • Conditions Treated with DBT
  • Certification Requirements for DBT
  • Criticisms and Limitations of DBT
  • Frequently Asked Questions
  • How Therapy Can Help

What Is Dialectical Behavior Therapy?

DBT is a multi-modal treatment approach that addresses severe mental health conditions characterized by emotion dysregulation, self-destructive behaviors, and interpersonal difficulties. According to the National Institute of Mental Health (2025), DBT was developed specifically for people with borderline personality disorder and uses concepts of mindfulness or awareness of one's present situation and emotional state, teaching skills to help people control intense emotions, reduce self-destructive behaviors, and improve relationships.

The treatment integrates four essential components: individual therapy, skills training groups, phone coaching, and therapist consultation teams. This comprehensive approach ensures that clients receive support across multiple contexts while building practical skills for managing life's challenges.

Core Features of DBT

Acceptance and Change Balance: DBT uniquely combines acceptance-based strategies with change-oriented techniques. Therapists validate clients' experiences while simultaneously encouraging behavioral change.

Skills-Based Approach: Unlike traditional talk therapy, DBT emphasizes teaching concrete skills that clients can apply in their daily lives. These skills address four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.

Structured Treatment Hierarchy: DBT prioritizes treatment targets based on severity, addressing life-threatening behaviors first, followed by therapy-interfering behaviors, quality-of-life issues, and skill acquisition.

Team-Based Model: DBT therapists work within consultation teams to prevent burnout and maintain treatment fidelity when working with high-risk populations.

Development and History

DBT emerged from Dr. Marsha Linehan's groundbreaking work in the 1970s with individuals who had chronic suicidal thoughts and borderline personality disorder. As a researcher at the University of Washington, Linehan initially attempted to apply standard cognitive-behavioral therapy (CBT) to this population but encountered significant challenges.

The Evolution from CBT to DBT

Linehan and her team discovered three major problems when applying traditional CBT to individuals with borderline personality disorder:

1. Invalidation Responses: Clients experienced change-focused interventions as invalidating, leading to treatment dropout, increased aggression, or alternating between these extremes.

2. Reinforcement Patterns: A problematic pattern emerged where therapists' focus on change was met with client anger, while allowing subject changes resulted in positive feedback. This created a false sense of progress without addressing core issues.

3. Crisis Management Dominance: The intensity and frequency of crisis situations—including suicidal behaviors, self-harm, and threats—consumed therapy time, leaving little opportunity for skill development or behavioral change work.

These observations led Linehan to develop crucial adaptations that would become the foundation of DBT. She incorporated acceptance-based techniques from Zen Buddhism, ensuring clients felt validated before focusing on change. The integration of dialectical philosophy allowed both therapists and clients to synthesize opposing concepts like acceptance and change, avoiding extreme positions that had previously derailed treatment.

In 1993, Linehan published the first official DBT treatment manual, Cognitive Behavioral Treatment of Borderline Personality Disorder, establishing DBT as a distinct therapeutic approach. Since then, research on DBT has grown significantly, with particular expansions in 2007 and 2015, as the treatment has been adapted for various disorders including personality disorders, depression, eating disorders, PTSD, suicide, self-harm behaviors, and high-risk behaviors among adolescents.

DBT Theory and Core Principles

Three major theoretical frameworks form the foundation of DBT: the biosocial theory of emotion dysregulation, mindfulness practices from Zen Buddhism, and dialectical philosophy.

Biosocial Theory

The biosocial theory explains how severe emotional and behavioral problems develop through the interaction of biological vulnerabilities and invalidating environments. According to this model:

  • Some individuals are born with heightened emotional sensitivity—they react more quickly and intensely to emotional stimuli
  • Invalidating environments that dismiss, punish, or minimize emotional experiences intensify these vulnerabilities
  • This combination leads to emotion dysregulation, destructive behavioral patterns, and difficulties across multiple life domains

Research indicates that borderline personality disorder, a primary condition treated with DBT, is characterized by pervasive patterns of instability in mood, self-image, and interpersonal relationships, with individuals often experiencing intense and rapidly shifting emotions, difficulty regulating emotions, and engaging in impulsive behavior including recurrent self-harm and suicidality.

