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  • DBT for BPDDBT for BPD
  • How It WorksHow It Works
  • How Long Does DBT for BPD Last?How Long Does DBT for BPD Last?
  • How Does DBT Help?How Does DBT Help?
  • What If It Doesn’t Help?What If It Doesn’t Help?
  • How to Find a DBT Therapist for BPDHow to Find a DBT Therapist for BPD
  • Questions to Ask a DBT TherapistQuestions to Ask a DBT Therapist
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources
BPD Articles BPD Treatment for BPD Types of BPD Best Online Therapy

DBT for Borderline Personality Disorder (BPD): What to Expect & How It Works

Headshot of Emma Jane Watson, M.Ed., MSW, LICSW

Author: Emma Jane Watson, M.Ed., MSW, LICSW

Headshot of Emma Jane Watson, M.Ed., MSW, LICSW

Emma Jane Watson M.Ed., MSW, LICSW

Emma Jane is a compassionate therapist with expertise in trauma, personality disorders, and complex bereavement. Empowering clients to find resilience through tailored therapeutic interventions.

See My Bio Editorial Policy
Rajy Abulhosn, MD

Medical Reviewer: Rajy Abulhosn, MD Licensed medical reviewer

Published: September 20, 2024
  • DBT for BPDDBT for BPD
  • How It WorksHow It Works
  • How Long Does DBT for BPD Last?How Long Does DBT for BPD Last?
  • How Does DBT Help?How Does DBT Help?
  • What If It Doesn’t Help?What If It Doesn’t Help?
  • How to Find a DBT Therapist for BPDHow to Find a DBT Therapist for BPD
  • Questions to Ask a DBT TherapistQuestions to Ask a DBT Therapist
  • In My ExperienceIn My Experience
  • InfographicsInfographics
  • Additional ResourcesAdditional Resources

Dialectical behavior therapy (DBT) for borderline personality disorder (BPD) is one of the most effective treatments for individuals struggling with intense emotions, impulsivity, and unstable relationships. If you or a loved one are considering DBT for BPD, it’s important to know what to expect from this evidence-based, long-term therapy. DBT therapists help individuals learn mindfulness, emotional regulation skills, and how to manage the unique challenges of BPD.

Borderline Personality Disorder Worksheets

This collection of worksheets is designed to offer tools and strategies that help you navigate the unique challenges of BPD. Find the one you need or download them all here.

BPD Workbook cover page
Complete Workbook Download
Identifying Your Emotions Worksheet
Identifying Your Emotions Download
Identify BPD Triggers
Identify Your BPD Triggers Download
DBT PLEASE Skill
DBT PLEASE Skill Download
Nervous System Regulation Worksheet
Nervous System Regulation Download

What Is DBT for BPD?

Dialectical behavior therapy (DBT) can help people with borderline personality disorder (BPD) improve their lives and relationships by teaching them to manage emotions and decrease impulsive actions. DBT therapists work to validate their clients’ feelings and hold them accountable for their actions through positive and negative reinforcement.

A DBT inpatient or intensive outpatient program (IOP) provides more opportunities for positive attachment and intensive therapy.1 Both individual and inpatient approaches require one weekly individual session (sometimes two) and one weekly group session.

Is DBT for BPD Effective?

In the early 1990s, Marsha Linehan established DBT as an effective treatment for BPD.2 Dialectical behavior therapy is considered the frontline treatment for BPD suicidality and self-harming behaviors.3 Substantial empirical research, including random control trials, has further supported the effectiveness of DBT for BPD.3

Recent MRI brain studies on women with BPD showed significant changes in participants’ gray matter after 12 weeks of DBT therapy.4 This important development demonstrates the future possibility of using neurobiologically-informed therapy to treat borderline personality disorder.4

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How DBT for BPD Works

DBT for borderline personality disorder consists of several skill-building modules, including mindfulness, interpersonal effectiveness, distress tolerance, and emotional regulation. These techniques aid in the treatment of common symptoms of borderline personality disorder.

