Living the Paradox: Finding Balance in Dialectical Dilemmas

Length
2 hour

CE Credit
2.0 unit

Recorded
May 30, 2025

Dialectical behavior therapy (DBT) is an evidence-based treatment designed to reduce self-injurious behaviors, decrease suicide risk, and enhance skillful behavior.

This training reviews the three main dialectical dilemmas established by Marsha Linehan that client’s receiving DBT experience. This training also reviews how these dilemma’s show up in session with clients, and how providers can effectively treat them with clients. 

Training Options

There are several ways to learn from this training. You can either watch the recording for free or take the self-paced course for CE credit. We also have the slides available to download. 

Watch Recording

(Free) You can watch the full recording of this training for free on our YouTube Channel. This is perfect if you’re not seeking CE credit or would like to preview the training before taking the course.

($37) You can receive 2 hours of self-paced, asynchronous CE credit for this training.

UCEBT is approved by the American Psychological Association to sponsor continuing education for psychologists. UCEBT maintains responsibility for this program and its content.

Additionally, this presentation is approved for 2 hours of home-study CE credit through NASW-UTUAMFT, and UMHCA.

Follow along with the recording by downloading the presentation slides personal use.

However, please note that no part of the materials available through the Utah Center for Evidence Based Treatment may be copied, photocopied, reproduced, translated or reduced to any electronic medium or machine-readable form, in whole or in part, without prior written consent of the presenter and creator of the presentation. Contact info@ucebt.com for questions.

About This Training

At the conclusion of this presentation, attendees should be able to describe the three main dialectical dilemmas experienced by clients receiving DBT treatment, and understand how to communicate and treat them effectively in session with clients.  

Learning Objectives: 

  1. Identify the three main dialectical dilemmas established by Marsha Linehan.
  2. Recognize how the dilemmas manifest in therapy sessions.
  3. Communicate the dilemmas to clients effectively
  4. Apply therapeutic strategies to address the dilemmas with clients.

About the Presenter

Rebecca Price, LCSW received her master’s degree in social work from the University of Georgia. Rebecca received foundational training in DBT from Behavior Tech, and worked as an individual and group therapist for a residential and outpatient DBT program in Atlanta, Georgia where she received further training and supervision in DBT. Rebecca now specializes in dialectical behavioral therapy.

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References

Behavioral Tech. (n.d.). Identifying and treating dialectical dilemmas in DBT (Part 1). Retrieved May 29, 2025, from https://behavioraltech.org/dialectical-dilemmas-dbt-part-1/

Cheung, R. Y. M., & Park, I. J. K. (2014). Anger suppression, interdependent self-construal, and depression among Asian American and European American college students. Cultural Diversity and Ethnic Minority Psychology, 20(3), 409–418. https://doi.org/10.1037/a0035326

DBT Vancouver. (n.d.). Emotion vulnerability and self-invalidation. Retrieved May 29, 2025, from https://dbtvancouver.com/emotion-vulnerability-and-self-invalidation/

Dimeff, L. A., Rizvi, S. L., & Koerner, K. (2021). Dialectical behavior therapy in clinical practice: Applications across disorders and settings (2nd ed.). The Guilford Press.

Farmer, R. F., & Chapman, A. L. (2016). Behavioral interventions in cognitive therapy: Practical guidance for putting theory into action (2nd ed.). American Psychological Association. https://doi.org/10.1037/14862-000

FRTC. (n.d.). The crucial role of validation in dialectical behavior therapy (DBT). Retrieved May 29, 2025, from https://frtc.ltd/dbtnews/the-crucial-role-of-validation-in-dialectical-behavior-therapy-dbt

Gonzalez, A., Andover, M. S., & Zvolensky, M. J. (2019). Cultural considerations in the dialectical behavior therapy conceptualization of suicidal behavior. The Cognitive Behaviour Therapist, 12, e5. https://doi.org/10.1017/S1754470X18000134

Heard, H. L., & Swales, M. A. (2016). Changing behavior in DBT: Problem solving in action. Guilford Press.

Klass, D., & Chow, A. Y. M. (2011). Culture and grief. Omega: Journal of Death and Dying, 64(3), 183–192. https://doi.org/10.2190/OM.64.3.a

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

Linehan, M. M. (1993). Skills training manual for treating borderline personality disorder. New York, NY: Guilford Press.

Miller, A. L., Rathus, J. H., & Linehan, M. M. (2007). Dialectical behavior therapy with suicidal adolescents. Guilford Publications.

Nickerson, A., Bryant, R. A., Silove, D., & Steel, Z. (2014). A critical review of psychological treatments of posttraumatic stress disorder in refugees. Clinical Psychology Review, 34(7), 482–494. https://doi.org/10.1016/j.cpr.2014.06.004

Psychotherapy Academy. (n.d.). Active passivity and apparent competence: The dialectical dilemma. Retrieved May 29, 2025, from https://psychotherapyacademy.org/section/active-passivity-vs-apparent-competence/

Psychotherapy Academy. (n.d.). Unrelenting crisis and inhibited grieving: Avoidance reinforced in a dialectical dilemma. Retrieved May 29, 2025, from https://psychotherapyacademy.org/section/unrelenting-crisis-vs-inhibited-grieving/

Rosenblatt, P. C. (2008). Grief across cultures: A review and research agenda. Bereavement Care, 27(3), 38–39. https://doi.org/10.1080/02682620808657684

Sayrs, J. H. R., & Linehan, M. M. (2019). DBT teams: Development and practice. The Guilford Press.

U.S. Department of Veterans Affairs. (n.d.). DBT visual review graphic handouts. VISN 16 Mental Illness Research, Education, and Clinical Center. Retrieved May 29, 2025, from https://www.mirecc.va.gov/visn16/docs/DBT_Visual_Review_Graphic_Handouts.pdf

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