Mindfulness Foundation

DBT incorporates mindfulness practices to help individuals:

  • Develop present-moment awareness
  • Observe thoughts and emotions without judgment
  • Make decisions based on "wise mind"—the synthesis of emotional and rational thinking
  • Reduce reactive behaviors driven by intense emotions

Dialectical Philosophy

Dialectics in DBT serve multiple functions:

  • For Clients: Learning to hold opposing truths (e.g., "I am doing the best I can" AND "I need to do better")
  • For Therapists: Balancing validation with push for change
  • For Treatment: Integrating acceptance and change strategies throughout all interventions

Components of Comprehensive DBT

Standard DBT consists of four interconnected components, each serving a specific function in the treatment process.

1. Individual Therapy

Weekly one-on-one sessions (typically 50-60 minutes) focus on:

  • Reviewing diary cards tracking behaviors, emotions, and skill use
  • Addressing treatment hierarchy targets
  • Applying DBT skills to current life problems
  • Processing therapy-interfering behaviors

2. Skills Training Group

Weekly group sessions (typically 2-2.5 hours) teach four skill modules:

  • Structured like a class with homework assignments
  • Led by trained DBT therapists
  • Focus on skill acquisition rather than group process
  • Include in-session practice and between-session assignments

3. Phone Coaching

Between-session contact provides:

  • Real-time skill coaching during crises
  • Support for skill generalization
  • Brief problem-solving (typically 10-15 minutes)
  • Prevention of hospitalization or self-harm

4. Therapist Consultation Team

Weekly team meetings offer:

  • Support for therapists working with high-risk clients
  • Adherence monitoring to maintain treatment fidelity
  • Problem-solving for challenging cases
  • Prevention of therapist burnout

Four Skills Modules

DBT skills training is organized into four modules, each addressing specific aspects of emotion dysregulation and behavioral difficulties.

Mindfulness Skills

Core Mindfulness skills form the foundation of DBT and include:

  • Observe: Noticing internal and external experiences without attachment
  • Describe: Putting words to experiences without judgment
  • Participate: Fully engaging in activities without self-consciousness
  • Non-judgmental Stance: Observing without evaluating as good or bad
  • One-mindfully: Focusing on one thing at a time
  • Effectiveness: Doing what works in each situation

Distress Tolerance Skills

These crisis survival skills help individuals:

  • TIPP: Using Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation
  • Distraction: Using activities, contributions, comparisons, emotions, pushing away, thoughts, and sensations (ACCEPTS)
  • Self-Soothing: Engaging the five senses for comfort
  • Radical Acceptance: Acknowledging reality without fighting it
  • Distress Tolerance: Building tolerance for emotional pain without making it worse

Emotion Regulation Skills

These skills target the core of emotional dysregulation:

  • Understanding Emotions: Identifying and labeling emotions accurately
  • PLEASE: Treating PhysicaL illness, balancing Eating, avoiding mood-Altering substances, balancing Sleep, and getting Exercise
  • Opposite Action: Acting opposite to emotional urges when emotions don't fit the facts
  • Check the Facts: Examining whether emotional reactions match reality
  • Problem-Solving: Addressing situations when emotions are justified

Interpersonal Effectiveness Skills

These skills improve relationships and self-respect:

  • DEAR MAN: Describe, Express, Assert, Reinforce; stay Mindful, Appear confident, Negotiate
  • GIVE: Be Gentle, act Interested, Validate, use an Easy manner
  • FAST: Be Fair, no Apologies (unnecessary), Stick to values, be Truthful
  • Validation Skills: Learning to validate self and others

Stages and Goals in DBT

DBT treatment progresses through four stages, each with specific targets and goals. This systematic approach ensures that the most severe issues are addressed first while building toward a life worth living.