DBT treatment for BPD includes four stages:

  • Reducing negative behaviors and improving behavioral skills
  • Treating issues related to past trauma
  • Developing self‐esteem
  • Finding a higher purpose

Initially, the therapist and client will sign a contract for treatment outlining specific expectations. Individuals in DBT therapy will also complete weekly diary cards documenting their behaviors. At this point, DBT therapists begin preparing their clients for group sessions. Once placed in a group, participants must attend weekly individual therapy.

4 DBT Techniques for BPD

The four core techniques of DBT help individuals manage the emotional and interpersonal challenges associated with BPD. Each of these skills—mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation—targets a different aspect of coping with BPD. Together, they offer a comprehensive approach to handling intense emotions, improving relationships, and developing healthier responses to stress.

Four DBT coping techniques for BPD include:

1. Mindfulness Meditation Skills

Mindfulness meditation teaches individuals to stay grounded in the here and now by remaining aware of the present, not the past or future. Those with BPD tend to have extreme emotions and can feel trapped in those emotions. Mindfulness for BPD can help individuals manage and cope with symptoms.5

2. Interpersonal Effectiveness Skills

Interpersonal skills help individuals fulfill their needs, nurture relationships, and improve their self-worth. Those with BPD can practice these when establishing appropriate boundaries for the situations and relationships they may be in.6

3. Distress Tolerance Skills

The distress tolerance skills used in DBT for BPD help clients cope when facing anger or turmoil. The goal is to prevent individuals from engaging in risky behaviors by developing a coping mechanism toolbelt. DBT distress tolerance skills help to mitigate reacting amid extreme anger, also known as borderline rage.6

4. Emotional Regulation Skills

Emotional regulation skills involve controlling one’s thoughts, feelings, and behaviors. For those with BPD, self-regulating emotions are challenging, possibly because of poor childhood experiences, trauma, or abuse. Using these DBT skills for BPD can make a big difference in how clients deal with stressful emotions they may have, as well as potential triggers.6

How Long Does DBT for BPD Last?

DBT for BPD can last anywhere from six months to two years. However, individuals may stay in treatment even longer if they find it helpful when working on goals and managing symptoms of BPD.

How Does DBT Help Those With BPD?

DBT for borderline personality disorder teaches skills to help manage symptoms and build a healthy life. Emotion regulation skills allow them to process extreme emotions, while interpersonal effectiveness skills can help improve their relationships and self-respect.

Once individuals develop distress tolerance, they can approach challenging situations in healthy, productive ways. Finally, DBT mindfulness techniques can help reduce stress and connect to self and others. Those with BPD can learn to avoid black-and-white thinking, which often contributes to increased emotional dysregulation.

Below are some ways in which DBT can improve symptoms of BPD:

  • Decreased suicidal thoughts and behaviors: Suicidal thoughts and behaviors may be an attempt to escape intolerable emotional suffering. DBT skills offer individuals new, more effective ways of coping with these intense emotions.
  • Improved anger management skills: Intense anger can feel impossible to manage when you do not know how or when your environment reinforces your rage. Understanding, validating, and managing your anger with DBT skills can help reduce its intensity over time. These techniques offer more effective ways to act when you experience this emotion.
  • Improved overall functioning: DBT techniques for BPD help improve overall functioning by teaching tools to tolerate inevitable challenges in life. DBT also helps assess your values and what may hinder you from pursuing them. You can then take action toward a fulfilling life.
  • Improved ability to maintain relationships: Interpersonal effectiveness skills in DBT help patients identify their relational goals and communicate effectively to achieve those goals. DBT for BPD also teaches you how to manage your emotions and act more skillfully, which can help improve your relationships with yourself and others.
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Help for BPD

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BPD Treatment for Teens & Young Adults – Charlie Health’s virtual intensive mental health program for young people (ages 11-33) includes curated groups, individual therapy, and family therapy for teens and adults with serious mental health issues. Insurance accepted. Learn More

DBT Skills Course – DBT is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses. Free Trial

What If DBT for BPD Doesn’t Help?

There are many other BPD treatment options if you are not benefiting from dialectical behavior therapy for BPD. Interventions and therapies for borderline personality disorder can be beneficial, singularly or in tandem with DBT.

