DBT Dialectics — MRCPsych Paper B MCQ

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ModeratePsychotherapyDBT DialecticsMRCPsych Paper B

During a dialectical behaviour therapy (DBT) session, the therapist validates that the patient’s emotional response is understandable in context, while also conducting a behavioural chain analysis and rehearsing alternative coping skills. Which two core positions is the therapist balancing?

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Correct answer: A — Acceptance and change

The correct answer is A: acceptance and change. DBT requires the therapist to validate and accept the patient’s current experience while simultaneously promoting behavioural change. In the stem, validation represents acceptance, whereas chain analysis and rehearsal of alternative coping skills are change-oriented strategies. Past and present are both considered in therapy but do not constitute DBT’s central dialectic. Conscious and unconscious are primarily psychodynamic concepts. Individual and group refer to components of comprehensive DBT delivery rather than opposing therapeutic positions. Medication and psychotherapy are treatment modalities, not the dialectical balance defining DBT.

Reference: Rotherham Doncaster and South Humber NHS Foundation Trust. Dialectical behaviour therapy (DBT), section explaining acceptance and change techniques. Last reviewed 28 October 2025. https://www.rdash.nhs.uk/services/complex-emotional-needs-pathway/dialectical-behaviour-therapy-dbt/?ufb=3