Video | 01:48:00

Dialectical Behavior Therapy

by Marsha Linehan

Watch Marsha Linehan, founder of Dialectical Behavior Therapy (DBT), in action in this session with a middle-aged man with a significant personality disorder struggling with suicidal depression and anger after being left by his girlfriend.

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Enjoy this rare opportunity to watch a true pioneer in action. Marsha Linehan, PhD, the creator of Dialectical Behavior Therapy (DBT), is best known for her success with suicidal and highly complex clients. The amount of evidence-based research surrounding DBT is tremendous; not only in its application with Borderline Personality Disorder, but also with many other hard-to-treat conditions.

In this video, watch Linehan demonstrate her approach with an extremely challenging client who manifests significant Axis II issues. This middle-aged man, brilliantly portrayed by Dutch actor Henk Grashuis, is struggling with depression, suicidal ideation, anger, and a sense that he has been treated unfairly by his ex-girlfriend—all of which is hidden behind a brittle defensiveness. You’ll see Linehan conducting an initial behavioral assessment, interspersed with DBT techniques, including her use of dialectics, irreverence, “validating the valid,” and an emphasis on client choice. While the client works to keep his worst behaviors hidden from Linehan, and is reluctant to commit to any treatment, Linehan carefully, cleverly, and matter-of-factly garners necessary information about him, assesses his suicidality and history of domestic violence, helps him define and commit to his goals, and builds an appropriate initial alliance. You’ll be impressed by how much she accomplishes in a single session!

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“Marsha Linehan’s work is searing. It leaves an indelible mark on your view of effective psychotherapy. Her irreverence wakes you up and her compassion is abundant. Keeping things rational, direct and practical is at the core of Marsha’s wisdom. This DBT training tape is extraordinary."
- Shelley McMain, PhD, Head, Borderline Personality Disorder Clinic, University of Toronto

"This video provides a concise, lucid review by Linehan of the origins and nature of DBT, making clear both its essential cognitive-behavioral core but also and most especially the differences. An initial assessment session illustrates a functional analysis of a patient’s problem, and Linehan’s interpolated comments about why she was doing a particular thing are especially helpful in understanding her thinking and strategizing. Overall a very useful training video by a master clinician and scientist."
- Gerald C. Davison, PhD, Professor of Psychology and Gerontology, University of Southern California

"Linehan provides the viewer with a concise yet thorough overview of the history and development of DBT as well as an update on the latest scientific advances supporting the treatment's efficacy. This discussion is nicely complemented by a clinical demonstration that allows viewers to see elements of DBT in action. The demonstration nicely highlights the importance of a behavioral assessment in DBT while also showcasing the unique interpersonal style of the DBT therapist that is active, matter-of-fact, and can have the effect of keeping the client slightly off balance throughout the session."
- Jamie Bedics, PhD, Director of DBT Training Program, California Lutheran University

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Perhaps no therapist of the last several decades has so influenced current practice as Marsha Linehan. Though she does a great deal of teaching and training, opportunities to see her practicing with a client in a full-length session are few and far between. Therapists, DBT practitioners, and newcomers alike will relish this rare opportunity.

In this initial session, Linehan works with a fascinating and difficult client. He makes it clear that he is actively suicidal, has little faith in therapy, and is not necessarily committed to treatment. He bobs and weaves as Linehan works with him, concealing some of the most damaging aspects of his own past behaviors and painting himself as an angry and wounded victim. With her upfront and frank style, Linehan defines the client’s goals, makes clear to him which behaviors must change immediately, and gets him to agree to postpone suicidality in favor of further investigating her treatment. Throughout the session, Linehan gives voiced-over explanations of why she made certain choices and what compelled her towards different interventions. Prepare to be fascinated, both by the client and by Linehan!

Note: This video is part of a series, Three Approaches to Personality Disorder. The other two forthcoming titles will feature psychoanalyst Otto Kernberg and CBT expert Art Freeman conducting sessions with the same client. These two titles will be released in 2013.

By watching this video, you will learn: