Abstract:
Borderline Personality Disorder (BPD) and disorders of emotional dysregulation represent significant
challenges in both diagnostic assessment and therapeutic management. DBT was developed to address these
core features, combining mindfulness and skills training with a therapeutic framework that emphasizes
validation and behavioral management. Randomized and observational studies consistently support DBT’s
efficacy in reducing self-harm, suicidal behaviors, emotional dysregulation, and hospitalizations, while
improvingoverall functioning. This abstract synthesizes contemporary evidence regarding DBT for BPD,
highlights mechanisms of change, and discusses implementation considerations in clinical settings and training
programs. The DBT model comprises individual therapy, group skills training, phone coaching, and a therapist
consultation team. Major randomized trials have demonstrated reductions in self-injury and suicide attempts,
decreased emergency service utilization, and improvements in global functioning and quality of life compared
with treatment-as-usual or community expert standards. Meta-analyses indicate moderate to large effects in
reducing self-harm and symptom severity, with sustained benefits during follow-up periods. Mechanistic
studies reveal improvements in emotion regulation, reduced impulsivity, optimized coping strategies, and
validation within the therapeutic relationship as mediators of therapeutic effects. DBT can be adapted to
various clinical contexts, including inpatient, day-treatment, outpatient, and integrated care models. It informs
personalized treatment planning by targeting core processes such as emotional dysregulation, distress
tolerance, mindfulness, and interpersonal effectiveness. Fidelity in implementation, quality supervision, and
adaptation of programs to resource constraints are essential for optimal outcomes. Robust research evidence
supports DBT as an evidence-based treatment for BPD, with benefits extending to comorbid conditions and
overall functioning. Future research should refine mechanisms of change, optimize treatment intensity and
delivery format, and evaluate cost-effectiveness in real-world practice.
