Talk:Dialectical behavior therapy/Archive 1

Name of article
Should we be keeping this her or rename it Dialectical Behavioral Therapy? I'd vote to move it; though most just refer to this as "DBT", whenever it's referred to in full, it's behaviorAL, to match "Behavioral Health". siafu20:45, 8 Apr 2005 (UTC)

We should move it to be under its proper name, and have this name re-direct to it. I don't know how to do that, but I'll figure it out ... Scot &rarr;Talk 19:58, 19 March 2006 (UTC)


 * Dialectical Behavioral Therapy or Dialectical behavioral therapy? The second is correct per WP:MOS unless there is a reason for the caps. You should be able to move to either now, and set redirects as desired.KillerChihuahua?!? 14:19, 23 March 2006 (UTC)

Current capitalisation seems fine. &mdash; Nightst a  llion (?) Seen this already?07:58, 24 March 2006 (UTC)

The correct name is Dialectical Behavior Therapy, not Dialectical Behavioral Therapy. This is how Linehan refers to it. Seehttp://faculty.washington.edu/linehan/ 20:40, 14 October 2006

With reference to the possible deletion, i'd have thought that its prevelance within the NHS alone marks it as worthy of an entry- with a bit more time i can collect some references to support this (Hampshire NHS would be a good starting point)

I'm kind of shocked that this entry would be up for deletion. It's used all over the place. I doubt youd run into a therapist who isn't familiar with what it is. i found this article useful for learning what it was before I started doing it and I'd hate to see it gone for other people to not be able to use Lyo 15:29, 10 November 2006 (UTC)


 * Apparently whoever added the template didn't bother to investigate the matter at all. Asimple search on Amazon.com yields 246 books with DBT in the title.  Having not read them, I can't add them as refs, but it should be obvious that this is a notable topic. siafu 15:40, 10 November 2006 (UTC)

This article bears importance in that DBT is becoming the preferred treatment model for Borderline personality disorder and is also proving effective in treating many other disorders including eating disorders. To delete it would be wrong. Almost any article you might find on Borderline personality disorder that was written recently at least mentions DBT and people need to know what it is.

Jargon / Pedantry / Overly Technical Language
I found this article looking to learn more about DBT and found some bits that are particularly loaded with jargonistic language. For example, parsing the sentence: "Arguably her signal contribution was to elide the adversarial paradigm implicit in the hierarchical modernist therapeutic alliance, using the deconstructive spirit of Hegel and the Buddha to substitute a postmodern alliance based on intersubjective tough love" took just about all my faculties as an English major. Seems like it could be re-written in a much clearer form by someone who was more familiar with the issue than I. I'll add the "Jargon" tag for now, though the "technical" tag might be just as appropriate. —Preceding unsigned comment added by Lenordbater (talk • contribs) 18:50, 7 July 2009 (UTC)

Yeah... I got to that same line and thought, jeesh! this putz writes like he or she is trying to impress a professor, not transmit useful information. Gawd. Up the academy or something. Pretentious boobs. —Preceding unsigned comment added by99.35.14.147 (talk) 14:13, 7 August 2009 (UTC)


 * I find the use of jargon makes much of the content anecdotal. The jargon is used in such a particular manner as to be unintelligible to anyone but the author or those already sufficiently familiar with the subject to be able to "decode" them.  Many statements are made that are disguised by this use of jargon and also by extensive "name-dropping".  The name-droping e.g. to Buddhism, Hegel, Thich Nhat Hanh and others is simply an attempt to provide incomplete references which because are both impossible to trace and may well not sustain the statements concerned. This is made more probable by the fact that some claims are palpably nonsensical e.g. "All DBT involves two components ... the grop whic meets".  If this statement is true then the fact that DBT is a group therapy should be stated in the first line of the article.