Below are alternative therapy options that can help improve BPD symptoms:

Cognitive behavioral therapy (CBT)

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CBT for BPD focuses on understanding thought distortions related to self and others.7 Other cognitive and behavioral approaches, such as acceptance and commitment therapy (ACT), can help distinguish thoughts and behaviors from self and establish parameters around identity.

Schema-focused therapy

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Schema-focused therapy helps people with BPD identify needs and understand how they meet these needs. Some research shows that those with BPD who participated in schema-focused therapy reported better self-understanding and improved emotional regulation.8

Humanistic approaches

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Humanistic therapy can help facilitate good outcomes in individuals with BPD, particularly due to its focus on client-therapist relationships. Humanistic approaches can assist clients in finding meaning in life and decrease BPD symptoms.9

Family therapy

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Due to the social discord and genetic/environmental causes associated with BPD, family therapy can be an important approach for long-term success. Researchers encourage better use of support systems in clients’ lives, and attending therapy together is one way loved ones can become more involved in a client’s treatment.10

Mentalization-based treatment (MBT)

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Mentalization refers to our ability to understand our own and others’ mental states.11 MBT focuses on developing mentalization to reduce symptoms of BPD and enhance interpersonal functioning.11

Good psychiatric management (GPM)

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GPM is a generalist therapeutic option that focuses on teaching and promoting “social adaptation.” GPM is a less intense option than DBT but can be effective in treating BPD.12

Transference-focused therapy (TFP)

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Transference refers to a patient’s feelings about their therapist, and transference-focused psychotherapy uses this client-therapist relationship as a primary tool for treating BPD.13

Short-term hospitalizations

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Involuntary or voluntary hospitalization can keep someone with BPD safe when necessary. The goal of hospitalization is to assess one’s medication management, symptoms, and next steps to aid in stabilization.

How to Find a DBT Therapist for BPD

Asking for a referral from your primary care physician or using an online therapist directory can help you find the right therapist. You can filter your search for a DBT therapist based on price, experience, and more. Feel free to ask a therapist about their education, training, certifications, and personal treatment philosophy. A good therapist can help you accomplish treatment goals in a safe, honest, and trustworthy environment.

You can also receive therapy through online therapy platforms. For individuals needing more intensive care, Charlie Health offers virtual intensive outpatient programs using DBT for teens and adults.

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Questions to Ask a Therapist About DBT for BPD

Before choosing a therapist, try to spend time getting to know them during an initial phone consultation. Doing so will help you gauge the experience they have with BPD, as well as figure out if they’re a good personality fit for you.

Here are questions to ask a new therapist before starting DBT for BPD:

  • How long have you been practicing DBT for BPD?
  • How often do you meet with individuals, and how long are appointments?
  • Do you have a crisis line or resources available?
  • Do you offer contact between sessions? Phone sessions?
  • What specialized DBT training do you have in treating BPD?
  • On average, how long do you see individuals with BPD before they report improvements?
  • Do you give therapy homework, and what might this look like?
  • What struggles do people encounter when receiving DBT for BPD, and what do you encourage them to do when these happen?

In My Experience

Headshot of Emma Jane Watson, M.Ed., MSW, LICSW Emma Jane Watson, M.Ed., MSW, LICSW
“If you or a loved one are dealing with unwanted symptoms of BPD, DBT could help you feel better and manage distress. The sooner you seek treatment, the better.”

DBT for BPD Infographics

What Is DBT?   How Does DBT for BPD Work?   Is DBT Effective for Treating BPD?4 DBT Techniques for BPD

Sources Update History

ChoosingTherapy.com strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Prada, P., et al. (2018). Strategies to Deal With Suicide and Non-suicidal Self-Injury in Borderline Personality Disorder, the Case of DBT. Frontiers in psychology, 9, 2595. https://doi.org/10.3389/fpsyg.2018.02595

  • Linehan, M. M. (2018). Cognitive-behavioral treatment of borderline personality disorder. Guilford Publications

  • Reddy, M. S., & Vijay, M. S. (2017). Empirical Reality of Dialectical Behavioral Therapy in Borderline Personality. Indian journal of psychological medicine, 39(2), 105–108. https://doi.org/10.4103/IJPSYM.IJPSYM_132_17

