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

Marsha Linehan’s Cognitive-Behavioral Treatment of Borderline Personality Disorder (1993) provides the framework of Dialectical Behavior Therapy (DBT), a treatment modality designed specifically for individuals with borderline personality disorder (BPD) and who may be a high risk for self-harm and suicide. The book details the criteria and symptoms of BPD, framing it as a disorder of emotional dysregulation that stems from a combination of biological vulnerabilities and invalidating environments. Linehan details the core components of DBT, including individual therapy, group skills classes, phone coaching, and therapist-led, DBT consultation team. She emphasizes the dialectical approach, which balances acceptance and change strategies, helping clients develop distress tolerance, emotion regulation, interpersonal effectiveness, and mindfulness skills. The book also provides guidance on structuring therapy, managing crises, and addressing high-risk behaviors such as self-harm and suicidal ideation. This text is crucial for clinicians working with BPD and has influenced a range of interventions for emotion dysregulation disorders.

As a clinical social worker who works in an agency that specializes in comprehensive DBT, this book was must a read. This text has provides guidance on how this modality is practiced to fidelity. Linehan’s text provides a framework for understanding borderline personality disorder (BPD) through the biopsychosocial lens, reinforcing the importance of considering both individual vulnerabilities and environmental factors, such as trauma and systemic invalidation. This perspective aligns with social work’s person-in-environment approach, helping me recognize how societal and relational dynamics contribute to emotional distress. The structured nature of Dialectical Behavior Therapy (DBT) has given me practical, evidence-based tools to use in session, including validation techniques, behavioral reinforcement, and balancing acceptance with change—skills that are crucial when working with clients who feel unheard or misunderstood. One of the most valuable aspects of this book is its guidance on managing high-risk behaviors, which is particularly relevant for my line of work with highly vulnerable clients. The emphasis on risk assessment, safety planning, and crisis intervention has strengthened my ability to support clients while maintaining ethical and professional boundaries. Linehan also highlights the importance of self-care and consultation with other therapists, which aligns with social work’s focus on praxis. The most impactful takeaway is the emphasis on skill-building—rather than focusing solely on pathology and problems, highlighting DBT’s strength-based approach. DBT empowers clients with everyday tools for distress tolerance, emotional regulation, mindfulness and interpersonal effectiveness. This strengths-based approach connects deeply with social work values, reinforcing my own commitment to providing compassionate, culturally appropriate, client-centered care that promotes long-term resilience, self-efficacy and well-being.