82.27.185.43 (talk) 23:34, 5 January 2010 (UTC) I agree that I have no idea what intersubjective tough love is. Can that portion be deleted? I agree that the lead section is too obfuscated. The document “Cognitive behavior therapy in a nutshell” currently cited as a reference and coauthored by Linehan herself is a lot clearer. From the article and that document, I think the sentence “Arguably her signal...tough love” means something like: “'''DBT strives to avoid having the client/patient see the therapist as an adversary rather than an ally in the treatment of psychological issues. Accordingly, in DBT the therapist aims to accept and validate the client’s feelings at any given time while nonetheless informing the client that some feelings and behaviors are maladaptive, and showing them better alternatives.'''” I think this is basically just restating things that are said earlier in the lead section, but I want to add the above sentences because I think having read something like them would have helped me grasp the idea more quickly. As always if someone thinks my prose is still obfuscated, don’t hesitate to improve it. Also, I think the purpose of the parenthetical contrasting Carl Rogers’ and Thich Nhat Hahn’s ideas is to contrast the idea of “I accept you no matter what you're like” with “I accept how you are, but I think you could be better and I want to help make you better”. My interpretation is just based on this article and the above DBT document by Linehan; I don’t know if the sentence is a fair representation of Rogers’ and Nhat Hahn’s ideas. Wikipedia’s article about Rogers mentions only: “Additionally, Rogers is known for practicing "unconditional positive regard," which is defined as accepting a person "without negative judgment of .... [a person's] basic worth.” I didn’t find anything about unconditional acceptance in the text of the article on Nhat Hahn (not to imply he doesn’t talk about it, just that it hasn’t been written about on Wikipedia for my easy perusal).     Riyuky (talk) 01:25, 14 January 2010 (UTC)

I've taken DBT courses and can much more easily explain how it works and where it comes from. DBT does come from Buddhism and Hegel. The major Buddhist concept used in DBT is the middle way. Basically, the best way to stay on solid ground is to find the middle between two extremes. Hegel's contribution is more or less the same with his thesis/antithesis/synthesis concept. Other Buddhist concepts include mindfulness and participation/presence. The rest is based on cognitive behavioral therapy with a much greater dose of acceptance and validation strategies. And oh, the comments about the client/therapist relationship is more easily explained by saying that the therapist acts more like a guide, role model, accountability buddy, external validation source, and a mentor rather than someone hell-bent on completely changing the client. Does that make sense? I'll tell you all what, I'll see what I can do to smooth some of this stuff out as I'm a big DBT fan.--Lonejedi (talk) 17:27, 28 April 2010 (UTC)


 * Having been through a month of outpatient DBT treatment at a psych ward, I can say that yes, it is loaded with a ridiculous amount of acronyms and jargon. Just... kinda go with it, it's how it is. Morrigi (talk) 04:27, 18 June 2011 (UTC)

graphs and logs
i was wondering if there are graphs and logs that are printable for to maintain my mood swings. it has been approximately 2 and half years since i have been in a dbt group. we had a weekly report sheet and a graph for wise mind that we kept with us. can you prvide me this information.
 * Within the next month I will try to get a diary card example on Wikibooks. :)68.22.19.194 17:00, 4 January 2007 (UTC)
 * Here's a good example. http://www.dbtselfhelp.com/html/diary_card_1.html --68.22.19.194 20:00, 8 January 2007 (UTC)

Mass removal
Normally I would bring my concerns here first, then remove after discussion. However, considering it's a copyvio, I removed the sections of quoted text. We can't do that. We have to write the information ourselves and cite the sources. Not just take what they've written and copy it over with a link.  Lara  ❤  Love  05:49, 8 February 2008 (UTC)

Article says there are four (4) modules, then lists only three (3)
The article includes a major headline that boldly announces

"The four modules."

Since it then lists 1.1, 1.2, and 1.3 ... and stops right there.

The reader is left wondering what happened to 1.4? Will someone who knows please add 1.4 and tell us about the fourth module.
 * This has been fixed. I don't know when. I was about to write the fourth. —Precedingunsigned comment added by Charmedguy18 (talk •contribs) 01:15, 4 August 2009 (UTC)

Article is missing their version of "dichotomy"
Dichotomy is a dialectic of DBT that is one of the most essential parts of it. I don't know a lot about the actual Leinham book as it bores me and I'm just a patient. In DBT, dichotomy is is "all-or-nothing" or "black-or-white" thinking. For example, idealization and devaluation. Or "he's hot, or he's not," or "he's good or he's bad," or "He loves me or he hates me," etc etc. I think you get the point: dichotomy is not only a major part of DBT, but also is missing this kind of definition from the dichotomy page on Wikipedia. Charmedguy18 (talk) 06:01, 1 August 2009 (UTC)

Please keep DBT in Wikipedia

 * This comment was moved from Talk:Dialectical behavioral therapy/Comments/skagedal... 15:01, 13 November 2008 (UTC)