Stage 1: Achieving Behavioral Control

Target: Moving from behavioral dyscontrol to behavioral control

  • Priority focus on eliminating life-threatening behaviors (suicide attempts, self-harm)
  • Addressing therapy-interfering behaviors
  • Reducing quality-of-life interfering behaviors
  • Increasing behavioral skills
  • Most clients begin treatment in this stage

Stage 2: Emotional Experiencing

Target: Moving from quiet desperation to emotional experiencing

  • Clients have achieved behavioral control but continue experiencing emotional pain
  • Safe exploration of trauma and traumatic experiences
  • Processing avoided emotions
  • Reducing symptoms of PTSD when present

Stage 3: Building Ordinary Life

Target: Achieving ordinary happiness and unhappiness

  • Focus on building a life worth living
  • Setting and achieving realistic life goals
  • Improving self-respect and self-efficacy
  • Developing stable relationships and life patterns

Stage 4: Finding Deeper Meaning

Target: Moving from incompleteness to completeness

  • Addressing sense of incompleteness even with stable life
  • Developing capacity for joy and freedom
  • Spiritual fulfillment (for some clients)
  • Expanding awareness and peak experiences

How Effective Is DBT?

Extensive research over the past three decades has established DBT as one of the most effective treatments for various mental health conditions. Meta-analyses demonstrate that DBT shows efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.

Effectiveness for Specific Conditions

Borderline Personality Disorder: Recent systematic reviews involving 1,755 participants found that both short-term and standard DBT improved suicidality in BPD patients with small to moderate effect sizes lasting up to 24 months after treatment, significantly improved general psychopathology and depressive symptoms, and led to improvements in compliance, impulsivity, mood instability, as well as reduction in hospitalization rates.

Suicide and Self-Harm: Meta-analyses have demonstrated that DBT reduced self-directed violence (d = -0.324, 95% CI = -0.471 to -0.176) and reduced frequency of psychiatric crisis services (d = -0.379, 95% CI = -0.581 to -0.176). Research shows that improvements in youth emotion regulation during DBT treatment mediated the association between treatment and self-harm remission during follow-up, with 49.3% of youth in DBT achieving self-harm remission compared to 29.7% in supportive therapy.

PTSD and Complex Trauma: A 2024 meta-analysis of 663 participants found that PTSD-specific DBT treatments showed moderate effects in reducing PTSD symptom severity (g = -0.69, 95% CI -1.03 to -0.34, p <.001) and depression (g = -0.62, 95% CI -1.13 to -0.12, p =.016). DBT adaptations for PTSD also showed significant reductions in dissociative symptoms, BPD symptoms, and non-suicidal self-injury frequency.

Eating Disorders: Recent studies demonstrate significant improvements in eating disorder psychopathology, depression, and anxiety with medium to large effect sizes, with changes in emotion regulation processes linked to improved eating psychopathology.

ADHD in Adults: A 2025 meta-analysis found that DBT shows potential as a clinical treatment for adult ADHD, offering an alternative to medication and addressing functional challenges, with new DBT adaptations potentially enhancing care accessibility and treatment adherence.

Treatment Completion and Engagement

One of DBT's strengths is its ability to retain clients in treatment. Based on extensive clinical trial data, DBT is one of the best treatments for reliably reducing suicidal ideation and overall symptom distress while increasing hope and decreasing hopelessness, with dozens of RCTs and meta-analyses clearly showing DBT's efficacy in reliably reducing suicide attempts and self-harm behaviors.

