Dialectical Behavior Therapy: A Brief Counseling Skill for Clinical Practice

Josh Bylotas; Mary-Katharine Cherubini; Mark A. Dixon

Jul 2025

Updated Guidelines From the Society of Critical Care Medicine Strongly Recommend Steroids for Hospitalized Adults With Severe CAP

Curbside Consultation

Dialectical Behavior Therapy: A Brief Counseling Skill for Clinical Practice

Josh Bylotas, PhD

Mary-Katharine Cherubini, MD

Mark A. Dixon, PhD

American Family Physician. 2025;112(1):88-90.

Author disclosure: No relevant financial relationships.

JOSH BYLOTAS, PHD; MARY-KATHARINE CHERU-BINI, MD; and MARK A. DIXON, PHD, Family Medicine Residency, Travis Air Force Base, California

Address correspondence to Josh Bylotas, PhD, at edward.j.bylotas.mil@health.mil.

Author disclosure: No relevant financial relationships.

1.Clement S, Schauman O, Graham T, et al. What is the impact of mental health–related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11-27.
2.Goodwin RD, Dierker LC, Wu M, et al. Trends in U.S. depression prevalence from 2015 to 2020: the widening treatment gap. Am J Prev Med. 2022;63(5):726-733.
3.Kyanko KA, Curry LA, Keene DE, et al. Does primary care fill the gap in access to specialty mental health care? A mixed methods study. J Gen Intern Med. 2022;37(7):1641-1647.
4.Linehan MM, Wilks CR. The course and evolution of dialectical behavior therapy. Am J Psychother. 2015;69(2):97-110.
5.Kothgassner OD, Goreis A, Robinson K, et al. Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychol Med. 2021;51(7):1057-1067.
6.Prillinger K, Goreis A, Macura S, et al. A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. Eur J Psychotraumatol. 2024;15(1):2406662.
7.Spong AJ, Clare ICH, Galante J, et al. Brief psychological interventions for borderline personality disorder. A systematic review and meta-analysis of randomised controlled trials. Clin Psychol Rev. 2021;83:101937.
8.Felix CB, Sand P. Feasibility and efficacy of intensive dialectical behavior therapy skills training in an outpatient setting for a group of patients with extensive care needs—a transdiagnostic approach. Psychiatr Q. 2023;94(4):691-704.
9.Ward-Ciesielski EF, Tidik JA, Edwards AJ, et al. Comparing brief interventions for suicidal individuals not engaged in treatment: a randomized clinical trial. J Affect Disord. 2017;222:153-161.
10.Valentine SE, Bankoff SM, Poulin RM, et al. The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. J Clin Psychol. 2015;71(1):1-20.
11.Brenner LA, Capaldi V, Constans J, et al. Assessment and management of patients at risk for suicide: synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines. Ann Intern Med. 2025;178(3):416-425.
12.Linehan MM. DBT Skills Training Manual. 2nd ed. Guilford Press; 2014.
13.Dialectical Behavior Therapy. Overview of DBT. January 24, 2024. Accessed February 22, 2025. https://dialecticalbehaviortherapy.com

Case scenarios are written to express typical situations that family physicians may encounter; authors remain anonymous. Send scenarios to afpjournal@aafp.org. Materials are edited to retain confidentiality.

This series is coordinated by Caroline Wellbery, MD, associate deputy editor.

A collection of Curbside Consultation published in AFP is available at https://www.aafp.org/afp/curbside.

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Updated Guidelines From the Society of Critical Care Medicine Strongly Recommend Steroids for Hospitalized Adults With Severe CAP

[afp20250700p88-b1] 1.Clement S, Schauman O, Graham T, et al. What is the impact of mental health–related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11-27.

[afp20250700p88-b2] 2.Goodwin RD, Dierker LC, Wu M, et al. Trends in U.S. depression prevalence from 2015 to 2020: the widening treatment gap. Am J Prev Med. 2022;63(5):726-733.

[afp20250700p88-b3] 3.Kyanko KA, Curry LA, Keene DE, et al. Does primary care fill the gap in access to specialty mental health care? A mixed methods study. J Gen Intern Med. 2022;37(7):1641-1647.

[afp20250700p88-b4] 4.Linehan MM, Wilks CR. The course and evolution of dialectical behavior therapy. Am J Psychother. 2015;69(2):97-110.

[afp20250700p88-b5] 5.Kothgassner OD, Goreis A, Robinson K, et al. Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis. Psychol Med. 2021;51(7):1057-1067.

[afp20250700p88-b6] 6.Prillinger K, Goreis A, Macura S, et al. A systematic review and meta-analysis on the efficacy of dialectical behavior therapy variants for the treatment of post-traumatic stress disorder. Eur J Psychotraumatol. 2024;15(1):2406662.

[afp20250700p88-b7] 7.Spong AJ, Clare ICH, Galante J, et al. Brief psychological interventions for borderline personality disorder. A systematic review and meta-analysis of randomised controlled trials. Clin Psychol Rev. 2021;83:101937.

[afp20250700p88-b8] 8.Felix CB, Sand P. Feasibility and efficacy of intensive dialectical behavior therapy skills training in an outpatient setting for a group of patients with extensive care needs—a transdiagnostic approach. Psychiatr Q. 2023;94(4):691-704.

[afp20250700p88-b9] 9.Ward-Ciesielski EF, Tidik JA, Edwards AJ, et al. Comparing brief interventions for suicidal individuals not engaged in treatment: a randomized clinical trial. J Affect Disord. 2017;222:153-161.

[afp20250700p88-b10] 10.Valentine SE, Bankoff SM, Poulin RM, et al. The use of dialectical behavior therapy skills training as stand-alone treatment: a systematic review of the treatment outcome literature. J Clin Psychol. 2015;71(1):1-20.

[afp20250700p88-b11] 11.Brenner LA, Capaldi V, Constans J, et al. Assessment and management of patients at risk for suicide: synopsis of the 2024 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines. Ann Intern Med. 2025;178(3):416-425.

[afp20250700p88-b12] 12.Linehan MM. DBT Skills Training Manual. 2nd ed. Guilford Press; 2014.

[afp20250700p88-b13] 13.Dialectical Behavior Therapy. Overview of DBT. January 24, 2024. Accessed February 22, 2025. https://dialecticalbehaviortherapy.com

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Dialectical Behavior Therapy: A Brief Counseling Skill for Clinical Practice

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