Dialectical Behavior Therapy (DBT):
Comprehensive Dialectical Behavior Therapy & DBT Therapy for Life-Changing Skills

Therapist sitting with client. Therapist has hands clapped together

Looking for evidence-based DBT to manage intense emotions, improve relationships, and build a life worth living? Dialectical behavior therapy provides powerful skills for borderline personality disorder, self-harm, eating disorders, and other mental health conditions. Learn DBT skills that transform how you handle difficult situations.

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When DBT Can Help:
Recognizing Signs You Need Dialectical Behavior Therapy

DBT was developed to treat borderline personality disorder but has proven effective for a range of mental health conditions. Here are signs that dialectical behavior therapy might be the right therapy for you.

Common Challenges DBT Addresses

Intense, Overwhelming Emotions You Can’t Control

If you experience emotions that feel overwhelming, intense, and difficult to manage, DBT can help. One core aspect of DBT is teaching emotion regulation skills that help you identify, understand, and manage intense feelings. Many people who benefit from DBT describe feeling like their emotions control them rather than the other way around. You might go from calm to extremely upset very quickly, experience emotions more intensely than others seem to, or have difficulty returning to baseline after emotional episodes. DBT teaches specific skills to manage these intense emotional experiences, helping you develop greater emotional stability. The emotion regulation skills within DBT are among the most valuable tools for people struggling with emotional intensity.

Self-Harm, Suicidal Thoughts, or Dangerous Behaviors

DBT was originally developed by psychologist Marsha Linehan specifically for individuals experiencing suicidal behavior and self-harm. If you engage in self-harm as a way to cope with emotional pain, have frequent suicidal thoughts, or engage in other life-threatening behaviors, DBT provides crucial support. The treatment for borderline personality disorder and suicidal behavior focuses on building skills to manage distress without resorting to harmful actions. DBT helps you understand the function these behaviors serve and develop healthier alternatives. The distress tolerance skills taught in DBT give you concrete techniques to survive crisis moments without making things worse. Studies of DBT consistently show significant reductions in self-harm and suicidal behavior among participants.

Unstable Relationships and Interpersonal Conflicts

If your relationships tend to be intense, unstable, or characterized by frequent conflict, DBT’s interpersonal effectiveness skills can be transformative. Many people who need DBT struggle with relationships that swing between intense closeness and devastating conflicts. You might fear abandonment intensely, have difficulty setting boundaries, struggle to ask for what you need, or find yourself repeatedly in similar relationship patterns. DBT teaches you how to maintain self-respect while getting your needs met, navigate conflict effectively, and build more stable, satisfying relationships. The interpersonal effectiveness module helps you balance maintaining relationships with maintaining your own values and self-respect.

Borderline Personality Disorder Diagnosis

If you’ve been diagnosed with borderline personality disorder, DBT is considered the gold-standard treatment. Extensive research, including behaviour research and therapy studies, has demonstrated the effectiveness of dialectical behavior therapy specifically for patients with borderline personality disorder. DBT was developed to treat borderline personality disorder and remains the most extensively studied therapy for this condition. The treatment of borderline personality disorder through DBT addresses the core features including emotional dysregulation, impulsivity, unstable relationships, and identity disturbance. One study found that DBT significantly reduces symptoms and improves functioning for people with this diagnosis. If you’ve struggled to find suitable DBT or therapy that truly helps with BPD symptoms, comprehensive DBT offers hope.

Difficulty Tolerating Distress or Crisis Situations

When difficult emotions or situations arise, do you feel completely unable to cope? DBT focuses significantly on distress tolerance, teaching you skills to manage crisis situations without making them worse. These are skills to manage moments when you feel you absolutely cannot stand what’s happening. DBT teaches you how to tolerate painful situations that can’t be immediately changed, accept reality rather than fighting what you cannot control, and survive crisis moments without impulsive or harmful actions. Many people who need DBT describe feeling like they have no tools when distress hits. The distress tolerance module provides a toolkit of specific techniques you can use in these moments, giving you options beyond the harmful coping strategies you might currently rely on.

Impulsive Behaviors You Later Regret

If you frequently act impulsively in ways you later regret, whether through spending, substance use, risky sexual behavior, reckless driving, binge eating, or other actions, DBT helps you develop greater impulse control. DBT uses a combination of mindfulness and behavioral skills to help you pause between impulse and action. You’ll learn to identify triggers for impulsive behavior, recognize urges without automatically acting on them, and choose responses aligned with your long-term goals rather than short-term relief. The skills you learn in DBT create space between feeling an urge and acting on it, giving you the opportunity to make choices you won’t regret.