Conditions Treated with DBT

While originally developed for borderline personality disorder, DBT has been successfully adapted for numerous mental health conditions:

Primary Applications

  • Borderline Personality Disorder: The original and most researched application
  • Suicidal and Self-Injurious Behaviors: Across diagnostic categories
  • Emotional Dysregulation: Regardless of specific diagnosis
  • Complex PTSD: Especially with comorbid BPD features

Expanded Applications

  • Eating Disorders: Including anorexia nervosa, bulimia nervosa, and binge eating disorder
  • Substance Use Disorders: Often as DBT-SUD adaptation
  • Depression: Particularly treatment-resistant depression
  • Bipolar Disorder: For emotion regulation between episodes
  • ADHD: Addressing emotional dysregulation and impulsivity
  • Anxiety Disorders: When accompanied by behavioral dyscontrol

Adolescent Adaptations

DBT has been modified for adolescents (DBT-A) with:

  • Family involvement through multi-family skills groups
  • Developmentally appropriate examples and exercises
  • Additional skill of "Walking the Middle Path" for teens and families
  • Shorter treatment duration options (16-24 weeks)

Research with 24 high-risk adolescents showed significant pre/post-treatment decreases in suicide attempts, non-suicidal self-injury behaviors, and suicidal ideation, with significant decreases in emotion dysregulation, depression, impulsivity, BPD symptoms, psychopathology, PTSD symptoms, and substance use.

Certification Requirements for DBT

The importance of proper DBT training and certification cannot be overstated. The DBT-Linehan Board of Certification™ (DBT-LBC™) was created to certify individual therapists in their competency to deliver DBT effectively and to certify programs that demonstrate their ability to deliver DBT programmatically with fidelity to the model as researched, with all criteria informed by consulting with Dr. Marsha Linehan, research-based adherence coding, and the original treatment manuals.

Individual Clinician Certification Requirements

To become a DBT-Linehan Board Certified Clinician™, professionals must:

1. Educational Requirements

  • Hold a graduate degree in a mental health field
  • Maintain current licensure as a mental health practitioner
  • Have formal training in mindfulness practice

1. Training Requirements- Complete documented 40 hours of didactic DBT training specific to comprehensive DBT

  • Training must cover all modes and functions of DBT
  • Include content on all four skills modules

1. Clinical Experience

  • Demonstrate clinical experience delivering DBT- Participate in a DBT consultation team for at least 12 months with current participation required
  • Show evidence of applying DBT with actual clients

1. Certification Process

  • Pass a comprehensive knowledge examination based on DBT treatment manuals
  • Submit work product samples demonstrating adherence- Provide three consecutive video recordings showing DBT adherence in individual therapy or skills training
  • Successfully complete all assessment phases

Program Certification Requirements

DBT-LBC™ program certification signals a commitment to evidence-based care, strengthens advocacy for fair reimbursement, protects the integrity of DBT as developed by Dr. Marsha Linehan, and helps clients find qualified providers when they need it most.

Programs seeking certification must:

  • Have a team leader who is DBT-LBC certified
  • Demonstrate adherence to comprehensive DBT model
  • Undergo extensive site review and evaluation
  • Maintain all four modes of standard DBT
  • Show evidence of positive client outcomes

Importance of Certification

The seal of certification is the only way to ensure that treatment is actually providing DBT in the manner that research has shown to be effective, as therapists or organizations advertising DBT without Linehan Board Certification may be providing only DBT-like treatment. Research has shown that improperly delivered DBT can lead to deterioration or worsening of conditions, particularly for individuals with severe or complex symptoms.

Criticisms and Limitations of DBT

While DBT has strong empirical support, several limitations and criticisms warrant consideration:

Research Limitations

  • Many early studies had small sample sizes and focused on specific populations
  • Much research was conducted by treatment developers, though independent replications now exist
  • Long-term follow-up data beyond one year remains limited for some applications
  • More research is needed on DBT's effectiveness across diverse cultural populations

Implementation Challenges

  • Intensive Training Requirements: DBT requires extensive training and ongoing consultation
  • Resource Intensity: Full model requires significant organizational commitment
  • Time Commitment: Standard DBT requires 6-12 months minimum, with some clients needing years
  • Cost and Accessibility: Not all insurance covers the full model; trained providers may be scarce

