ABSTRACT
The dialectical strategies permeate the application of all other DBT strategies. They refer both to the continual re-balancing between acceptance and change in the use of other strategies and to a speci®c set of techniques that inherently include elements of acceptance and change. To progress dialectically, the therapist must attend to the entire context of a problem and learn how the various elements in¯uence each other. The therapist must also embrace the con¯icts that arise as opportunities to develop further. Though being dialectical may prove the most effective way forward, it is seldom easy. Success requires comprehensive assessments, rapid movement among the strategies and rigorous application of the treatment as a whole. Furthermore, the therapist must balance adherence to the treatment manual with responsiveness to the client, just as a ballroom dancer must follow both the steps of the dance and the movements of his or her partner. Indeed, therapy may seem rather like dancing with a partner, albeit sometimes dancing by the side of a cliff on rocky ground in a fog.