Additional Conditions Where DBT Helps

Eating Disorders and Disordered Eating

Research has shown that DBT is effective for eating disorders, particularly binge eating disorder and bulimia. The skills taught in DBT help you manage the intense emotions that often drive disordered eating, tolerate distress without turning to food behaviors, and develop healthier relationships with food and your body. DBT helps you identify the functions that eating disorder behaviors serve and develop alternative skills. Many people with eating disorders also struggle with other issues DBT addresses, like emotion dysregulation, impulsivity, and self-harm. The comprehensive nature of DBT treatment makes it particularly valuable for these complex presentations.

Substance Use and Addiction

DBT has been adapted and proven effective for substance use disorders. If you use substances to manage intense emotions or cope with distress, DBT provides alternative skills while addressing the underlying emotional dysregulation that often fuels addiction. DBT helps you understand urges, develop distress tolerance so you don’t need substances to cope, improve emotion regulation reducing the need to numb feelings, and build a life worth living that doesn’t center on substance use. The combination of skills training and individual therapy within standard DBT provides comprehensive support for recovery.

Chronic Feelings of Emptiness or Identity Confusion

Many people who benefit from DBT describe chronic feelings of emptiness or confusion about who they are. This is common in borderline personality disorder but can occur in other contexts too. DBT uses mindfulness and other techniques to help you develop a clearer sense of self. The mindfulness skills taught in DBT help you observe and describe your experiences, increasing self-awareness. As you practice DBT skills and build a life aligned with your values, your sense of identity often becomes more stable and defined. DBT also helps you develop self-respect and self-validation, reducing dependence on others for your sense of worth.

Previous Therapy Hasn’t Helped or Made Things Worse

If you’ve tried other forms of therapy without success, or if previous therapy actually made you feel worse, DBT might be what you need. DBT was specifically developed because existing therapies weren’t adequately helping people with complex emotional and behavioral difficulties. The structure and comprehensiveness of dialectical behavior therapy, combined with its emphasis on validation alongside change, often helps people who haven’t responded to other treatments. DBT incorporates elements of cognitive behavioral therapy (CBT) while adding mindfulness, acceptance, and dialectical thinking that make it more effective for certain populations. Many people find that DBT finally provides the right balance of support and skill-building they need.

If you recognize yourself in these descriptions, DBT might be exactly what you need.

Dialectical behaviour therapy has helped countless people build lives worth living, and it can help you too.

77% reduction

in self-harm behaviors for people who complete DBT, with lasting improvements in emotion regulation

Evidence-based

DBT was specifically developed for intense emotions and is backed by decades of research and clinical studies

4 core skill modules

Mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness taught systematically

Understanding Dialectical Behavior Therapy:
What DBT Is and How It Works

DBT is a comprehensive, evidence-based treatment approach developed by Marsha Linehan in the late 1980s. Originally created as therapy for borderline personality disorder, DBT has since been adapted for various mental health conditions. The foundation of DBT is dialectical philosophy, which emphasizes that two seemingly opposite things can both be true.

The central dialectic in DBT is acceptance and change: you need to accept yourself as you are while also working to change problematic patterns. This balance makes DBT unique among different forms of therapy and particularly effective for people who’ve felt invalidated by purely change-focused approaches.

DBT teaches four core skill modules: mindfulness (being present and aware), distress tolerance (surviving crisis without making things worse), emotion regulation (understanding and managing emotions), and interpersonal effectiveness (maintaining relationships while respecting yourself). These DBT skills provide concrete techniques you can practice skills in a safe environment and then use in your everyday life.

Unlike some forms of therapy that focus primarily on insight, DBT is highly practical, teaching you new skills you can implement immediately. The behavioral skills you learn become tools you carry with you, available whenever challenging situations arise.

The Four Skill Modules DBT Teaches

Mindfulness is the foundation, teaching you to be fully present in the moment without judgment. This cognitive awareness helps you observe thoughts and feelings without being controlled by them.

Distress tolerance provides skills for crisis situations when you can’t immediately fix the problem. Emotion regulation helps you understand your emotions, reduce emotional vulnerability, and respond skillfully rather than reactively.

Interpersonal effectiveness teaches you how to ask for what you need, say no when necessary, and maintain self-respect in relationships.

