Dialectical Behavioral Therapy (DBT) Apps: A Review

Dialectical Behavioral Therapy (DBT) is among the most widely-used and studied forms of psychotherapy. Originally developed by Marsha Linehan for the treatment of borderline personality disorder, it has subsequently been used for the treatment of a range of psychological disorders.

At its core, DBT combines the kind of cognitive methods familiar from cognitive behavioral therapy with practices of mindfulness that are more familiar from non-Western spiritual practices, notably meditation. It is structured by the philosophical concept of a dialectic that resolves itself into a synthesis. The first and most fundamental of these dialectics is between acceptance and change.

This can sound abstruse, but DBT is an eminently practical style of therapy. And its distinctive techniques lend themselves to apps. This review focuses on a handful of apps that bring DBT and its methods to users’ phones.

1. DBT Coach

Created by: Swasth Inc.

Available for: iOS, Android

DBT is a set of principles and skills. DBT Coach does a nice job of encapsulating a lot of these principles and skills into a single app. The “Lessons” sections of the app explains some central ideas of DBT, such as “wise mind”:

These explanations are generally clear and informative, and some of them incorporate short video lessons as well. The “Exercises” section allows the user to implement DBT techniques, such as methods of emotional regulation. There are some useful methods here, though many of the methods are put behind a paywall for “premium” users ($11.99 for a month’s subscription).

Interestingly, DBT Coach has already been the focus of a academic study. The study suggests that the app is easily used and adopted, thought its effectiveness in producing positive treatment outcomes appears to be limited. Given the ever-increasing popularity of both DBT and apps, this is clearly an area that calls for further research.

2. DBT Travel Guide

Created by: Dialexis Advies B.V.

Available for: iOS, Android

DBT Travel Guide is a product of a Dutch DBT institute, and there are occasional solecisms in the English (including the app’s curious title). But the app is an excellent catalog of DBT exercises, each of them simply but clearly explained:

It also includes a range of helpful DBT tools, including a section for making agreements, a library of helpful audio files, and a section for using when one is in crisis. The app is also elegantly designed, and a pleasure to use and to look it. Finally, it includes many of the same resources as the more popular DBT Coach, but without requiring any extra payment for them.

In light of these features, any user interested in DBT should overlook the odd name and occasionally odd English and give DBT Travel Guide a try.

3. Impulse App

Created by: Spotwish

Available for: iOS

Responding thoughtfully to one’s impulses – recognizing them without necessarily acting on them – is a core skill in DBT. Impulse App is a kind of diary for assisting this skill. When the user has an impulse, they record its skill and intensity, as well as whether they acted on it:

The user can then keep track of these episodes over time, and witness improvement in their responses.

Impulse App is extraordinarily simply designed – it is almost monochrome and has just a few options for user input. It also is available only on iOS. Nonetheless, it is good at what it does. It does not purport to be a guide to DBT (as the previous two apps do). Rather, it is a tool for carrying out a simple but crucial task in DBT. As such, its simple but effective design may prove exactly what some users are looking for.

4. The Dime Game

Created by: Commerce Kitchen, Inc.

Available for: iOS, Android

This app has scarcely any reviews, does not have many installs, and seems to be discussed by almost no one. Yet it’s brilliant. The “dime game” is a simple DBT exercise that asks several questions to help someone decide whether they should ask for (or say no to) something, and how strongly they should do so. This app simply puts that exercise into the user’s phone. The user confronting a decision answers various questions about it:

They then get a “score” telling them whether or not to ask (or say no), and how strongly to do so. That’s all.

This kind of algorithmic yet deliberative approach to life choices is characteristic of DBT, and this app really shows how apps can enhance that approach. Rather than simply putting DBT principles in an app (as one might put them in a book or on a website), The Dime Game implements them in a way that really draws on what makes apps so useful in the first place: their ability to materialize algorithmic processes in a portable and usable way.

This app seems to come out of nowhere – its makers, Commerce Kitchen, Inc., do not even seem to have a website – but it’s a real achievement in the slowly emerging area of DBT apps.

Summary

DBT apps constitute a small fraction of the overall mental health app space. Indeed, while DBT is now a relatively well-established form of therapy, DBT apps remain in their early stages. This can be somewhat frustrating for the user who is hoping for more mature developments. It also, however, creates an opportunity for innovation, as this distinctive mode of therapy suggests a variety of possible apps. This opportunity is really seized by one of the apps above: The Dime Game. Let’s hope that future app developers pursue the lead of The Dime Game and pursue the ways in which DBT’s diverse set of skills may be developed into an equally diverse range of apps.

Note: The contents of this post are for informational purposes only. This is not professional medical advice and it is not intended to be a substitute for professional medical advice. Always consult with a physician with any questions that you have about a medical condition, including a mental health condition. If you think you are in a medical emergency, call 911 or your local emergency services number immediately.

 

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