Dialectical Behavior Therapy (DBT) is a comprehensive cognitive-behavioral treatment developed by 
Dr. Marsha Linehan over the last 25 years. DBT was originally developed to treat suicidal patients,evolved
into a treatment for suicidal BPD patients, and has since been adapted for the treatment of BPD patients with
presenting problems other than suicidal behaviors. DBT is designed to treat BPD patients at all levels of
severity and complexity of disorder and is conceptualized as occurring in stages.

In Stage I, the primary focus is on stabilizing the patient and achieving behavioral control. Stage I treatment targets are addressed in the following hierarchical order:

     1.) life-threatening behaviors (primarily suicidal and self-injurious behavior)
     2.) therapy-interfering behaviors (e.g., poor attendance)
     3.) severe quality of life-interfering behaviors (e.g., frequent use of crisis services, substance abuse)

Stage I DBT consists of several modes of treatment, each designed to achieve specific functions:
     Individual therapy focuses on increasing client motivation (i.e., identifying specific factors maintaining
problem behavior and providing interventions)
     Group skills training teaches basic capabilities (i.e., behavioral skills including
distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness);
     Phone coaching provides the basis for generalization of skills to the natural environment and the
therapist consultation team functions to increase therapist capabilities and motivation.

Presently, DBT is by far the best studied treatment for BPD and DBT treatment outcome studies have focused primarily on Stage I targets. While DBT was originally designed to treat those diagnosed with Borderline Personality Disorder, it is now being effectively used with a wide range of individuals who struggle to regulate their emotions and/or behaviors.

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