Together, these four modules give you a comprehensive toolkit. You’ll learn DBT skills progressively, practicing each before moving to the next, ensuring you can actually use the skills when you need them most.

How DBT Differs from Other Therapies

While DBT incorporates cognitive behavioral therapy (CBT) elements, it differs in significant ways. DBT includes mindfulness and acceptance strategies not typically part of CBT.

The emphasis on dialectics, balancing acceptance with change in dialectical thinking, sets it apart from purely change-focused cognitive behavioral approaches. DBT also uses validation more extensively than traditional CBT, recognizing that people need to feel understood before they can change. The comprehensive structure, combining individual and group therapy, is more intensive than typical outpatient treatment.

Compared DBT to other therapies, research shows it’s particularly effective for emotion dysregulation and impulsive behaviors. The unique combination of acceptance, change, skill-building, and validation makes DBT powerful for populations that haven’t responded well to other treatments.

Evidence for DBT Effectiveness

The effectiveness of DBT is well-established through extensive research. Multiple trials of DBT have demonstrated significant improvements for borderline personality disorder, with studies showing reduced self-harm, fewer hospitalizations, and better overall functioning.

The efficacy of dialectical behavior therapy has been shown in randomized controlled trials, the gold standard of therapy research. DBT has been found effective not just for BPD but also for eating disorders, substance use, depression, and other conditions.

Research published in journals like Behaviour Research and Therapy consistently supports DBT’s effectiveness. Current indications and unique applications continue expanding as researchers adapt DBT for new populations. The evidence base for DBT is one of the strongest among psychotherapy approaches.

Full DBT typically includes four components: individual therapy sessions where you work one-on-one with a DBT therapist, group skills training where you learn DBT skills with others, phone coaching for support between sessions, and a consultation team where therapists support each other in providing effective treatment.

However, the specific structure of DBT treatment can vary, and not all DBT programs include all components. Some people access DBT through a comprehensive program offering all components, while others participate in adapted versions that might include only certain elements. What matters is that the core principles and skills of DBT are present, even if the format differs from standard DBT.

Peaceful brain icon showing a brain with a heart

Practice Mindfulness

Learn to stay present and aware without judgment, reducing emotional reactivity and increasing your ability to respond thoughtfully instead of impulsively.

Replace Unhealthy Patterns

Identify unhelpful coping mechanisms like avoidance, substance use, or emotional eating and replace them with healthier alternatives that truly support your well-being.

How DBT Helps You Manage Intense Emotions

Dialectical Behavior Therapy (DBT) is a skills-based approach specifically designed for people who experience intense, overwhelming emotions. Unlike traditional talk therapy, DBT teaches four core skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. You’ll learn practical techniques you can use immediately when emotions feel out of control, while also addressing the underlying patterns that keep you stuck in emotional pain and relationship difficulties.

Regulate Emotions icon showing person with gear for brain and circle with smile and sad emojis

Regulate Intense Emotions

Develop skills for identifying, understanding, and changing intense emotional responses that feel overwhelming, uncontrollable, or lead to destructive behaviors.

Tolerate Distress Effectively

Build capacity to survive crisis situations and intense emotional pain without making things worse through self-harm, substance use, or other harmful coping mechanisms.

How DBT Helps: The Life-Changing Benefits of New Skills and Therapy

Dialectical behavior therapy provides profound, lasting benefits by teaching practical skills and addressing core emotional and behavioral patterns.

Learn Practical Skills for Everyday Life

The heart of DBT is skills training, teaching you concrete techniques you can use in your everyday lives. These aren’t abstract concepts, they’re specific strategies you practice repeatedly until they become second nature.

DBT skills training provides step-by-step guidance on how to handle situations that currently overwhelm you. You’ll learn exactly what to do when emotions feel unbearable, how to communicate effectively during conflict, techniques to calm your body and mind during crisis, and ways to make decisions aligned with your values.

The skills you learn don’t just help during therapy, they become lifelong tools. Many people report that years after completing DBT, they still regularly use the skills they learned, applying them to new challenges and situations.

Reduce Self-Harm and Life-Threatening Behaviors

For people struggling with self-harm, suicidal behavior, or other life-threatening actions, DBT can be lifesaving. DBT therapy specifically targets these behaviors, understanding them as (ineffective) attempts to solve problems or manage pain.

