North Texas DBT Associates treats adults with borderline personality disorder (BPD) through Comprehensive DBT, by telehealth anywhere in Texas. Every Comprehensive DBT client has all four parts of the program: weekly individual therapy, a weekly skills training group, phone coaching between sessions, and a therapist who meets with our DBT consultation team every week.
What borderline personality disorder is
The National Institute of Mental Health describes BPD as a serious mental illness that affects how a person feels about themselves and other people, and makes everyday life hard to manage. It often shows up as emotions that swing fast and hard, a sense of self that keeps shifting, relationships that move from very close to very painful, and a strong fear of being left [1].
Other signs NIMH lists include chronic feelings of emptiness, intense anger, impulsive or risky behavior, self-harm, and recurring thoughts of suicide [1]. Not everyone has all of them, and they vary from person to person. NIMH estimates that 1.4% of U.S. adults had BPD in the past year [2], which works out to about 1 adult in 70.
BPD often comes with other conditions, such as depression, PTSD, anxiety, substance use or eating disorders [1]. That overlap is one reason a full assessment matters before treatment starts.
Why Comprehensive DBT for BPD
Dialectical behavior therapy was developed by Dr. Marsha Linehan specifically for people with borderline personality disorder [1]. It teaches skills to manage intense emotions, reduce self-destructive behavior and improve relationships, and it pairs those skills with individual therapy that keeps the work pointed at what matters most in your life.
The research behind it is the deepest of any therapy for BPD. A 2020 Cochrane review pooled 75 randomized trials with 4,507 participants and found that DBT was the subject of about a third of them, more than any other approach. Compared with usual care, DBT reduced BPD severity and self-harm and improved day-to-day functioning [3]. The same review found mentalization-based treatment also helped, and rated much of the evidence as low quality, so DBT is the most studied option rather than the only one.
Two trials led by Linehan show why the full program matters:
- In a two-year trial, women with BPD and recent suicidal behavior who received Comprehensive DBT were half as likely to make a suicide attempt as women treated by community experts, and had fewer hospital stays and emergency room visits [4].
- In a 2015 trial of 99 women with BPD, standard DBT with both individual therapy and the skills group had half the dropout of individual therapy without the group (24% against 48%) [5].
These results come from treatment delivered with all four parts in place. That is the program we run.
DBT started with BPD, and it goes further
DBT was built for BPD, but people come to us for many other reasons too, including suicidal thoughts, self-harm, trauma and PTSD, and emotions that feel impossible to control. You do not need a BPD diagnosis to start DBT with us. See What is DBT? for the conditions it has been studied for, and Is DBT only for borderline personality disorder? for a fuller answer.
If you have BPD and PTSD, your individual therapist can add the DBT Prolonged Exposure (DBT PE) protocol once you have the stability to start, so trauma is treated inside DBT [6].
What BPD treatment looks like at North Texas DBT Associates
- Assessment first. Your intake looks at what is happening now, your history, and any other conditions, and we talk through whether Comprehensive DBT fits.
- Weekly individual therapy. You keep a diary card through the week, and sessions work through problems in a set order, starting with anything that puts your life at risk.
- Weekly skills group. Mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. Behavioral Tech, the training institute Linehan founded, sets the full skills curriculum at 24 weeks [7].
- Phone coaching between sessions, so you can use a skill when the hard moment is actually happening.
- A consultation team that every DBT therapist here meets with weekly.
- How long it takes. Comprehensive DBT is often planned as a year. In a 2022 trial of 240 adults with BPD, 6 months of Comprehensive DBT did as well as 12 months on self-harm [8]. Your therapist will plan the length with you.
Our clinicians are led by Courtney Hicks, MS, LMFT-Supervisor, DBT-Linehan Board of Certification, Certified Clinician™. Meet the team.
Fees
We are a private-pay practice with a sliding scale. See Our Fees for current rates and the sliding scale.
Find out if DBT is right for you
Call (817) 214-7200, email info@ntxdbt.com, or use our contact form to request an intake. We will answer your questions and help you decide on the next step.
In crisis? Call or text 988 to reach the 988 Suicide and Crisis Lifeline, or chat at 988lifeline.org. It is free, confidential and open at any hour. If you are in immediate danger, call 911.
Frequently asked questions
Can BPD be treated?
Yes. NIMH says evidence-based treatments help many people with BPD have fewer and less severe symptoms, function better and have a better quality of life, and that psychotherapy is the primary treatment [1].
Is DBT the only treatment for BPD?
No. DBT has the most trials behind it, and the 2020 Cochrane review also found benefit from mentalization-based treatment [3]. NIMH lists cognitive behavioral therapy as another option [1]. Your assessment is where we look at what fits you.
Does medication treat BPD?
NIMH says the benefits of medication for BPD are unclear and that it is not a first-line treatment, though a prescriber may add it for specific symptoms or co-occurring conditions such as depression [1].
Can I do DBT for BPD by telehealth?
Yes. Our individual sessions, skills group and phone coaching are all available by telehealth to adults anywhere in Texas.
Do I need a BPD diagnosis to start?
No. You can start the conversation without one. The intake assessment is where diagnosis gets looked at.
Sources
- National Institute of Mental Health. Borderline Personality Disorder. https://www.nimh.nih.gov/health/publications/borderline-personality-disorder
- National Institute of Mental Health. Personality Disorders statistics. https://www.nimh.nih.gov/health/statistics/personality-disorders
- Storebø, O. J., et al. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 5, CD012955. https://doi.org/10.1002/14651858.CD012955.pub2
- Linehan, M. M., et al. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757-766. https://doi.org/10.1001/archpsyc.63.7.757
- Linehan, M. M., et al. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475-482. https://doi.org/10.1001/jamapsychiatry.2014.3039
- Harned, M. S., Korslund, K. E., and Linehan, M. M. (2014). A pilot randomized controlled trial of Dialectical Behavior Therapy with and without the Dialectical Behavior Therapy Prolonged Exposure protocol for suicidal and self-injuring women with borderline personality disorder and PTSD. Behaviour Research and Therapy, 55, 7-17. https://doi.org/10.1016/j.brat.2014.01.008
- Behavioral Tech Institute. What is DBT? https://behavioraltech.org/dialectical-behavior-therapy-dbt/
- McMain, S. F., et al. (2022). The effectiveness of 6 versus 12 months of dialectical behavior therapy for borderline personality disorder: a noninferiority randomized clinical trial. Psychotherapy and Psychosomatics, 91(6), 382-397. https://doi.org/10.1159/000525102