Dialectical Behavior Therapy
What Is Dialectical Behavior Therapy (DBT)?
Dialectical Behavior Therapy (DBT) is an evidence-based form of psychotherapy developed by psychologist Marsha M. Linehan, Ph.D. Originally created to treat individuals diagnosed with Borderline Personality Disorder (BPD), DBT has since become one of the most researched and effective treatments for a wide range of mental health concerns involving emotional and behavioral dysregulation. Today, DBT is used to help individuals struggling with anxiety, depression, trauma-related symptoms, self-harm, suicidal thoughts, substance use disorders, eating disorders, chronic stress, and relationship difficulties.
DBT is a specialized form of Cognitive Behavioral Therapy (CBT) that combines behavioral change strategies with principles of mindfulness, acceptance, and validation. The term "dialectical" refers to the balance between two seemingly opposite ideas: accepting yourself as you are while simultaneously working toward meaningful change. This balance helps clients develop self-compassion without becoming stuck in patterns that no longer serve them.
One of the primary goals of DBT is to help individuals build a life worth living. Rather than focusing solely on symptom reduction, DBT helps clients create a life that aligns with their values, goals, and personal priorities. Through structured therapy and skills training, individuals learn practical tools to navigate difficult emotions, tolerate distress, improve relationships, and respond more effectively to life's challenges.
Core DBT Skills
DBT teaches four essential skill sets that help individuals manage emotions, reduce suffering, and improve overall functioning.
Mindfulness
Mindfulness is the foundation of all DBT skills. Mindfulness teaches individuals how to stay present in the current moment rather than becoming trapped in regrets about the past or worries about the future. Clients learn to observe their thoughts, emotions, and physical sensations without judgment and without immediately reacting to them. Developing mindfulness skills can improve focus, reduce emotional reactivity, increase self-awareness, and help individuals make more intentional decisions.
Distress Tolerance
Life inevitably includes painful experiences, disappointment, loss, and stress. Distress tolerance skills help individuals survive difficult situations without making them worse through impulsive behaviors, avoidance, emotional outbursts, substance use, self-harm, or other ineffective coping strategies. These skills focus on getting through a crisis safely while maintaining long-term goals and values. Distress tolerance can be especially helpful for individuals who feel overwhelmed during periods of high stress or emotional intensity.
Emotion Regulation
Many people seek therapy because they feel controlled by their emotions rather than in control of them. Emotion regulation skills help clients understand the purpose of emotions, identify emotional triggers, and reduce vulnerability to intense emotional experiences. Individuals learn strategies to manage anxiety, sadness, anger, shame, and other difficult emotions while increasing positive emotional experiences. By improving emotion regulation, clients often experience greater stability, confidence, and resilience in daily life.
Interpersonal Effectiveness
Relationship difficulties are one of the most common sources of emotional distress. Interpersonal effectiveness skills help individuals communicate clearly, set healthy boundaries, navigate conflict, ask for what they need, and maintain self-respect in relationships. Clients learn how to balance their own needs with the needs of others while building stronger, healthier connections. These skills can improve relationships with partners, family members, friends, coworkers, and others important in a person's life.
How DBT Can Help
Although comprehensive DBT is often recommended for individuals experiencing severe emotion dysregulation, chronic suicidal behaviors, self-injury, or Borderline Personality Disorder, DBT-informed therapy can benefit many individuals who do not require the full DBT model. The practical skills taught through DBT can help people manage anxiety, depression, trauma-related symptoms, burnout, perfectionism, emotional overwhelm, anger, impulsivity, and relationship challenges.
DBTICI offers both Adolescent DBT and Adult DBT programs. For a list of recommended readings that dive deep into DBT, check out my recommended readings page.
Below are two short videos that describe DBT.
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Whether you are seeking help for a specific mental health concern or simply want to improve your ability to cope with stress and emotions, DBT provides practical, evidence-based tools that can create meaningful and lasting change.
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