  • Mancke, F., et al. (2018). Assessing the marks of change: how psychotherapy alters the brain structure in women with borderline personality disorder. Journal of psychiatry & neuroscience : JPN, 43(3), 171–181. https://doi.org/10.1503/jpn.170132

  • Keng, S. L., Lee, C. S. L., & Eisenlohr-Moul, T. A. (2019). Effects of brief daily mindfulness practice on affective outcomes and correlates in a high BPD trait sample. Psychiatry research, 280, 112485. https://doi.org/10.1016/j.psychres.2019.112485

  • May, J. M., Richardi, T. M., & Barth, K. S. (2016). Dialectical behavior therapy as treatment for borderline personality disorder. The mental health clinician, 6(2), 62–67. https://doi.org/10.9740/mhc.2016.03.62

  • Maillard, P., et al. (2017). Metacognition as a predictor of change in the treatment for borderline personality disorder: A preliminary pilot study. Journal of Psychotherapy Integration, 27(4), 445–459. https://doi.org/10.1037/int0000090

  • Tan, Y. M., et al. (2018). Schema therapy for borderline personality disorder: A qualitative study of patients’ perceptions. PloS one, 13(11), e0206039. https://doi.org/10.1371/journal.pone.0206039

  • Marco, J. H., et al. (2017). Meaning in Life in People with Borderline Personality Disorder. Clinical psychology & psychotherapy, 24(1), 162–170. https://doi.org/10.1002/cpp.1991

  • Fitzpatrick, S., Wagner, A. C., & Monson, C. M. (2019). Optimizing borderline personality disorder treatment by incorporating significant others: A review and synthesis. Personality disorders, 10(4), 297–308. https://doi.org/10.1037/per0000328

  • Mentalization. (n.d.) American Psychological Association. Retrieved from https://dictionary.apa.org/mentalization

  • Gunderson, J., Masland, S., & Choi-Kain, L. (2018). Good psychiatric management: a review. Current opinion in psychology, 21, 127–131. https://doi.org/10.1016/j.copsyc.2017.12.006

  • McMain, S. F., et al. (2009). A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder. The American journal of psychiatry, 166(12), 1365–1374. https://pubmed.ncbi.nlm.nih.gov/19755574/

  • Understanding Transference-Focused Psychotherapy. (n.d.). McLean Hospital. Retrieved from https://www.mcleanhospital.org/essential/tfp

Show more Click here to open the article sources container.

We regularly update the articles on ChoosingTherapy.com to ensure we continue to reflect scientific consensus on the topics we cover, to incorporate new research into our articles, and to better answer our audience’s questions. When our content undergoes a significant revision, we summarize the changes that were made and the date on which they occurred. We also record the authors and medical reviewers who contributed to previous versions of the article. Read more about our editorial policies here.

September 20, 2024
Author: No Change
Medical Reviewer: No Change
Primary Changes: New borderline personality disorder worksheets added. Fact checked and edited for improved readability and clarity.
June 7, 2023
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources. Revised “What If DBT Doesn’t Help?” Added “How Long Does DBT for BPD Last?,” and “How Does DBT Help Those With BPD?” New material written by Caitlin Bergh, LCSW, and reviewed by Dena Westphalen, PharmD.
November 21, 2022
Author: No Change
Reviewer: No Change
Primary Changes: Updated for readability and clarity. Reviewed and added relevant resources.
December 22, 2021
Author: No Change
Reviewer: No Change
Primary Changes: Updated for Readability; Revised and clarified “How Does DBT for Borderline Personality Disorder Work?”; Revised “Examples of DBT For Borderline Personality Disorder”; Added “What If DBT Doesn’t Help?”, “How Hard Is It to Find a DBT Therapist for BPD?”, and “How Much Does DBT Typically Cost?” All new material written by Silvi Saxena, MBA, MSW, LSW, CCTP, OSW-C and reviewed by Dena Westphalen, Pharm.D.
March 25, 2021
Author: Emma Jane Watson, M.Ed., MSW, LICSW
Reviewer: Rajy Abulhosn, MD
Show more Click here to open the article update history container.

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