Treatment Considerations

  • Complexity: The comprehensive model can be overwhelming for some clients or settings
  • Homework Requirements: Success depends heavily on between-session skill practice
  • Group Requirement: Some individuals struggle with the group format
  • Phone Coaching: Boundary issues can arise; not all therapists are comfortable with between-session contact

Specific Populations

Some critics argue that while DBT effectively reduces self-harm and improves emotion regulation, it may not adequately address:

  • Core trauma symptoms in PTSD without specific adaptations
  • Cognitive schemas and core beliefs without additional interventions
  • Cultural considerations for non-Western populations
  • Modifications needed for individuals with cognitive limitations

Frequently Asked Questions

How long does DBT treatment typically last?

Standard comprehensive DBT typically lasts 6-12 months, though many individuals benefit from longer treatment. The duration depends on severity of symptoms, treatment goals, and individual progress through the stages. Some adaptations offer shorter protocols (16-24 weeks) for specific populations or settings.

What's the difference between DBT and CBT?

While DBT evolved from CBT, key differences include: DBT's emphasis on acceptance alongside change, inclusion of mindfulness and distress tolerance skills, focus on emotion regulation, structured skills training groups, phone coaching component, and therapist consultation teams. DBT also specifically targets severe behavioral dyscontrol and emotion dysregulation.

Can I do DBT without the group component?

While individual DBT therapy exists, research supports the full model including skills groups. The group provides unique benefits: learning from peers, practicing interpersonal skills, normalizing struggles, and structured skill acquisition. Some adaptations offer individual skills training for those unable to attend groups.

Is DBT only for people with borderline personality disorder?

No. While originally developed for BPD, DBT effectively treats various conditions involving emotion dysregulation, self-destructive behaviors, or interpersonal difficulties. Current applications include eating disorders, PTSD, substance use disorders, depression, and ADHD among others.

How do I know if a therapist is properly trained in DBT?

Look for DBT-Linehan Board Certification, which requires extensive training, examination, and demonstrated competence. Ask potential therapists about their DBT training, whether they participate in consultation teams, and if they offer all four components of comprehensive DBT. Verify certification at dbt-lbc.org.

Does insurance cover DBT?

Coverage varies by insurance plan and provider. Many plans cover individual therapy and some cover skills groups. Phone coaching and extended treatment duration may require authorization. Contact your insurance to verify coverage for comprehensive DBT, including all components.

How Therapy Can Help

DBT offers hope for individuals who have struggled with traditional therapies or feel overwhelmed by intense emotions and self-destructive behaviors. The treatment provides concrete skills for managing life's challenges while fostering self-acceptance and personal growth.

For those considering DBT, the journey begins with finding a properly trained provider or program. The comprehensive nature of DBT—combining individual therapy, group skills training, phone coaching, and therapist support—creates multiple avenues for change and growth.

If you or someone you know struggles with emotion regulation, self-harm, suicidal thoughts, or relationship difficulties, DBT may offer a path forward. The treatment's strong evidence base and structured approach have helped thousands build lives worth living.

Find a DBT Therapist: Search our directory for DBT-trained therapists in your area who can help you determine if this evidence-based treatment is right for your needs.

References:

  1. Amin, R., Gillespie, S., Puckett, M., Potts, M., Zaki, T., Glennon, D., & Tchanturia, K. (2024). Early evaluation of a DBT-informed online intervention for people with eating disorders. Journal of Eating Disorders, 12, Article 9. https://doi.org/10.1186/s40337-024-00974-5
  2. Asarnow, J. R., Berk, M. S., Bedics, J., Adrian, M., Gallop, R., Cohen, J., Korslund, K., Hughes, J., Avina, C., Linehan, M. M., & McCauley, E. (2021). Dialectical behavior therapy for suicidal self-harming youth: Emotion regulation, mechanisms, and mediators. Journal of the American Academy of Child & Adolescent Psychiatry, 60(9), 1105-1115. https://doi.org/10.1016/j.jaac.2021.01.016
  3. Bohus, M., Kleindienst, N., Hahn, C., Müller-Engelmann, M., Ludäscher, P., Steil, R., Fydrich, T., Kuehner, C., Resick, P. A., Stiglmayr, C., Schmahl, C., & Priebe, K. (2020). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD) compared with cognitive processing therapy (CPT) in complex presentations of PTSD in women survivors of childhood abuse: A randomized clinical trial. JAMA Psychiatry, 77(5), 459-468. https://doi.org/10.1001/jamapsychiatry.2019.4886
  4. Brown, T. A., Wisniewski, L., & Anderson, L. K. (2022). Exploring skill utilization as a mechanism of dialectical behavioral therapy among adults with eating disorders in a partial hospitalization program. Eating Behaviors, 45, Article 101622. https://doi.org/10.1016/j.eatbeh.2022.101622
  5. Buerger, A., Fischer-Waldschmidt, G., Hammerle, F., von Auer, K., Parzer, P., & Kaess, M. (2021). A systematic review of cognitive behavior therapy and dialectical behavior therapy for adolescent eating disorders. Journal of Eating Disorders, 9, Article 133. https://doi.org/10.1186/s40337-021-00461-1
  6. Chapman, J., Jamil, R. T., Fleisher, C., & Torrico, T. J. (2024). Borderline personality disorder. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430883/
  7. DBT-Linehan Board of Certification™. (2025). Certification. https://dbt-lbc.org/certification/
  8. DBT-Linehan Board of Certification™. (2025). Individual clinician certification. https://dbt-lbc.org/certification/clinician-application/
  9. DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior Therapy, 50(1), 60-72. https://doi.org/10.1016/j.beth.2018.03.009
  10. Frontiers in Psychology. (2025). Bibliometric analysis of global research on dialectical behavior therapy from 1987 to 2024. Frontiers in Psychology, 16, Article 1450497. https://doi.org/10.3389/fpsyg.2025.1450497
  11. Hernandez-Bustamante, M., Pérez-García, L. F., Gómez-Medialdea, A., García-Vega, M., Tierno-Lilo, J., Bilbao-Ramírez, J., Mira-Agulló, L., Gil-Carcedo, E., Sánchez-Hernández, L., Piqueras, J. A., Llanes-Álvarez, C., Franco-Martín, M. A., Pastor-Cabeza, M., & Andreo-Jover, J. (2024). Efficacy of dialectical behavior therapy in the treatment of borderline personality disorder: A systematic review of randomized controlled trials. Iranian Journal of Psychiatry, 19(3), 335-346. https://doi.org/10.18502/ijps.v19i3.15812
  12. Jobes, D. A., Gregorian, M. J., & Colborn, V. A. (2024). The use of CAMS and DBT to effectively treat patients who are suicidal. Frontiers in Psychiatry, 15, Article 1354430. https://doi.org/10.3389/fpsyt.2024.1354430
  13. Junkes, L., Gherman, B. R., Appolinario, J. C., & Nardi, A. E. (2024). Dialectical behavior therapy as an intervention for treatment resistant depression in adults: A protocol for systematic review and meta-analysis. PLOS One, 19(5), Article e0303967. https://doi.org/10.1371/journal.pone.0303967
  14. Kothgassner, O. D., Goreis, A., Robinson, K., Huscsava, M. M., Schmahl, C., & Plener, P. L. (2021). Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: A systematic review and meta-analysis. Psychological Medicine, 51(7), 1057-1067. https://doi.org/10.1017/S0033291721001355
