How DBT Helps

Whether you are a client or family member looking at treatment options, a researcher or clinician who wants to learn more, or an administrator considering implementing DBT in your system, this page will help you make sense of the research on DBT.

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You can also download flyers about DBT for specific populations and/or treatment settings.

Why is DBT effective?

DBT assumes that many of the problems exhibited by clients are caused by skills deficits. In particular, the failure to use effective behavior when it is needed is often a result of not knowing skillful behavior or when or how to use it. For example, deficits in emotion regulation skills are believed to be a core problem in individuals with borderline personality disorder, and these deficits result in the use of maladaptive behaviors to regulate emotions (e.g., suicide attempts, non-suicidal self-injury, substance use). Therefore, a key focus in DBT is to improve clients’ ability to use skillful behavior when needed, with a particular focus on learning effective emotion regulation strategies.

Consistent with this skills deficit model, use of DBT skills has been found to fully or partially explain improvements during standard DBT and DBT skills training in problems such as suicidal behavior, non-suicidal self-injury, depression, anger control, emotion dysregulation, and anxiety (Neacsiu et al., 2010; Neacsiu et al., 2014). In addition, improvements in emotion regulation (Axelrod et al., 2011), experiential avoidance (Berking et al., 2009), and assertive anger (Kramer et al., 2015) have been found to account for changes in outcomes such as substance use, depression, and social functioning during DBT. Taken together, these findings suggest that DBT works because it successfully increases clients’ ability to use effective coping skills, particularly strategies for expressing, experiencing, and regulating intense emotions.

For what conditions is DBT effective?

Although the strongest evidence exists for DBT as a treatment for people with borderline personality disorder, DBT has been found to be effective for a wide variety of mental health conditions. Conditions for which standard or adapted versions of DBT have been found to be effective in at least one randomized controlled trial are listed below (Note: DBT has been evaluated for many other conditions in non-RCT research).

  • Borderline personality disorder, including those with co-occurring:
    • Suicidal and self-harming behavior
    • Substance use disorder
    • Posttraumatic stress disorder
    • High irritability
  • Cluster B personality disorders
  • Self-harming individuals with personality disorder
  • Attention deficit hyperactivity disorder (ADHD)
  • Posttraumatic stress disorder related to childhood sexual abuse
  • Major depression, including:
    • Treatment resistant major depression
    • Older adults with chronic depression and one or more personality disorders
  • Bipolar disorder
  • Transdiagnostic emotion dysregulation
  • Suicidal and self-harming adolescents
  • Pre-adolescent children with severe emotional and behavioral dysregulation
  • Binge eating disorder
  • Bulimia nervosa

For whom does DBT work?

DBT has been evaluated and found to be effective among individuals from diverse backgrounds in terms of age, gender, sexual orientation, and race/ethnicity. Specifically, the demographic groups listed below have made up a sizeable proportion (25-100%) of the sample in at least one study of DBT.

Ages:

  • Children (ages 7-12 years)

  • Adolescents (ages 12-18 years)

  • Young Adults (ages 18-25 years)

  • Adults (ages 25-60 years)

  • Older Adults (ages 60+ years)

Genders:

  • Female

  • Male
Sexual Orientations:

  • Lesbian, gay, and bisexual

  • Heterosexual
Races/Ethnicities:

  • American Indian/Alaska Native

  • Black or African American

  • Hispanic or Latino

  • Multi-racial

  • White or Caucasian

Is DBT effective cross-culturally?

DBT has been implemented in more than 25 countries across 6 continents, making it one of the few evidence-based psychological treatments with a truly global reach (see map).

Although DBT was originally developed and researched in the United States, it has since been evaluated in 12 randomized controlled trials (RCTs) conducted in other countries including Canada (McMain et al., 2009; Courbasson et al., 2012: Van Dijk et al., 2013; Uliaszek et al., 2016), the Netherlands (Verheul et al., 2003), Australia (Carter et al., 2010), Great Britain (Feigenbaum et al., 2011; Priebe et al., 2012), Germany (Bohus et al., 2013), Norway (Mehlum et al., 2014), Spain (Soler et al., 2009), and Sweden (Hirvikoski et al., 2011). These international RCTs have found that DBT is effective when implemented in other cultures and results are similar to those found in studies conducted in the United States. For example, DBT has been found to be superior to treatment as usual in Great Britain, the Netherlands, Australia, and Norway.

Click map to expand
DBTGlobalMap

Flyers about Specific Populations and Settings