A dialectical behavior therapy perspective on the case of anna

Abstract

Dialectical behavior therapy (DBT; Linehan, 1993a , Linehan, 1993b ) is a cognitive-behavioral treatment designed specifically for individuals with “borderline behaviors,” particularly self-injurious and suicidal behaviors. In fact, currently it is the only psychosocial treatment for this population with published efficacy data from a randomized trial ( Linehan, Armstrong, Suarez, Allmon, & Heard, 1991 ; Linehan, Heard, & Armstrong, 1993 ; Linehan, Tutek, Heard, & Armstrong, 1994 ). My colleagues and I recently also reported superior outcomes across many areas of functioning for DBT compared to treatment as usual for borderline women veterans ( Koons, Robins, Bishop, Morse, & Lynch, 1998 ), demonstrating the transportability of this treatment. I appreciate this opportunity to present a DBT perspective on the case of Anna and look forward to the responses of others with somewhat different perspectives. My assumption is that all cognitive-behavioral perspectives have more commonalities than differences; therefore, I will attempt to highlight the ways in which DBT may be different.