Dialectical Behavior Therapy (DBT) is a comprehensive, evidence-based cognitive-behavioral treatment. Originally developed by Dr. Marsha Linehan to treat borderline personality disorder, it has since been adapted to help individuals struggling with emotional regulation, self-harm, substance use, and interpersonal conflicts.

At its core, DBT is built on the concept of dialectics: the idea that two seemingly opposite things can both be true. In therapy, this translates to the balance between acceptance (accepting yourself as you are) and change (recognizing the need for change to reach your goals).

Dialectical Behavioral Therapy

DBT focuses on providing high-utility skills to manage immediate crises and long-term emotional health.

Mindfulness: The practice of being fully aware and present in the moment without judgment. It is the foundation for all other DBT skills.

Distress Tolerance: Techniques for getting through a crisis without making the situation worse. This involves "surviving" the moment when you cannot immediately change it.

Emotion Regulation: Learning to identify, understand, and reduce the intensity of painful emotions while increasing positive emotional experiences.

Interpersonal Effectiveness: Tools to communicate needs clearly, set healthy boundaries, and maintain self-respect in relationships.

The Four Pillars of DBT Skills

How DBT is Used in Sessions

A standard DBT program is structured differently than traditional "talk therapy." It typically involves a multi-pronged approach to ensure you have support both in and out of the office.

In individual sessions, you and your therapist focus on applying DBT skills to your specific life challenges. The session is often guided by a Diary Card—a tool you use daily to track emotions, urges, and the skills you practiced.

Sessions follow a strict hierarchy, addressing life-threatening behaviors first, followed by behaviors that interfere with therapy, and finally, quality-of-life improvements.

If a difficult event occurred during the week, you and your therapist may conduct a "chain analysis" to understand the triggers and identify where a skill could have been used instead.

Much like a class, these sessions focus on learning the four pillars mentioned above. While individual therapy focuses on motivation, the group focuses on capability—teaching you the actual "how-to" of emotional management.