top of page



Dialectical Behavior Therapy (DBT) was developed by Marsha Linehan when she combined cognitive behavioral/change therapeutic principles with a philosophy of acceptance and focusing on this moment. The result is an empirically- based, structured protocol that includes individual therapy, skills training groups, coaching in crisis (phone, text or e-mail consultation between sessions, case management etc) and consultation team (for clinicians and other DBT providers). It may also include additional modes of therapy (that may include inpatient treatment, psychopharmacology etc). Although originally designed to help individuals who are self harming or suicidal, DBT has been adapted for individuals of all ages with a wide array of behaviors (including substance abuse, anxiety driven behaviors, mood dysregulation, aggression, risk taking behaviors) that are understood as helping the person regulate painful emotions.

The goal of DBT treatment is to help individuals who live with emotional pain to develop a life worth living. This is done in a collaborative, transparent treatment in which the clinician accepts that the unsafe or dangerous behaviors are being used to manage pain while helping the person replace those behaviors with healthier and safer behaviors.

Dialectics (in Dialectical Behavior Therapy) refers to the ability to hold two truths that seem like opposites and accept that they both may be true or valid. The Core Dialectic is that individuals are doing the best they can AND individuals need to change.


DBT promotes the use of validation (acceptance) and non-judgmental language as a way to acknowledge the feelings of another person, and take him/her seriously, given the circumstances of his/her life, even if you disagree with him/her. Acceptance is balanced with the expectation that an individual can change. Acceptance is necessary for change. It seems that people will listen more when they feel they are being heard.


To watch a video about Validation that Pat created for the Mental Health Association of Southeastern Pennsylvania click the play button below.

DBT Treatment fulfills the following functions:

  • Improving Motivation to change by gaining and maintaining commitment to changing unhealthy behaviors that may help meet immediate needs and that also have longer term negative consequences

  • Enhancing Capabilities by teaching and reinforcing the use of new skills

  • Ensuring Skill Generalization by coaching individuals to use skills in their environment and by encouraging practice and completion of homework

  • Structuring the environment by helping parents to developing a safe, validating and non-judgmental environment that reinforces healthy behaviors and lessens reactivity to unhealthy behaviors.

  • Improving therapists’ motivation and capabilities by providing a learning and validating environment for therapists


"Structuring the environment" may take place when parents, caregivers and other supportive family members learn DBT skills and effectively implement those skills in support of their loved ones. Parents and other family members can de-escalate emotionally intense situations by validating their loved one and remaining calm themselves. They can also learn to reinforce and respond positively to adaptive and healthy behaviors and to be less responsive to unsafe behaviors. While change is up to each individual, and up to the person who is having difficulties, change in family members may lead to different responses and different behaviors from their loved ones over time.

The various modes of treatment that help to fulfill the above functions and that define comprehensive DBT treatment include:

  • Individual therapy

  • Skills Training Groups

  • Telephone/Crisis Coaching

  • Consulting with family and other environments to encourage the reinforcement of healthy/adaptive behaviors

  • Consultation Team


Skills Training involves learning skills that increase:

  • Mindfulness - awareness of self and others in the moment, learning how to be non-judgmental and do what is effective (what works) by thinking wisely rather than emotionally

  • Emotion Regulation - awareness of emotions, how they develop and how their intensity can be reduced

  • Distress Tolerance - how to manage difficult situations without making them worse and also learning how to accept life in this moment when it cannot be changed

  • Interpersonal Effectiveness - learning how to ask for things skillfully while maintaining relationships and self-respect

  • Finding the Middle Path/Balanced Family and Parenting Responses - by learning how to think dialectically, validate (to show acceptance)  and use behavioral principles to bring about change


Many parents and family members find the Distress Tolerance skills helpful in managing stressful situations in ways that do not make the situation worse. Skills include learning to distract from painful emotions by engaging in pleasant or soothing activities. Distress Tolerance skills also help individuals to accept the life they have even if it is not the life they want. Acceptance of painful situations, even if you don’t like them, enables individuals to move from suffering to problem solving and allows him/her to find opportunities for change

DBT skills help everyone who learns them how to develop a non-judgmental awareness of this moment, find ways to distract and self-soothe when life becomes difficult, find a balanced approach to parenting and to life, and develop the most effective strategies to help him/her develop the life he/she wants to have. Its benefits go way beyond its original intentions and help those who learn the skills and strategies to live ever more meaningful and fulfilling lives.

