Considerations for the Use of Dialectical Behavior Therapy for Individuals Experiencing Oppression

As the popularity of dialectical behavior therapy (DBT) grows, so does its use with increasingly diverse groups of clients. In this article, we demonstrate that DBT in its standard form can incorporate the sequelae of oppression as a target of treatment by providing clients with skills to identify oppression and its impact while responding effectively. To support the use of DBT with individuals experiencing emotion/behavior dysregulation and oppression, we review how each of the primary strategies of DBT can be used within the context of oppression. Specifically, we discuss how dialectical philosophy, the acceptance/change dialectic, communication strategies, and case management strategies can be viewed through an oppression lens. A brief review of DBT research with historically oppressed populations and common pitfalls in treating oppressed individuals is presented. As research in examining and adapting DBT for minoritized groups continues to catch up to clinical need, guidance is presented here for researchers and clinicians interested in using this empirically supported treatment in communities that experience oppression. Clinical Impact Statement Question: How can standard dialectical behavior therapy (DBT) be used with clients who are from groups that are historically oppressed (such as people who are racially minoritized and sexually minoritized)? Findings: We discuss how each of the primary strategies of DBT can be used to incorporate the experiences of people who experience oppression while addressing treatment targets. Meaning: With the information presented in this article, clinicians should be better informed as to how to balance their desire to be adherent to DBT while also making appropriate adjustments to the treatment to incorporate their clients' identities and experiences. Next Steps: Future research should focus on the outcomes and potential modifications necessary for DBT to be effective for individuals from oppressed groups.