Rather than just demanding you stop these behaviors, DBT helps you understand what function they serve and teaches alternative skills to manage the same issues. The distress tolerance and emotion regulation skills provide healthier ways to cope with overwhelming feelings.

DBT also helps you build a life worth living, reducing the despair that often underlies suicidal thoughts. Research consistently shows that DBT significantly reduces self-harm and suicidal behavior, with effects lasting long after treatment ends. This is perhaps the most critical benefit for people whose lives are at risk.

Build Healthier, More Stable Relationships

DBT often uses interpersonal examples because relationship difficulties are so common among people who need this treatment. The interpersonal effectiveness skills teach you how to balance getting your needs met with maintaining relationships and self-respect.

You’ll learn specific techniques for asking for what you want, saying no to unwanted requests, dealing with conflict, and building new relationships. DBT helps you recognize patterns that damage relationships and replace them with healthier approaches.

Many people find their relationships become more stable, satisfying, and reciprocal after learning DBT skills. The mindfulness and emotion regulation skills also help with relationships by reducing reactivity and helping you respond more thoughtfully to others’ behaviors.

Develop Emotional Regulation and Stability

One of the most transformative aspects of DBT is developing better emotion regulation. DBT helps you understand that emotions aren’t the enemy, they provide important information.

But you can learn to experience emotions without being controlled by them. The emotion regulation skills teach you to identify and label emotions accurately, understand what triggers specific emotions, reduce vulnerability to intense emotions through self-care, and change unwanted emotions when possible. You’ll also learn techniques to help ride out emotional waves when you can’t immediately change how you feel.

Over time, most people who complete a DBT program notice they experience less emotional intensity, recover more quickly from upsets, and feel more stable overall. This increased emotional regulation improves virtually every area of life.

Our DBT Approach:
Evidence-Based Skills Training and Cognitive Therapy

At Relationship Counseling Center of California, we provide DBT treatment grounded in Linehan’s model while adapting to meet your individual needs.

DBT Skills Training in Individual and Group Settings

We offer DBT skills training in both individual therapy and group settings, allowing flexibility based on your needs and preferences. Individual DBT sessions allow you to work one-on-one with your therapist, applying DBT principles to your specific situation.

For those who can benefit from group skills training, we may offer therapy through DBT course-style groups where you learn alongside others facing similar challenges. Group therapy provides the advantage of practicing skills in a safe, supportive environment and learning from others’ experiences.

Whether you receive DBT through individual sessions, a skills group, or ideally both, you’ll get comprehensive instruction in all four skill modules. We teach you skills using the same evidence-based curriculum developed by Linehan and her colleagues.

Integration of Cognitive Behavioral and Mindfulness Approaches

Our DBT incorporates both cognitive behavioral therapy principles and mindfulness practices. The cognitive elements help you identify and change thought patterns that contribute to emotional and behavioral difficulties.

DBT uses cognitive restructuring techniques to challenge unhelpful thoughts while emphasizing acceptance and validation. The mindfulness component, drawn from Eastern contemplative practices, teaches you to observe your experience without judgment.

This combination of cognitive behavioral strategies and mindfulness creates a balanced approach. You learn both to accept reality as it is and to work toward change where possible. This dialectical balance is what makes DBT unique and particularly effective.

Adaptation for Individual Needs

While we ground our work in the standard DBT model, we recognize that not everyone needs full comprehensive DBT with all four components.

We tailor our approach based on your specific situation, symptoms, and access to resources. For some, individual therapy using DBT principles and skills is most appropriate. Others benefit from adding skills training group components. We work with you to determine what level of DBT involvement makes sense.

Some people complete a DBT course lasting six months to a year, while others engage in longer-term treatment. We also consider how DBT results might be maximized for your unique circumstances, ensuring the therapy can vary to meet you where you are.

Focus on Building a Life Worth Living

A core aspect of DBT that we emphasize is not just reducing problems but actively building a life worth living. DBT isn’t just about crisis management, it’s about creating meaning, purpose, and satisfaction in life.

We help you identify your values, set meaningful goals, and work toward a life aligned with what matters most to you. This might involve pursuing relationships, career aspirations, creative pursuits, or other valued activities. DBT involves examining what’s keeping you from the life you want and developing skills to overcome those barriers.

This positive, life-affirming focus makes DBT more than just symptom reduction, it becomes a path to genuine fulfillment.

