La DBT, sviluppata da Marsha M. Linehan, professore di Psicologia Clinica presso la Washington University di Seattle (USA), è un trattamento cognitivo-comportamentale complesso originariamente sviluppato per soggetti a grave rischio suicidario che in seguito è stato specificamente applicato a soggetti che soffrono di disturbo borderline di personalità.

La ricerca empirica ha ampiamente dimostrato l’efficacia della DBT nel disturbo borderline di personalità soprattutto nel ridurre i comportamenti suicidari, i ricoveri in ambiente psichiatrico, l’abbandono delle cure, l’abuso di sostanze, la disregolazione emozionale e le difficoltà interpersonali.

In seguito la DBT è stata adattata ad altre condizioni psicopatologiche in cui la disregolazione emozionale gioca un ruolo importante quali la dipendenza da sostanze e da alcol, i disturbi del comportamento alimentare (bulimia, binge eating), la suicidarietà nell’adolescenza, la depressione nell’anziano.

Marsha Linehan

Marsha M. LinehanMarsha M. Linehan, nata nel 1943, è professoressa di Psicologia Clinica presso la University of Washington di Seattle (USA) dove inoltre dirige la Behavioral Research and Therapy Clinic (BRTC). Partendo dalla psicoterapia comportamentale ha messo a punto, nel corso degli anni, un sistema terapeutico denominato Dialectical Behavior Therapy (DBT) in cui confluiscono in maniera organica varie componenti tra cui la mindfulness. La DBT, nata dall’interesse per soggetti gravemente suicidari, si è in seguito affermata come uno dei trattamenti di maggiore efficacia per il disturbo borderline, ma anche per i disturbi del comportamento alimentare e per le dipendenze da sostanze. Peculiarità della DBT è di essere un sistema fondato sulla ricerca scientifica empirica, e di svilupparsi sulla base dei risultati della ricerca stessa. In sintesi, Marsha Linehan ha saputo, e ciò è ampiamente documentato sia dai manuali che dalle decine di lavori scientifici pubblicati su riviste di alto livello, creare un nuovo modo di trattare gravi condizioni di sofferenza psicologica integrando clinica e scienza.

Marsha at University of Washington
Marsha at BehavioralTech

Biblioteca DBT

Manuali DBT

Bibliografia essenziale

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  • Cognitive-behavioral treatment of chronically parasuicidal borderline patients

    Linehan MM, Armstrong HE, Suarez A, Allmon D, Heard HL
    Arch Gen Psychiatry. 1991 Dec;48(12):1060-4.
  • Dialectical behavior therapy for borderline personality disorder: theoretical and empirical foundations

    Acta Psychiatr Scand Suppl. 1994;379:61-8.
    Arch Gen Psychiatry. 1991 Dec;48(12):1060-4.
  • Naturalistic follow-up of a behavioral treatment for chronically parasuicidal borderline patients.

    Linehan MM, Heard HL, Armstrong HE.
    Arch Gen Psychiatry. 1993 Dec;50(12):971-4.
  • Dialectical behavior therapy for treatment of borderline personality disorder: implications for the treatment of substance abuse.

    Linehan MM.
    NIDA Res Monogr. 1993;137:201-16.
  • Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence.

    Linehan MM, Schmidt H 3rd, Dimeff LA, Craft JC, Kanter J, Comtois KA.
    Am J Addict. 1999 Fall;8(4):279-92.
  • Dialectical behavior therapy–family skills training.

    Hoffman PD, Fruzzetti AE, Swenson CR.
    Fam Process. 1999 Winter;38(4):399-414.
  • Dialectical behavior therapy for personality disorders.

    Rizvi SL, Linehan MM.
    Curr Psychiatry Rep. 2001 Feb;3(1):64-9.
  • Efficacy of dialectical behavior therapy in women veterans with borderline personality disorder.

    Koons CR, Robins CJ, Tweed JL, Lynch TR, Gonzalez AM, Morse JQ, et Al.
    Behav Ther. 2001 32: 371-390
  • Effectiveness of inpatient dialectical behavioral therapy for borderline personality disorder: a controlled trial.

    Bohus M, Haaf B, Simms T, Limberger MF, Schmahl C, Unckel C, Lieb K, Linehan MM.
    Behav Res Ther. 2004 May;42(5):487-99.
  • Dialectical behaviour therapy for women with borderline personality disorder: 12-month, randomised clinical trial in The Netherlands.

    Verheul R, Van Den Bosch LM, Koeter MW, De Ridder MA, Stijnen T, Van Den Brink W.
    Br J Psychiatry. 2003 Feb;182:135-40.
  • Dialectical behavior therapy for depressed older adults: a randomized pilot study.