"Focus on the moment without worries about the future or regrets about the past."


1. Dialectics: What is it? 

2. Validating and Invalidating Behaviors in Families

3. Thinking Non-Judgmentally 

4. Balanced and Effective Parenting






Pat talks to Neil D. Brown on Google Hangouts about Parenting.

To hear a podcast of Pat's interview with ADAA in which she talks about DBT skills with children, adolescents, and parents click the button below.

Articles co-authored by Pat

Harvey, P. and Ahmann E. “Validation: A Family-Centered Communication Skill”, Pediatric Nursing, May/June, 2014

Penzo, J., and Harvey, P. “Understanding Parental Grief as a Response to Mental Illness: Implications for Practice”. Journal of Family Social Work, 2008

To read an article about parenting young children in Washington Parent Magazine, May, 2015,  in which Pat is quoted, click on the link below:
Stopping Temper Tantrums: Helping Your Child Deal with Strong Emotions


Web resources for parents and family members

National Alliance on Mental Illness ( Family-to-Family Programs; peer-to-peer programs, In 
Our Own Voices (personal stories that help build awareness of mental illness), support groups for family 
members and consumers, and advocacy. – DBT official website, provides information on trainings

NEA-BPD Family Connections Classes:
The Director is Perry Hoffman. This website also provides audio and video trainings and presentations 
about DBT and other treatments.

TARA Treatment and Research Advancement: National Association for Personality Disorder: DBT Family 
Workshops: The Director is Valerie Porr.

Books for parents and family members:
*“Loving Someone with Borderline Personality Disorder” by Shari Manning

  • “Acquainted with the Night” by Paul Raeburn

  • “The Buddha and the Borderline” by Kiera Van Gelder

  • “Mania” by Terri Cheney (to go inside the mind of someone when she is manic)

  • “The Burden of Sympathy” by David Karp

  • “I hate you...Don't leave me” (early) and “Sometimes I act crazy” (new) by Jerold Kreisman

  • “The Essential Family Guide to Borderline Personality Disorder” by Randi Kreger

  • “Stop Walking on Eggshells” by Paul Mason and  Randi Kreger

  • “Will's Choice” by Gail Griffith

  • “Understanding and Treating Borderline Personality Disorder” by John Gunderson and Perry Hoffman

  • “Beyond Borderline: True Stories of Recover” Edited by John Gunderson and Perry Hoffman

  • “New Hope for Children and Teens with BiPolar Disorder” by Boris Birmaher

  • “New Hope for people with Borderline Personality Disorder” by Neil Bockian

  • “Overcoming Borderline Personality Disorder: A Family Guide for Healing and Change” by Valerie Porr

  • “Wasted” and “Madness” by Marya Hornbacher

  • Workbooks by New Harbinger especially: “Don’t Let Emotions Run Your Life for teens” by Sheri Van Dijk and “Dialectical Behavior Therapy” by McKay

  • “Parenting a Child Who Has Intense Emotions” by Pat Harvey and Jeanine Penzo

  • “Parenting a Teen Who Has Intense Emotions” by Pat Harvey and Britt Rathbone

  • “I am not Sick, I Don't Need Help” by Xavier Amador

  • “An Unquiet Mind” by Kaye Jamison

  • “Blackout” by Sarah Hepola

  • “The Mindfulness Solution for Intense Emotions” by Cedar Koons

  • “The Price of Silence” by Liza Long

  • “Secret No More: A true story of hope for Parents with an Addicted Child” by Lisa Hillman


To purchase any of the books below via Amazon please click here.



bottom of page