PTSD Treatment Dialectical Behavior Therapy (DBT) for PTSD By Matthew Tull, PhD Matthew Tull, PhD Twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial process Updated on November 23, 2020 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD LinkedIn Twitter Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print Moment /Joe Houghton / Getty Images Dialectical behavior therapy (DBT) was originally developed to help people struggling with the symptoms of borderline personality disorder (BPD). Many people with BPD also have PTSD, and vice versa. Although people with PTSD and BPD have different symptoms, they share some of the same problems, such as: Difficulty managing emotionsInterpersonal problemsHigh risk of impulsive behavior You won't be surprised then, to discover that some researchers have also explored whether DBT may help people with PTSD. What Is DBT? DBT, considered a cognitive behavioral therapy (CBT), focuses on changing poorly formed thoughts, behaviors, and beliefs as a way of reducing a person's BPD symptoms. However, DBT differs from traditional CBT. How? By also emphasizing acceptance of the person's emotions and thoughts. In fact, DBT was one of the first CBT treatments to use mindfulness skills to help achieve this acceptance. DBT is based on the idea that the most important problem among people with BPD is difficulty managing their emotions (also called emotion dysregulation). Many of the problem behaviors of people with BPD (for example, deliberate self-harm) are thought to arise from problems they have managing their emotions. Emotion-management problems stem from a combination of: Biology (such as a person's tendency to experience emotions intensely)A childhood environment where emotions were ignored or where expressing them was punished Therefore, DBT focuses on improving emotion-management problems and the problem behaviors that they cause. Therapists who provide DBT use and teach four different types of skills: Mindfulness meditation skillsInterpersonal effectiveness skillsDistress tolerance skillsEmotion regulation skills Exploring the Usefulness of DBT for PTSD The skills used in DBT, originally developed for people with BPD, may also greatly benefit people with PTSD. Just like people with BPD, people with PTSD have problems managing their emotions. They may also have problems with relationships or engage in self-destructive behaviors, such as deliberate self-harm. To explore whether DBT might be effective in people with PTSD, a group of researchers at the Central Institute of Mental Health in Mannheim, Germany, treated a group of women who had PTSD (from childhood sexual abuse) using an intensive treatment that combined DBT and traditional CBT approaches to PTSD treatment, such as exposure. The joint treatment was referred to as DBT-PTSD. After three months of treatment, the researchers found that DBT-PTSD significantly reduced the women's PTSD symptoms, including depression and anxiety. In addition, the women's PTSD symptoms were still improving six weeks after they completed the treatment, suggesting that they may have learned skills during the study that helped them continue to recover from PTSD after the treatment ended. Why More Research Is Needed Research on DBT-PTSD is still ongoing, but the studies that have been done show a great deal of promise. More studies are needed to explore how DBT-PTSD compares to other CBT treatments for PTSD. One study comparing the use of dialectical behavior therapy for PTSD to cognitive processing therapy (CPT) found that while both led to significant improvements, DBT achieved significantly higher symptoms remission rates. Another study looked at a DBT-PTSD treatment program for complex PTSD stemming from childhood abuse and found that the treatment was both safe and effective in residential and outpatient settings. If you're interested in learning more about DBT, a number of resources are available on Dr. Marsha Linehan's Behavioral Tech website, including a database of mental health professionals who have been trained in, and can provide, DBT. The Best Online Therapy Programs We've tried, tested and written unbiased reviews of the best online therapy programs including Talkspace, Betterhelp, and Regain. 5 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Pagura J, Stein M, Bolton J, Cox B, Grant B, Sareen J. Comorbidity of borderline personality disorder and posttraumatic stress disorder in the U.S. population. J Psychiatr Res. 2010;44(16):1190-8. doi:10.1016/j.jpsychires.2010.04.016 May JM, Richardi TM, Barth KS. Dialectical behavior therapy as treatment for borderline personality disorder. Ment Health Clin. 2016;6(2):62-67. doi:10.9740/mhc.2016.03.62 Steil R, Dyer A, Priebe K, Kleindienst N, Bohus M. Dialectical behavior therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study of an intensive residential treatment program. J Trauma Stress. 2011;24(1):102-6. doi:10.1002/jts.20617 Bohus M, Kleindienst N, Hahn C, et al. Dialectical behavior therapy for posttraumatic stress disorder (Dbt-ptsd) compared with cognitive processing therapy (Cpt) in complex presentations of ptsd in women survivors of childhood abuse: a randomized clinical trial. JAMA Psychiatry. Published online July 22, 2020. doi:10.1001/jamapsychiatry.2020.2148 Bohus M, Priebe K. DBT-PTSD: A treatment programme for complex PTSD after childhood abuse. In M. A. Swales (Ed.), The Oxford handbook of dialectical behaviour therapy. 2019: 815–844. Oxford University Press. Additional Reading Linehan MM. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: Guilford Press; 1993. By Matthew Tull, PhD Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for PTSD Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.