Dialectical Behavior Therapy vs. Mentalization-Based Therapy: What are the Differences?

Dialectical Behavior Therapy (DBT) and Mentalization-Based Therapy (MBT) are two therapies often used in Borderline Personality Disorder (BPD) treatment. Both strive to help those who are severely disordered and highly emotionally dysregulated to manage their emotions. But what is the difference between the two?

Dialectical Behavior Therapy (DBT)

Marsha Linehan’s initial goal in developing Dialectical Behavior Therapy was to address the needs of suicidal women, but she discovered she was working almost exclusively with clients who had Borderline Personality Disorder. DBT treats BPD based on the understanding that it is caused by a combination of biological and environmental influences.

DBT provides the tools needed to reduce the intensity of your emotions and impulsivity in your daily life so you can improve your relationships and make good decisions for yourself. DBT was extensively tested and established as an effective treatment in the 1980s, and has continued to evolve.

Here is some more information about Dialectical Behavior Therapy:

  • DBT focuses on teaching skills to tolerate distress, stabilize emotions, be more mindful, and maintain healthier relationships. These DBT skills are reinforced in individual therapy and DBT skills classes.
  • While in DBT treatment, you will track your emotions, impulses, urges, and any substance use (including alcohol, drugs, and caffeine) on a daily basis.
  • Phone coaching with a DBT therapist provided between sessions and DBT skills groups can help you use skills to get through difficult moments.
  • DBT therapists work in a team to keep them supported so they can effectively help clients and receive support themselves.
  • DBT has undergone several research studies during the past 20 years and continues to be found very effective in each.

Mentalization-Based Therapy (MBT)

Peter Fonagy expanded upon research in the field of mentalization and applied it to treatment of Borderline Personality Disorder. Mentalization helps you with the capacity to form personal attachments, which when lacking cause emotional instability and difficulty relating to others. If you did not form proper attachments in early development due to sexual, physical, or emotional abuse, you may have difficulty with self-awareness and interpreting others’ emotions and intentions.

Mentalization-Based Therapy (MBT) provides a way to increase your capacity to make personal attachments and therefore reduce the emotional intensity you experience. Initial research has proved that mentalization is effective for BPD treatment as compared to the usual treatments in the field.

Here is some more information about Mentalization-Based Therapy:

  • MBT focuses on understanding your mental state, such as emotions, feelings, and thoughts and that of others so you can manage your emotions and improve your relationships.
  • Work in sessions helps you understand the steps that trigger any episodes of extreme emotions and behaviors that occurred during the week.
  • You and your therapist decide each session what you will work on until your next meeting.
  • Initial research shows significant reduction in suicide attempts and suicidal ideation, hospitalization due to suicidal or feelings of/intent to self-harm, and trips to the emergency room.

If you are looking into BPD treatment using either Dialectical Behavior Therapy or Mentalization-Based Therapy, be sure to research both to determine which would work best for you given your diagnosis and preferences.

Tags: dbt, Dialectical Behavior Therapy, MBT, Mentalization-Based Therapy


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