In Dialectical Behavior Therapy (DBT), which priority should be addressed first?

In Dialectical Behavior Therapy (DBT), addressing high-risk behaviors is of utmost priority because these behaviors pose a significant threat to the client's safety and well-being. DBT recognizes that individuals who struggle with emotional regulation may engage in self-harming behaviors or suicidal ideation, which can lead to severe consequences if not addressed immediately. By prioritizing the reduction of these high-risk behaviors, therapists can create a more stable and safe environment for the client, which is essential for the efficacy of therapy.

Once the immediate risks are mitigated, therapists can then gradually work on other important areas, such as enhancing self-respect, addressing post-traumatic stress responses, and reducing behaviors that interfere with therapy. However, the foundation of successful therapeutic work hinges on ensuring that the client is safe and that their immediate needs for stabilization are met. This hierarchical approach is critical in DBT, as it helps to build the trust and rapport necessary for more effective interventions later on.