Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is a highly effective, evidence-based treatment that helps individuals manage intense emotions, reduce harmful behaviors, and improve relationships. Originally developed by Dr. Marsha Linehan in the late 1980s, DBT blends cognitive-behavioral strategies with mindfulness and an emphasis on balancing acceptance and change.

DBT skills focus on four key areas:

Mindfulness – staying present and aware in the moment
Distress Tolerance – coping with crisis without making things worse
Emotion Regulation – understanding and managing intense feelings
Interpersonal Effectiveness – navigating relationships with clarity and respect

When people hear “DBT,” they may not realize there’s a difference between DBT-informed treatment and Comprehensive DBT.

Comprehensive DBT refers to the full treatment model as designed by Dr. Linehan and studied in clinical trials. This structured approach is most effective for individuals struggling with conditions such as Borderline Personality Disorder, chronic suicidality, self-destructive behaviors, eating disorders, and emotional dysregulation.

Comprehensive DBT for children, teens, and adults includes four essential components:

Individual Therapy – Weekly one-on-one sessions focused on applying DBT skills to personal challenges and goals.
DBT Skills Group – A group where participants learn and practice core DBT skills.
Consultation Team – A team of DBT therapists who meet regularly to support one another and ensure fidelity to the model.
Phone Coaching – Access to your therapist between sessions for support in real-life, high-stress moments.
Youth Parent Coaching– For patients who live at home, we provide group or 1:1 coaching to parents to equip them with the necessary skills.

FAQs

What is DBT?

DBT is an evidence based treatment that stands for dialectical behavior therapy and it was initially created in the 1980s by Marsha Linehan. This treatment was originally created for individuals with borderline personality disorder and who exhibited suicidality. It has now been adopted for many different populations, including adolescents, children, and for anxiety and depressive disorders. The main model of DBT is helping people with emotional dysregulation.

Who does DBT help?

DBT helps people of all ages find tools and ways to help them regulate emotions more effectively. It also gives them a framework on how to live in an environment that is more supportive and validating. DBT is a trans diagnostic treatment that targets emotion dysregulation.

What are the core components of DBT?

The main theoretical underpinnings of DBT is in the name dialectic. The main dialect in DBT is that of acceptance versus change. The therapist who is working with a patient in DBT vacillates between accepting their current reality, validating the patient and helping them move towards change and building a life that’s worth living. Within DBT there are certain components that make it comprehensive including access to phone coaching, the therapist’s participation in weekly team meetings, and the patient attending both weekly individual sessions and group skills training. The DBT therapist also uses diary cards to track symptoms and emotions and progress towards living a meaningful life.

What makes DBT different from other therapies?

DBT is different from other therapies as the therapy is grounded on a dialectic of acceptance and change. In terms of acceptance, individuals are taught to radically accept their current realities (which might bring up pain and negative feelings) but also to work on changing their current situation to live a meaningful life.

How long does DBT treatment last?

DBT tends to be a longer therapeutic intervention than other evidence based therapies such as CBT and exposure response prevention for adults. The initial commitment is six months, which includes the amount of time it takes to complete a full set of skills. For children this time frame may be longer as the therapist initially worked with parents upfront before meeting with the child. This treatment can take 6 to 9 months total or sometimes even longer.

Do I have to do group therapy?

If a patient is enrolled in a comprehensive DBT program, participation in group skills training is typically a required component. However, exceptions may be made on a case-by-case basis. In some instances, individual skills training may be offered instead of group. This determination is made collaboratively during the treatment planning phase of the intake process.

Can DBT be done virtually?

Absolutely! Ever since the pandemic, we have realized that telehealth DBT is much more accessible and feasible for patients and other parts of the city state or country. We run a telehealth group skills training so that everyone can access DBT at our clinic, regardless of where they physically live as long as we are licensed in one of the states.

Is DBT evidence-based?

DBT is absolutely evidence based. Since the first randomized control trial in 1991, there has been extensive research for the effectiveness of DBT. There are various forms of research studies that provide ample evidence of DBT’s effectiveness. There are efficacy trials which focus on whether an intervention, in an ideal setting, effectively produces a desired outcome. There are also effectiveness trials which focus on how the “beneficial effects” may vary or remain consistent across various environmental changes. Dissemination and implementation research distribution of information and implementation of information into clinical settings. There is research that also focuses on DBT rigor and credibility as adherence to a full DBT model is imperative to its’ success.

What qualifications do DBT therapists have?

All of the therapists at Clarity CBT and DBT center have been extensively trained by a certified DBT Linehan therapist or behavioral tech, which is the standard training institution for DBT.

What happens if I miss a session?

Life happens and missing a session is simply missing a session however, there’s only one way to be out of DBT and no longer considered a patient and that is if you miss four group skill training sessions in a row or four individual therapy sessions in a row. DBT works if someone shows up for therapy and so this rule of DBT encourages patients to actively show up in their treatment process.

Is DBT effective for adults?

DBT is extremely effective for adults and is proven in multiple research studies. It is proven in clinical and community settings that DBT is a very effective treatment for those with borderline personality disorder or those who struggled to regulate emotions effectively or who have self harming or suicidal behavior

Is DBT effective for children?
Is DBT-C evidence-based?
How does DBT for children differ from DBT for Adults?