Dialectical behavior therapy or DBT is a kind of cognitive behavioral therapy (CBT). It focuses mainly on living in the moment, coping healthily with stress, regulate emotions, and improve relationships with others. Originally intended for those with borderline personality disorder (BPD), it has now been adapted for other mental health conditions.

A Brief History

DBT was developed in the late 1980s by Dr. Marsha Linehan and colleagues. They had realized CBT alone wasn’t working as well as expected in patients with BPD. As a result, Dr. Linehan and her team added techniques and developed treatments which would meet the needs of those patients.

A Philosophical Approach

Change occurs when one opposing force is stronger than the other.

DBT is derived from the philosophical process called dialectics. Dialectics stems from the concept that everything is composed of opposites. It is made up of three basic assumptions that 1. All things are interconnected. 2. Change is constant and inevitable. And 3. Opposites can be integrated to form a closer approximation of the truth. So, in DBT, the patient and therapist aim to work on resolving the clashing of inner opposition.

The Four Strategies of DBT

The goal of DBT is to transform negative thinking patterns and destructive behaviors into positive outcomes. Which is why those in DBT are taught four different strategies to effectively change their behavior. They include:

Mindfulness – the ability to focus on the present and “live in the moment”

Distress Tolerance – learning to accept oneself and the current situation as it is. Patients learn how to tolerate and survive a crisis through coping skills and techniques.

Interpersonal Effectiveness – learning how to be assertive in a relationship while still keeping it positive and healthy. Includes setting boundaries and learning to say no.

Emotional Regulation – recognizing and coping with negative emotions. Also helps to reduce a patient’s emotional vulnerability by increasing positive emotional experiences.

Specific Success

DBT has been proven to specifically help those patients who suffer from eating disorders. Research conducted by the Linehan Institute on groups of people with bulimia nervosa, binge-eating disorder, and anorexia has shown the skills learned from DBT to be highly effective during moments of personal crisis. These studies show that self-injury, negative thoughts, and binge-eating behavior all decrease in patients who practice DBT. In addition, the research also shows that patients are much less likely to restrict and attend more follow-up sessions.

Why DBT is Important for Everyone

DBT helps transform negative mental thoughts and behaviors into an understanding of your own journey. The skills learned in DBT sessions truly help to cope with stress and crisis in everyday life. They help a person become more productive and positive, but most importantly, show more self-compassion.

Let Us Help You!

As we said, one of the best parts of DBT is that it can be useful for anyone. This even includes when you feel you are doing well. DBT teaches healthy life skills that can be used years into the future. If you are interested in DBT, Cristina Panaccione and Associates has two locations in the South Hills and one office in Robinson Township. We are currently accepting a limited number of new patients, so check out our videos to learn more about how we can help you learn DBT skills to overcome everyday challenges!


* This information has not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease. Please contact a medical professional for advice.

Scott Cunningham – LPC 

For the past 20 years, Scott has been providing a safe and supportive environment where people feel comfortable talking about their depression, fears, stresses, and hopes for life. Having a collaborative relationship with clients is important to him. Scott brings hope and knowledge into his sessions and provides psycho-education to aid in the effectiveness of therapy. He works with clients coping with issues such as, but not limited to anxiety, trauma, depression, partner-relational issues & phase of life transitions. My experience entails couples, adolescent, family and adult counseling. He is certified in Chemical Dependency Counseling, ASIST Suicide Intervention, Crisis Intervention Stress Management, and Comprehensive Crisis Management. He has earned his Master’s Degree in Counseling Education from the University of Pittsburgh and a Bachelor’s of Science in Christian Counseling from Fort Wayne Bible College.

Scott’s goal is to help people struggling with trauma to regain stability and strength as well as insight into their issues. He believes that everyone has an innate ability to grow and learn. He enjoys helping people accomplish that goal and live better and more productive lives.