Please keep DBT in Wikipedia. I have been a part of a DBT group for over 2 years although it has been disbanded now. My son was suicidal with serious self-harm at 17. Was able to do DBT through County Mental Health. Was tested to see if he qualified for it. I do know it is recommended to be sucessful in helping, a commitment of 6 months to go through Linehan's book and another 6 months to go through it again. My son had to commit to 1 year skills training, keeping a diary, meeting one on one and in a group. I also have attended "NAMI" meeting where DBT was mentioned as helping family members who were diagnosed borderline or were suicidal or self-harming. I read an article but unfortunately do not have the reference, of DBT being used in prison setting for those inmates diagnosed with borderline personality and was helpful. I have been in counseling off and on for 40 years, since first panic attack in college. No med or therapy helped me or continues to like DBT. Its 4 components of distress tolerance, mindfulness, emotion regulation, and interpersonal effectiveness are a lifestyle for creating a "life worth living". To me its premise is we can all learn "skills" to help ourselves even if we do not possess them intuitively as some might. It is full of help and compassion for self accepting where you are in level of skills and continuing to always get better and healthier. there is no end to trying to be a better person or to learn "self-soothing" skills or any lack of skills that cause pain in your life. I would be glad to help on this subject in anyway I can. I discovered this therapy in trying to help my son but has helped my diagnosis of "dysthimia" and anxiety as well as adult ADD. I am not nor never been suicidal or self-harming yet I never could shake the depression and struggled to cope with anxiety. I have been very functional as far as keeping a job but my relationships were always painful. 2 divorces. I still struggle with the 4 areas focused on in DBT but continue to work on them on my own and wish I still had a group to bounce my trials and errors off during the week. It's amazing how much help others who are learning skills can help each other. Carolejolly (talk) 01:32, 6 February 2008 (UTC)

Name of article
It's a bit odd that this article is called "Dialectical behavioral therapy", when it refers to a specific therapy that is called "Dialectical behavior therapy" by its author (as discussed above on this page). I'll move it if there are no objections. /skagedal... 15:08, 13 November 2008 (UTC)

Controversy
Right now the controversy section is empty. Is there any controversy? From what I've seen supporters of DBT are still flushed with their early successes, and mindfulness is rapidly gaining acceptance as a legitimate topic for scientific study. It would be nice if someone could reference a measured criticism by a supporter of CBT, responding to DBT's criticisms. For example, I know that mindfulness and distress tolerance are implicit in many cognitive techniques, though DBT may have been the first approach to give them the attention they deserve. Inhumandecency (talk) 23:30, 13 May 2009 (UTC)
 * If someone wants to re-add it with some content, by all means please do so. I'm going to remove the empty header, though, at least until we have some information to put there. --Roman à clef (talk) 21:26, 14 July 2009 (UTC)

criticism
As a individual not schooled in psychology but seeking some basic information about DBT, I found this article unreadable and impossible to understand. —Preceding unsignedcomment added by 74.170.102.73 (talk) 01:38, 29 January 2010 (UTC)

Specific Skills
I don't see how anyone can get anything from a site on DBT without a description of each skill taught in skills training. I've participated in a DBT group for some time now, and been taught each skill twice around. I've put a brief description of them, my sources are under references. —Preceding unsigned comment added by ZoiiMeu (talk • contribs) 15:43, 1 April 2010 (UTC)

comment
Thank you for these comments and to the author for the original contribution.

Although I agree thats work would improve the sense of this contribution and I am lucky in being a lawyer able to sift through the sense of the sentence constructions, I do not agree that it is out of reach of our adinces. Please be careful not to assume ignorance. What is today's jargon might be tomorrow's ordinary parlance. Steve Reynolds 00:12, 6 April 2010 (UTC)  —Preceding unsigned comment added by92.11.122.200 (talk)

Formatting
I read the criticisms and assumed they were in good faith. I reviewed the article and it's layout seemed confusing. Much of this topic is new definitions and skill sets so the best layout is HTML definitions and indents with proper italicizing and bold lettering. The wording still seems a bit awkward but they are almost verbatim to the workbooks. Some rephrasing is needed. I hope any newcomer can glance through and get a good idea quickly what the skill sets are.Alatari(talk) 22:33, 26 April 2010 (UTC)

Reads like a brochure--but not Linehan's!
I just read Linehan's starter material, and it is nothing like this page. She avoids the philosophy for one, and focuses on what the therapy means. I am not saying that the philosophy is irrelevant (or overly interesting), it's not the key concept. --John Bessa (talk) 20:14, 8 December 2010 (UTC)

Dialectical?
Why is it dialectical? The article currently doesn't discuss etymology or the nature of whatever is dialectical in general or specifcially here. I don't think I know, hence I'm not trying to edit it. Midgley (talk) 01:11, 20 January 2015 (UTC)
 * "Dialectical" in the sense of dialectic not dialect. Keahapana (talk) 18:29, 20 January 2015 (UTC)

Readability
Besides lacking attribution, most of the Overview section is written in a style that is far to difficult for the average reader to understand. Can anyone tell me what the following sentence means?


