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Cited by 628Personality Disorders and PsychopathologyPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Mechanisms of change in dialectical behavior therapy: theoretical and empirical observations

Lynch, Thomas R., Chapman, Alexander L., Rosenthal, M. Zachary, Kuo, Janice R., Linehan, Marsha M.·2006·Journal of Clinical Psychology
DOI 10.1002/jclp.20243
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Abstract

Dialectical behavior therapy (DBT) can be considered a well-established treatment for borderline personality disorder (BPD) as evidenced by seven well-controlled randomized clinical trials across four independent research teams. The primary purpose of this article is to address a variety of potential mechanisms of change that may be associated with those aspects of DBT that are unique to the treatment and its theoretical underpinnings. Based on the biosocial theory of BPD, many of these mechanisms can be distilled down to the following process: the reduction of ineffective action tendencies linked with dysregulated emotions. Specifically we address the following interventions and associated mechanisms of change: mindfulness, validation, targeting and chain analysis, and dialectics. Patient change in BPD is conceptualized primarily as helping the patient to engage in functional, life-enhancing behavior, even when intense emotions are present. Ultimately, our goal was to provide guidance for theoretically and empirically grounded research on the mechanisms of change in DBT.

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113 of 113 references verified0 citation errors · 0 not checkable

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  • Decreased emotional avoidance is a hypothesized mechanism by which reduced negative reactivity improves psychological functioning.

    “A hypothesized mechanism through which decreased negative reactivity may lead to improvements in psychological functioning is decreased emotional avoidance.”

    From The role of negative affectivity and negative reactivity to emotions in predicting outcomes in the unified protocol for the transdiagnostic treatment of emotional disorders (2012) · cites this paper as Lynch, Chapman, Rosenthal, Kuo & Linehan, 2006

  • DT skills facilitate an improvement in conscious control over attentional processes, emotional and rational thinking integration, and a sense of unity with themselves.

    “These skills facilitate an improvement in conscious control over attentional processes, emotional and rational thinking integration, and a sense of unity with themselves (Linehan, 1993; Lynch et al., 2006).”

    From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006

  • Mindfulness skills could address avoidance and safety behaviors by changing emotion-linked automatic responses and fear, allowing individuals to acquire new responses.

    “Mindfulness skills could address these factors by changing emotion-linked automatic responses and fear, allowing individuals to acquire new responses (Lynch et al., 2006), and, thus, disrupting avoidance and safety behaviors.”

    From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006

  • Increases in mindfulness lead to increased executive and attentional control, and as mindfulness skills improve so does the ability to control and direct attention.

    “Extant research highlights increases in mindfulness lead to increased executive and attentional control and as mindfulness skills improve so does the ability to control and direct attention (Lynch et al., 2006).”

    From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006

  • DBT may increase perceived control, reduce self-focused attention and improve control over attentional processes, fostering a sense of ownership and behavioral acceptance in individuals with SAD.

    “Lynch and colleagues (Lynch et al., 2006) found DBT may increase perceived control, reduce self-focused attention and improve control over attentional processes, fostering a sense of ownership and behavioral acceptance in individuals with SAD.”

    From Can dialectical behavior therapy skills group treat social anxiety disorder? A brief integrative review (2024) · cites this paper as Lynch et al., 2006

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Authors
Lynch, T. R., Chapman, A. L., Rosenthal, M. Z., Kuo, J. R., & Linehan, M. M.
Affiliations
  • Duke University (US)
  • University of Washington (US)
  • Duke Medical Center (US)
Corresponding author
Lynch, Thomas R.
ORCID
Venue
Journal of Clinical Psychology
Publisher
Wiley
Published
2006-02-09
Volume
62
Issue
4
Pages
459-480
ISSN
  • 0021-9762 (ISSN-L)
  • 1097-4679
DOI
10.1002/jclp.20243
OpenAlex
W2136654837
Cited by
628
References
110
Citations by year
2026: 19 · 2025: 29 · 2024: 31 · 2023: 34 · 2022: 30 · 2021: 64 · 2020: 39 · 2019: 27 · 2018: 23 · 2017: 32 · 2016: 42 · 2015: 33 · 2014: 33 · 2013: 30 · 2012: 23
FWCI
29.85
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Journal of Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
Funders
National Institute of Mental Health (MH-34486, R01MH034486, K23 MH01614-01A3, K23MH001614)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
dialectical behavior therapy, mechanisms of change, borderline personality disorder, biosocial theory, mindfulness, validation, targeting, chain analysis, dialectics, emotional dysregulation, functional behavior
MeSH terms
Affect, Behavior Therapy, Borderline Personality Disorder, Cognition, Defense Mechanisms, Humans, Psychological Theory, Empirical Research

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