Validation Balanced with Change

A key element within DBT is the balance between validation and change. We recognize that you’re doing the best you can with the skills you currently have, while also supporting you in building new skills.

This validation isn’t empty reassurance, it’s genuine recognition that your responses make sense given your biology, history, and current situation. At the same time, DBT also acknowledges that some patterns aren’t working and need to change.

This both/and approach, accepting you while encouraging growth, is what many people find most healing about DBT. Unlike approaches that feel purely critical or purely accepting, DBT holds both truths simultaneously.

Emphasis on Practicing Skills Between Sessions

DBT emphasizes that learning happens through practice, not just discussion. Between therapy sessions, you’ll be expected to practice skills you’re learning, complete homework assignments, and track your use of skills and their effectiveness.

This active practice is what makes DBT work. You can’t just hear about DBT skills, you have to actually use them repeatedly until they become automatic. We provide homework sheets, skills practice forms, and other resources to support this between-session work.

The more you practice skills in your everyday life, the more natural they become and the better your DBT results will be. This practice-focused approach is what creates lasting change.

Who Benefits from Dialectical Behavior Therapy: Access to DBT for Various Mental Health Conditions

While DBT was originally therapy for borderline personality disorder, it now helps people with various mental health conditions who struggle with emotion dysregulation and impulsive behaviors.

Severe emotion dysregulation

Depression with emotional instability

Borderline personality disorder

Self-harm and suicidal behaviors

Eating disorders (especially binge eating)

Substance use disorders

Post-traumatic stress disorder

Anger and aggression issues

Chronic relationship problems

Impulsive and risky behaviors

Treatment-resistant conditions

Complex mental health presentations

Is DBT Right for You?

DBT might be right for you if you struggle with intense emotions that feel unmanageable, engage in behaviors you know aren’t healthy but feel unable to stop, have relationship patterns that repeatedly cause problems, or haven’t found relief from other therapies you’ve tried. You don’t necessarily need to be diagnosed with borderline personality disorder to benefit from DBT, many people with other conditions or simply with emotion regulation difficulties find DBT helpful. The key is whether you’re willing to actively engage in learning and practicing new skills.

DBT requires commitment and effort. Unlike some therapies where you primarily talk about problems, DBT involves actively learning new skills, completing homework, and practicing techniques regularly. This can feel demanding, but it’s also what makes DBT effective. If you’re willing to invest the time and energy into learning these skills, DBT can be transformative. The question isn’t whether you’re “sick enough” for DBT, it’s whether you’re ready to engage fully in the process of building new skills and creating meaningful change in your life.

To determine if DBT is appropriate for you, schedule a consultation. We’ll discuss your specific challenges, treatment history, and goals. Together, we’ll determine whether DBT offers what you need and what format (individual, group, or both) would work best for your situation.

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What to Expect from DBT Sessions:
The DBT Course and Therapy Process

Understanding what DBT involves helps you feel prepared and confident about beginning treatment. Here’s what your DBT journey typically looks like.

Step 1: Free Consultation (10 minutes)

Your journey begins with a free phone consultation where we’ll discuss whether DBT might be helpful for you. We’ll talk about the challenges you’re facing, what you’ve tried before, and what you hope to achieve through therapy. This conversation helps us determine if DBT is appropriate for your needs or if another approach might be better suited. You can ask questions about what DBT involves, the time commitment required, and practical details about therapy structure. We’ll explain the difference between individual DBT and comprehensive programs, helping you understand options for access to DBT. There’s no pressure, just an honest conversation about whether DBT might be the right therapy for your situation.

Step 2: Comprehensive Assessment and Orientation

If you decide to proceed, we’ll conduct thorough assessment to understand your complete picture. This includes discussing your current difficulties, mental health history, what brings you to therapy now, your goals for treatment, and your readiness to commit to the DBT process. We’ll determine if you meet criteria for conditions DBT treats and identify which DBT skills will be most relevant for you. We’ll also provide orientation to DBT, explaining the four skill modules, how therapy sessions will be structured, expectations for homework and skills practice, and what you can realistically expect from the program. This orientation ensures you understand what you’re committing to before beginning.

Step 3: Learning the Four Core Skill Modules

The heart of DBT treatment involves systematically learning the four skill modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. In standard DBT, this happens through weekly skills training group sessions, though skills can also be taught in individual therapy. Each module typically takes several weeks to complete, with the full skills training cycle lasting about six months. You’ll learn new skills each week, receive handouts and homework assignments, practice skills between sessions, and return to discuss what worked and what didn’t. This repetitive practice is what makes the skills stick. Many DBT programs go through the modules twice, reinforcing learning and allowing you to deepen your practice of each skill.