 * "Arguably her signal contribution was to elide the adversarial paradigm implicit in the hierarchical modernist therapeutic alliance, using the deconstructive spirit of Hegel and buddhism to substitute a postmodern alliance based on intersubjective tough love."

I mean REALLY? I ♥ ♪♫ (talk) 23:39, 15 July 2010 (UTC)
 * Wow. But let's all give it a try! Now, I'm a non native speaker, so copy edit will be needed. However, the following might be easier to understand...
 * Possibly, her main contribution was to get rid of the opposition between client and therapist that is built in in modern therapeutic relationships, in which the therapist has a higher status than the client.
 * I didn't succeed with the second part of the sentence...  Lova Falk     talk   08:42, 16 July 2010 (UTC)


 * Let's work on this whole paragraph:


 * Linehan united commitment to the core conditions of acceptance and change through the Hegelian principle of dialectical progress, in which thesis + antithesis → synthesis, and proceeded to assemble a modular array of skills for emotional self-regulation, drawn from Western (e.g., cognitive behavioral therapy and an interpersonal variant, “assertiveness training”) and Eastern (e.g., Buddhist mindfulness meditation) psychological traditions. Arguably her signal contribution was to elide the adversarial paradigm implicit in the hierarchical modernist therapeutic alliance, using the deconstructive spirit of Hegel and buddhism to substitute a postmodern alliance based on intersubjective tough love.


 * Let's first eliminate the weasel words and peacock phrases from the original (not your additions)


 * Professor Linehan combined the concepts of acceptance and change through Hegelian dialectical progress (thesis + antithesis → synthesis) with an array of skills for emotional self-regulation based on a combination of Western therapies (cognitive behavioral therapy and the interpersonal variant, “assertiveness training”) and Eastern Buddhist mindfulness meditation. Her significant contribution was to "reduce or eliminate" the "opposition or friction or tension or ??" between client and therapist that was inherent in modern therapeutic relationships, where the therapist has a higher "status or level of importance or ??" than the client.


 * Does this convey the same message as the original paragraph? I think I'm starting to grasp what was being said. I ♥ ♪♫ (talk) 00:29, 17 July 2010 (UTC)
 * Going back and rereading the original I see that I missed the "intersubjective tough love" part. A little help here please? I ♥ ♪♫ (talk) 00:33, 17 July 2010 (UTC)


 * I note from the date (July 2010) that half a year has gone by and the pretentious writing that was a part of the original article is still there, so I've taken a crack at replacing it. My version lacks some of the subtlety in the attempts above, but I lack the patience to tease meaning out phrases like "postmodern alliances" and "Hegelian deconstructive spirit".  By moving this editorial work out of the talk page and into the article itself, I encouraging others to make further improvements.  Or perhaps I should say, "encourage an ongoing post-Wikipedian dialectical discourse of multi-editorial intermediated prosody in the combinatoric spirit of William Burroughs and Werner Heisenberg".   Ross Fraser (talk) 04:36, 17 January 2011 (UTC)


 * "Linehan and others combined a commitment to the core conditions of acceptance and change through the Hegelian principle of dialectical progress (in which thesis + antithesis → synthesis) and assembled an array of skills for emotional self-regulation drawn from Western psychological traditions (e.g., cognitive behavioral therapy and an interpersonal variant, “assertiveness training”) and Eastern meditative traditions (e.g., Buddhist mindfulness meditation). Arguably her most significant contribution was to alter the adversarial nature of the therapist/client relationship in favour of an alliance based on intersubjective tough love."
 * Thanks Ross, however your edit states that there were others who had the realization stated in the paragraph. Can you suport that claim? Otherwise it should read "Professor Linehan..." all-in-all nice job. I ♥ ♪ ♫ 03:56, 18 January 2011 (UTC)


 * Sorry, can't help. The text "Linehan and others" was already in this section of the article before I edited it.  This section needs references, on this point and others.  Ross Fraser (talk) 00:47, 18 February 2011 (UTC)

My personal insight was contravorial of the thesis, without patient input, real input, the practice is self fulfilling. I do not contest any of work professionally done, but failure is not recognize as a Simple Definition of intelligentsia liberation force, where are the statistical cited? Warning signs, the number of school with mass murder of, here and internationally, leads to disconcerting feelings. Christ in biblical antiquity was the first trial of the therapy. The act to behold the supernatural. — Preceding unsigned comment added by 184.5.68.81 (talk) 18:55, 19 August 2016 (UTC)