    Lynch TR, Morse JQ, Mendelson T, Robins CJ.
    Am J Geriatr Psychiatry. 2003 Jan-Feb;11(1):33-45.
  • Dialectical Behavior Therapy of borderline patients with and without substance use problems. Implementation and long-term effects.

    van den Bosch LM, Verheul R, Schippers GM, van den Brink W.
    Addict Behav. 2002 Nov-Dec;27(6):911-23.
  • Sustained efficacy of dialectical behaviour therapy for borderline personality disorder.
    van den Bosch LM, Koeter MW, Stijnen T, Verheul R, van den Brink W.
    Behav Res Ther. 2005 Sep;43(9):1231-41.
  • Dialectical behavior therapy: current status, recent developments, and future directions.

    Robins CJ, Chapman AL.
    J Pers Disord. 2004 Feb;18(1):73-89.
  • Mechanisms of change in dialectical behavior therapy: theoretical and empirical observations.

    Lynch TR, Chapman AL, Rosenthal MZ, Kuo JR, Linehan MM.
    J Clin Psychol. 2006 Apr;62(4):459-80.
  • Family connections: a program for relatives of persons with borderline personality disorder.

    Hoffman PD, Fruzzetti AE, Buteau E, Neiditch ER, Penney D, Bruce ML, Hellman F, Struening E.
    Fam Process. 2005 Jun;44(2):217-25.
  • Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder.

    Linehan MM, Comtois KA, Murray AM, Brown MZ, Gallop RJ, Heard HL, Korslund KE, Tutek DA, Reynolds SK, Lindenboim N.
    Arch Gen Psychiatry. 2006 Jul;63(7):757-66.
  • Olanzapine plus dialectical behavior therapy for women with high irritability who meet criteria for borderline personality disorder: a double-blind, placebo-controlled pilot study.

    Linehan MM, McDavid JD, Brown MZ, Sayrs JH, Gallop RJ.
    J Clin Psychiatry. 2008 Jun;69(6):999-1005.
  • Dialectical behavior therapy for clients with binge-eating disorder or bulimia nervosa and borderline personality disorder.

    Chen EY, Matthews L, Allen C, Kuo JR, Linehan MM.
    Int J Eat Disord. 2008 Sep;41(6):505-12.
  • Dialectical behavior therapy for borderline personality disorder.

    Lynch TR, Trost WT, Salsman N, Linehan MM.
    Annu Rev Clin Psychol. 2007;3:181-205.
  • Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: a 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

    Harned MS, Chapman AL, Dexter-Mazza ET, Murray A, Comtois KA, Linehan MM.
    J Consult Clin Psychol. 2008 Dec;76(6):1068-75.
  • Do improvements after inpatient dialectial behavioral therapy persist in the long term? A naturalistic follow-up in patients with borderline personality disorder.

    Kleindienst N, Limberger MF, Schmahl C, Steil R, Ebner-Priemer UW, Bohus M.
    J Nerv Ment Dis. 2008 Nov;196(11):847-51.
  • Dialectical behavior therapy for substance abusers.

    Dimeff LA, Linehan MM.
    Addict Sci Clin Pract. 2008 Jun;4(2):39-47.
  • A randomized trial of dialectical behavior therapy versus general psychiatric management for borderline personality disorder.

    McMain SF, Links PS, Gnam WH, Guimond T, Cardish RJ, Korman L, Streiner DL.
    Am J Psychiatry. 2009 Dec;166(12):1365-74. Epub 2009 Sep 15.
  • Dialectical behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder.

    Neacsiu AD, Rizvi SL, Linehan MM.
    Behav Res Ther. 2010 Sep;48(9):832-9. Epub 2010 May 23.
  • Dialectical behavior therapy versus general psychiatric management in the treatment of borderline personality disorder.

    Case BG.
    Am J Psychiatry. 2010 Apr;167(4):475; author reply 475-6.
  • Outcome from a randomized controlled trial of group therapy for binge eating disorder: comparing dialectical behavior therapy adapted for binge eating to an active comparison group therapy.

    Safer DL, Robinson AH, Jo B.
    Behav Ther. 2010 Mar;41(1):106-20. Epub 2010 Jan 25.
  • Dialectical behavior therapy for posttraumatic stress disorder related to childhood sexual abuse: a pilot study of an intensive residential treatment program.

    Steil R, Dyer A, Priebe K, Kleindienst N, Bohus M.
    J Trauma Stress. 2011 Feb;24(1):102-6. doi: 10.1002/jts.20617. Epub 2011 Feb 4.
  • Adapting Dialectical Behaviour Therapy for Children: Towards a New Research Agenda for Paediatric Suicidal and Non-Suicidal Self-Injurious Behaviours.

    Perepletchikova F, Axelrod SR, Kaufman J, Rounsaville BJ, Douglas-Palumberi H, Miller AL.
    Child Adolesc Ment Health. 2011 May 1;16(2):116-121.
  • Moderators of dialectical behavior therapy for binge eating disorder: Results from a randomized controlled trial.

    Robinson AH, Safer DL.
    Int J Eat Disord. 2011 Apr 15. doi: 10.1002/eat.20932. [Epub ahead of print]
  • Dialectical behavior therapy for suicidal adolescents with borderline personality disorder.

    Klein DA, Miller AL.
    Child Adolesc Psychiatr Clin N Am. 2011 Apr;20(2):205-16.