Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy, or DBT, is a structured, skills-based therapy. The word "dialectical" points to its central balance: accepting yourself as you are while also working to change what is not serving you.
Where DBT comes from
DBT was developed by psychologist Marsha Linehan, originally to help people who experience emotions very intensely and who had not been helped by other approaches. It has since been studied widely and adapted for many concerns. The American Psychological Association's Society of Clinical Psychology lists DBT for borderline personality disorder, rating its research support strong in 1998 and its current status pending re-evaluation. DBT also has evidence for self-harm, chronic emotion dysregulation, and related difficulties.
The four skill areas
Full DBT teaches four sets of skills:
- Mindfulness: noticing the present moment without being swept away by it.
- Distress tolerance: getting through a crisis without making things worse.
- Emotion regulation: understanding and shifting intense feelings.
- Interpersonal effectiveness: asking for what you need and setting boundaries while keeping relationships intact.
In a full DBT program these are taught in a skills group alongside individual therapy. Many clinicians also use DBT-informed skills within regular individual sessions, which can be enough when the goal is steadier emotion regulation rather than a full program.
What it can help with
People often turn to DBT when emotions feel overwhelming, when relationships are turbulent, or when impulsive reactions get in the way. The skills are concrete and practical, which is part of their appeal: you learn tools you can use the same week.
How DBT fits our work
It is one of several evidence-based approaches our clinicians draw on. Some integrate DBT-informed skills, especially around emotion regulation and distress tolerance, alongside related support for anxiety, depression, and relationship problems. If you are looking for a structured DBT skills group rather than DBT-informed individual work, it is worth saying so up front, and our intake staff can help you figure out the right level of care.
Common questions
No. It was first developed with that group, where its evidence is strongest, but the skills have since helped many people who struggle with intense emotions, self-harm, or impulsivity, with or without any specific diagnosis.
Full DBT is a structured program with a weekly skills group, individual therapy, and between-session coaching. DBT-informed therapy borrows the skills and uses them within regular individual sessions. The first is more intensive. The second can be enough when steadier emotion regulation is the goal.
Often, yes. DBT is skills-based, so practising between sessions is part of how it works. The practice is usually trying a specific skill in a real situation and noticing what happens, then reviewing it with your therapist the following week.
Because the skills are concrete, many people find some of them useful within the first few weeks. Lasting change in long-standing patterns takes longer, and your therapist will track how it is going with you and adjust along the way.
Yes. A full program includes a group, but many people gain a lot from DBT-informed individual work that teaches the same skills one to one. Which makes sense depends on how much structure and support you need, and a therapist can help you decide.
Is DBT right for you
If your main difficulty is that feelings escalate fast and the aftermath is hard to manage, the DBT skill set is built for exactly that. To find a therapist who draws on DBT, browse our team or contact our intake staff to talk through what would fit.
If you are in crisis or thinking about harming yourself, call or text 988 to reach the Suicide & Crisis Lifeline (US), free and confidential, 24/7.
This page is for general education and is not a substitute for professional diagnosis or treatment.
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