Distress tolerance
I added a hyperlink to a new wikipedia page on distress tolerance. Aaroncjl (talk) 07:19, 27 November 2016 (UTC)

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Efficacy and Effectiveness
A badly needed section. Thanks. --1000Faces (talk) 14:59, 10 June 2010 (UTC)

Seconded — Preceding unsigned comment added by 24.124.55.21 (talk) 02:16, 19 December 2013 (UTC)

I also agree, but I'm slightly unsure how to approach this. I would argue to only really cite what therapies are effective for what according to what is considered effective by Division 12 of the APA. Then again I don't have a clinical Ph.D, and I have no idea how frequently they update that list.Dabrams13 (talk) 16:37, 14 November 2017 (UTC)

Lack of differentiation from CBT
The article states that DBT is a modified form of DBT, but does not outline even in passing which of its attributes are borrowed from CBT, and which are distinct. It also does not describe which failures and/or shortcomings of CBT were the impetus to develop DBT, and how well DBT purports to rectify those failures or shortcomings. This is a serious lack of context and a barrier to understanding DBT's place in the current landscape. Does attribution for this information exist? — Preceding unsigned comment added by 2001:56a:7042:6000:29c2:e32e:119a:478d (talk) 11:07, 30 November 2018 (UTC)

Lack of criticisms
I find it hard to believe that a behaviour therapy notable enough to justify its own Wikipedia page lacks any relevant criticisms after almost 40 years of practice.

Agreed, there have been numerous discussions of the cultural cooptation and repackaging of Buddhist practices for profit, amongst others. — Preceding unsigned comment added by 216.243.16.154 (talk) 22:14, 30 December 2020 (UTC)

Why is the American Journal of Psychiatry tagged as a potentially unrelaible source?
Next to the intext citation for this article:

^ McMain, Shelley (1 December 2009). "A Randomized Trial of Dialectical Behavior Therapy Versus General Psychiatric Management for Borderline Personality Disorder". American Journal of Psychiatry. 166 (12): 1365–1374. doi:10.1176/appi.ajp.2009.09010039. Retrieved 16 November 2017.

Someone has added the following: "[unreliable medical source?]"

The American Journal of Psychiatry is, to put it mildly, pretty reputable. — Preceding unsigned comment added by 156.22.8.20 (talk) 23:39, 18 November 2018 (UTC)

(replying Sep 2019 to the above...) I also think it's a shame the unreliable tag is on there. It's also a shame that this article is still listed as needing more medical sources. Most of the citations as of right now are from academic medical journals. Smells, to me, of something a certain religious cult that starts with S would do.


 * No idea, and I've removed those tags. They looked like longstanding drive-by tagging and/or sneaky POV edits. If anyone disagrees, I suggest they make their case on the talk page, here, and/or go to WP:RSN to discuss. Killer Chihuahua 18:26, 24 September 2019 (UTC)


 * Most of the sources used in this article are from Linehan herself, or don't comply with WP:MEDRS, which recommends not randomized trials, but review articles. --159.196.100.171 (talk) 11:53, 15 April 2021 (UTC)

Wiki Education Foundation-supported course assignment
This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): K.khare96.

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Wiki Education Foundation-supported course assignment
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Stages of Change are not part of DBT
"DBT has five specific states of change which the therapist will review with the patient: pre-contemplation, contemplation, preparation, action, and maintenance.[22] Precontemplation is the first stage, in which the patient is completely unaware of their problem. In the second stage, contemplation, the patient realizes the reality of their illness: this is not an action, but a realization. It is not until the third stage, preparation, that the patient is likely to take action, and prepares to move forward. This could be as simple as researching or contacting therapists. Finally, in stage 4, the patient takes action and receives treatment. In the final stage, maintenance, the patient must strengthen their change in order to prevent relapse."

Not sure the rules on deleting stuff, but this is very misleading. This describes the Stages of Change in the Transtheoretical Model and is not part of DBT. It should not appear in this article. — Preceding unsigned comment added by 172.97.190.104 (talk) 21:40, 22 April 2022 (UTC)

Unclear part of text
Quote: "This module outlines healthy coping behaviors intended to replace harmful ones, such as distractions, improving the moment, self-soothing, and practicing acceptance of what is." From the way it is written here, I don't understand which behaviors are meant to be harmful and which are meant to be healthy. I would suppose that only distractions are meant as harmful but the way the sentence is structured it allows the reading that all following behaviors are understood as harmful so I am honestly confused. 37.48.60.73 (talk) 20:04, 28 June 2022 (UTC)
 * ✅ I added parentheses to help make the distinction. Dawnseeker2000  00:47, 29 June 2022 (UTC)