Mechanisms of change in dialectical behaviour therapy for people with borderline personality disorder

This paper reviews current knowledge on mechanisms of change targeted in dialectical behaviour therapy for people with borderline personality disorder. Improvements in emotion regulation capacity and the use of coping skills or mindfulness skills helping patients to downregulate emotional reactions and to cope with stressful situations seem to play important roles. In addition, strong therapeutic relationships, where therapists use high levels of validation, seem equally beneficial for treatment outcomes. When therapists actively install hope in their patients and foster the capacity of hopeful thinking in other ways, long-term outcomes seem to improve. A growing body of evidence shows us how neurobiological and epigenetic change in brain regions important to emotion regulation and behaviour control correspond with more favourable treatment outcomes.