Comprehensive Dialectical Behavior Therapy (DBT)

Comprehensive Dialectical Behavior Therapy (DBT)

Clinical services

What is Comprehensive DBT?

  • Comprehensive DBT is a full model therapy program that was initially developed to treat people who were chronically suicidal and who met criteria for the diagnosis of borderline personality disorder (BPD).
  • The treatment has been studied in a number of randomized controlled trials, and we now know that comprehensive DBT is helpful in teaching individuals to better regulate their emotions in order to engage in fewer impulsive behaviors (e.g., suicidal behaviors, self-injury, substance misuse, binge eating, gambling).
  • Comprehensive DBT was also designed to help individuals with emotion regulation difficulties interact more effectively with others by decreasing impulsive, angry, or indirect interpersonal behaviors.
  • DBT has a considerable amount of research support and is considered the gold standard treatment for borderline personality disorder (BPD). Though you do not need to have BPD to benefit from a Comprehensive DBT program, you will want to make sure the program treats the concerns most relevant to you.
  • You may have heard of comprehensive DBT programs that target specific concerns, such as DBT-SUD (for substance use), DBT-PE (for PTSD), or DBT-ED (for eating disorders). These programs use the DBT model, but the program (and the therapists) focus heavily on a specific concern rather than emotion dysregulation broadly.
  • There are also adaptions to comprehensive DBT, such as RO-DBT. RO-DBT is a treatment designed to address emotional over-control, which is very different than the emotional under-control treated in traditional DBT. TAP does not offer RO-DBT; however, you can find providers who do here.
  • The TAP Clinic offers a traditional comprehensive DBT program that is implemented with fidelity to the model articulated by the treatment developer, Dr. Marsha Linehan. Several therapists also offer DBT-PE for those in need of DBT with active PTSD symptoms.

What Does Comprehensive DBT Entail?

Comprehensive DBT is a term that requires a level of therapist training, particular treatment components, and a particular style of therapy.

Therapist Training:

  • To conduct Comprehensive DBT, your DBT therapist must have a very high level in training in DBT. The gold-standard of this training is achieving the Linehan Board Certification (LBC), which you can learn more about here.
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Treatment Components

  • Weekly individual therapy with a Comprehensive DBT therapist.
  • Weekly skills training, usually in a DBT group. To learn more about our DBT groups, click here.
  • Phone coaching for skills use between sessions.
  • Therapist participation on a DBT Consultation Team.

Style of Therapy 

  • DBT requires a specific format and style of individual therapy. This includes a diary card to track your treatment goals, behavior chains to understand impulsive behaviors, and a treatment hierarchy to guide what is discussed each week.
  • Comprehensive DBT groups are required to cover specific skills content from the DBT skills manual. This includes the skills of Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness.
  • Both individual and group DBT are skills-focused. Unlike some other forms of talk therapy, a Comprehensive DBT program is quite structured and sessions are focused on learning and practicing particular skills.

Is Comprehensive DBT Right For You?

Comprehensive DBT is a multicomponent, intensive treatment and is not right for everyone. We are most likely to recommend Comprehensive (or "full model") DBT if:

  • You experience your emotions as easily triggered, intense, and requiring a long time to return to baseline.
  • You engage in impulsive behaviors in an attempt to regulate your emotions (e.g., self-injury, substance use, gambling, binge eating)
  • You have difficulty in interpersonal interactions due to your emotions. This could include difficulty getting along with others, engaging in problematic interpersonal communication behaviors (e.g., yelling, threatening), or difficulty effectively asking for what you need when upset.
  • These emotional and interpersonal skills deficits cause significant problems in your ability to work (or attend school), build and maintain relationships, and complete tasks of daily living.

If this does not describe you, or only partially describes you, you may be a better fit for our DBT-informed program or other skills programs such as the Unified Protocol (UP) or Emotional Resiliency (ER) programs.

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Adjuncts to the Comprehensive Program:

Depending on the individual or family needs, the following adjunct treatments may be part of your comprehensive program:

  • DBT for Families

DBT for families utilizes the behavioral principles and skills of standard DBT and applies them across the family unit in family therapy sessions. Family members are taught how to apply DBT skills to familial interactions, how to better validate and understand others’ points of view, and how to apply behavioral principles more effectively.

  • DBT-focused Couples Therapy

DBT for couples utilizes the behavioral principles and skills of standard DBT and applies them to the couple in couples therapy sessions with a DBT-trained couples therapist.

  • Behavioral Parent Training (BPT)

BPT uses behavioral principles and skills to the parenting framework. Parents are taught how to use their own DBT skills to increase effective communication, set and maintain parental expectations, and increase positive interactions with their teen or adult in the DBT program.