  15. Kujovic, M., Benz, D., Riesbeck, M., Hausmann, J., Rössler, K., Brühl, A., Lang, U. E., Tschacher, W., & Euler, S. (2024). Comparison of 8-vs-12 weeks, adapted dialectical behavioral therapy (DBT) for borderline personality disorder in routine psychiatric inpatient treatment—A naturalistic study. Scientific Reports, 14, Article 11264. https://doi.org/10.1038/s41598-024-61795-9
  16. Leichsenring, F., Fonagy, P., Heim, N., Kernberg, O. F., Leweke, F., Luyten, P., Salzer, S., Spitzer, C., & Steinert, C. (2024). Borderline personality disorder: A comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies. World Psychiatry, 23(1), 4-25. https://doi.org/10.1002/wps.21156
  17. Lenz, A. S., Taylor, R., Fleming, M., & Serman, N. (2014). Effectiveness of dialectical behavior therapy for treating eating disorders. Journal of Counseling & Development, 92(1), 26-35. https://doi.org/10.1002/j.1556-6676.2014.00127.x
  18. Liakopoulou, E., Vassalou, G., Tzavara, C., Poulakou, U., Charpidou, E., Soldatou, A., & Michopoulos, I. (2023). A 12-month study of dialectical behavioral therapy for borderline patients suffering from eating disorders. Eating and Weight Disorders, 28, Article 81. https://doi.org/10.1007/s40519-023-01612-w
  19. McCauley, E., Berk, M. S., Asarnow, J. R., Adrian, M., Cohen, J., Korslund, K., Avina, C., Hughes, J., Harned, M., Gallop, R., & Linehan, M. M. (2018). Efficacy of dialectical behavior therapy for adolescents at high risk for suicide: A randomized clinical trial. JAMA Psychiatry, 75(8), 777-785. https://doi.org/10.1001/jamapsychiatry.2018.1109
  20. National Institute of Mental Health (NIMH). (2025). Borderline personality disorder. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/publications/borderline-personality-disorder
  21. Oppenauer, C., Sprung, M., Gradl, S., & Burghardt, J. (2023). Dialectical behavior therapy for posttraumatic stress disorder (DBT-PTSD): Transportability to everyday clinical care in a residential mental health center. European Journal of Psychotraumatology, 14(1), Article 2157159. https://doi.org/10.1080/20008066.2022.2157159
  22. Prillinger, K., Goreis, A., Macura, S., Hajek Gross, C., Lozar, A., Fanninger, S., Atteneder, C., Vierlinger, R., Mairhofer, D., Rohringer, C., & Kothgassner, O. D. (2024). A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. European Journal of Psychotraumatology, 15(1), Article 2406662. https://doi.org/10.1080/20008066.2024.2406662
  23. Steil, R., Müller-Engelmann, M., Priebe, K., Fydrich, T., Weiß, S., Dyer, A., Herzog, J., & Bohus, M. (2025). Trauma-focused dialectical behavior therapy: Study protocol for a randomized controlled multi-center trial in online and face-to-face formats. Borderline Personality Disorder and Emotion Dysregulation, 12, Article 294. https://doi.org/10.1186/s40479-025-00294-3
  24. Syversen, A. M., Schønning, V., Fjellheim, G. S., Elgen, I., & Wergeland, G. J. (2024). Evaluation of dialectical behavior therapy for adolescents in routine clinical practice: A pre-post study. BMC Psychiatry, 24, Article 447. https://doi.org/10.1186/s12888-024-05876-z
  25. Tuda, D., Stefancic, A., Lam, P., John, D., Sadaghiyani, S., Choo, T. H., Galfalvy, H., Coronel, B., Gil, R., & Lewis-Fernández, R. (2018). Implementation of dialectical behavior therapy with suicidal and self-harming adolescents in a community clinic. Archives of Suicide Research, 22(1), 118-123. https://doi.org/10.1080/13811118.2018.1472690
  26. Zhang, Z., Gu, W. J., Wei, Y., Wu, S., & Wang, C. (2025). Dialectical behavioral therapy for adult attention deficit/hyperactivity disorder: A meta-analysis of randomized controlled trials. Psychiatry Research, 351, Article 116551. https://doi.org/10.1016/j.psychres.2025.116551