Step 4: Individual Therapy and Application

Alongside skills training, individual therapy sessions help you apply DBT skills to your specific life situations. In these therapy sessions, you’ll work with your therapist on current issues and challenges, identify which DBT skills apply to problems you’re facing, address barriers to using the skills, process difficult emotions and experiences, and work toward your life-worth-living goals. Individual sessions ensure the skills you’re learning aren’t just abstract concepts but practical tools you use to address real problems in your life. The combination of skills training and individual application is what makes comprehensive DBT so effective.

Step 5: Graduation and Maintenance

Most people complete a full DBT program within six months to a year, though some continue longer depending on their needs. As you near completion, we’ll review the skills you’ve learned, identify situations where you might need refresher practice, create a plan for maintaining your gains, and discuss when you might benefit from future DBT sessions. Many people find that after completing DBT, they have the skills they need to manage life’s challenges independently. Some choose to continue individual therapy for ongoing support, while others successfully maintain their progress on their own. The skills you learned become permanent tools you can use throughout your life, even after formal treatment ends.

Timeline and Duration:
How Long Does DBT Take?

Standard DBT typically lasts six months to a year, though the exact duration can vary. This timeframe allows you to learn all four skill modules thoroughly, practice skills extensively, and see meaningful changes in your life. Some programs go through the skills modules twice (taking about a year), which reinforces learning. Individual circumstances affect how long DBT treatment continues, some people benefit from longer-term involvement while others complete the core program and move on.

Many people notice improvements relatively early in treatment, experiencing benefits within the first few months as they begin using new skills. However, deep, lasting change in long-standing patterns typically takes the full program duration. DBT might seem like a significant time commitment, but compared to years of struggling without effective tools, six months to a year is a worthwhile investment. The skills you gain last a lifetime, continuing to benefit you long after the program ends.

We’ll discuss realistic timelines during your initial sessions, helping you understand what to expect for your particular situation. The key is committing to the full process rather than expecting quick fixes. DBT requires patience and persistence, but for people who fully engage, the life-changing results make the time investment worthwhile.

Therapists Who Specialize in Dialectical Behavior Therapy

Common Questions About Dialectical Behavior Therapy

Do I need to be in a group to do DBT?

Traditional comprehensive DBT includes both individual therapy and a skills group where you learn alongside others. The skills group component is valuable because you learn from others’ experiences, practice skills in a safe environment with peers, and benefit from group support and accountability. However, not everyone has access to DBT groups or feels comfortable in group settings. Adapted versions of DBT can be delivered in individual therapy format, where your therapist teaches you the DBT skills one-on-one. While this isn’t standard DBT as originally developed, it can still be effective. If group participation is difficult for you, discuss options with potential DBT providers. The most important thing is that you learn and practice the core DBT skills, whether that happens in group or individual format.

How is DBT different from regular CBT?

While DBT incorporates cognitive behavioral therapy principles, it differs in significant ways. DBT uses acceptance and mindfulness strategies extensively, not typically emphasized in traditional CBT. The dialectical approach, balancing acceptance with change, is unique to DBT. DBT also includes more structured skills training in specific areas (mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness) rather than CBT’s broader focus on thought patterns and behaviors. DBT was specifically developed for people with severe emotion dysregulation and self-destructive behaviors, while CBT was developed for a broader range of issues. The validation and acceptance components in DBT are more pronounced than in standard CBT. Both are evidence-based approaches, but DBT is particularly effective for the complex presentations it was designed to treat.

What if I don’t have borderline personality disorder?

You absolutely don’t need to be diagnosed with borderline personality disorder to benefit from DBT. While DBT was originally developed to treat borderline personality as mentioned throughout this research and therapy literature, it’s now used for many other conditions. DBT has been found effective for eating disorders, substance use, depression, PTSD, and other mental health conditions characterized by emotion dysregulation or impulsive behaviors. The skills taught in DBT are useful for anyone who struggles with intense emotions, relationship difficulties, or harmful coping behaviors, regardless of diagnosis. Many people without any specific diagnosis find DBT skills helpful for managing life’s challenges. The question isn’t whether you have a particular diagnosis, but whether you struggle with issues DBT addresses and are willing to learn the skills.

Is DBT really evidence-based? Does it actually work?

Yes, DBT is one of the most extensively researched psychotherapy approaches. The effectiveness of DBT has been demonstrated in numerous randomized controlled trials, which are the gold standard for evaluating treatments. Research specifically shows that dialectical behavior therapy in routine public mental health settings (not just research clinics) produces significant improvements. Studies consistently find that DBT reduces self-harm, suicidal behavior, hospitalizations, and other problematic behaviors while improving overall functioning and quality of life. The evidence for DBT’s effectiveness is particularly strong for borderline personality disorder, but studies also support its use for other conditions. This solid research base is why DBT is recommended by major mental health organizations and included in treatment guidelines for various conditions.

What does “dialectical” mean in DBT?

“Dialectical” refers to the idea that two seemingly opposite things can both be true at the same time. The core dialectic in DBT is between acceptance and change: you need to accept yourself and your current reality as valid while also working to change patterns that aren’t serving you. This both/and thinking (rather than either/or) runs throughout DBT. For example, you can accept that your emotions make sense given your situation AND work to manage them differently. You can validate your struggle AND push yourself to try new approaches. DBT helps you hold these apparent contradictions simultaneously rather than getting stuck in extreme thinking. This dialectical philosophy is what makes DBT unique and particularly helpful for people who’ve felt invalidated by purely change-focused therapies or stuck by purely acceptance-focused approaches.

Will I have to do homework between DBT sessions?

Yes, homework and skills practice between sessions are essential components of DBT. You’ll be asked to practice skills you’re learning, complete diary cards or worksheets tracking your behaviors and emotions, try using specific techniques in real-life situations, and prepare for upcoming sessions by reviewing materials. This between-session work is where much of the learning happens. The skills only become automatic through repeated practice. If you’re not willing to practice skills between sessions, DBT won’t be as effective. However, the homework is practical and directly relevant to improving your life, not just busy work. Your therapist will help you identify realistic practice goals and troubleshoot any barriers to completing assignments. The time you invest in homework translates directly into faster progress and better outcomes.

How do I know if my therapist is properly trained in DBT?

It’s important to work with therapists who have proper training in DBT, as the approach requires specific expertise. You can ask potential therapists about their DBT training, including whether they’ve completed intensive DBT training workshops, if they have certification in DBT or are working toward it (certified DBT therapists have met specific training and practice requirements), whether they participate in a DBT consultation team, and how long they’ve been providing DBT. True DBT providers should be able to clearly explain the DBT model and how they implement it. Be wary of therapists who say they “use some DBT skills” but don’t provide structured, comprehensive DBT. While adapted versions of DBT exist, the therapist should be transparent about whether they’re offering standard DBT or a modified approach. Don’t hesitate to ask these questions, qualified DBT therapists will appreciate your diligence in finding appropriate treatment.

What if DBT doesn’t work for me?

While DBT is highly effective for many people, it doesn’t work for everyone, and that’s okay. Sometimes the issue is that the therapy wasn’t implemented properly (not all therapists calling what they do “DBT” are actually providing comprehensive, adherent DBT). Other times, people don’t engage fully in the practice required for DBT to work. And sometimes, even with good implementation and full engagement, a person simply doesn’t respond to DBT as expected. If you’re not seeing benefits after a reasonable trial (usually at least a few months of active participation), discuss this with your therapist. You might need adjustments to how DBT is being delivered, additional support for underlying issues interfering with progress, or potentially a different therapeutic approach altogether. DBT isn’t the only effective therapy, and finding what works for you is what matters most.

Do you accept insurance, or what are the costs?

We understand that the cost of therapy is an important consideration. We accept most major insurance companies. You can check to see if we accept your insurance here. Many insurance plans do cover therapy. We also accept cash payments for clients who do not have or do not want to use insurance.

Ready to Learn DBT Skills and Transform Your Life?

You don’t have to continue struggling with overwhelming emotions, impulsive behaviors, or relationship difficulties. DBT provides practical skills that can fundamentally change how you handle life’s challenges. Whether you’ve been diagnosed with borderline personality disorder or simply struggle with emotion regulation, DBT offers hope and concrete tools for change.

Your first step is simple: schedule a free consultation. We’ll discuss your specific challenges, answer your questions about what DBT involves, and help you determine if this evidence-based approach is right for you.

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When DBT Can Help: Recognizing Signs You Need Dialectical Behavior Therapy