Dialectical behavior therapy, or DBT, is a specialized form of psychotherapy designed to help people manage intense emotions, improve relationships and reduce harmful behaviors. Originally developed to treat borderline personality disorder (BPD), DBT is now used for a variety of mental health conditions, especially those that involve emotional dysregulation.
If you’ve been told DBT might help you or a loved one, this article will walk you through what DBT is, how it works and why it’s become one of the most trusted forms of therapy in mental health care today.
What’s Dialectical Behavior Therapy?
DBT is a type of cognitive behavioral therapy (CBT). While CBT focuses on changing unhelpful thoughts and behaviors, DBT adds something extra: the concept of dialectics. In DBT, dialectics means learning to hold two seemingly opposite ideas at once — for example, accepting yourself while also working to change.
This balance of acceptance and change is the heart of DBT. Many people who struggle with extreme emotional responses feel invalidated or misunderstood. DBT provides tools to acknowledge those feelings without judgment while building skills to manage them.
Who’s DBT For?
DBT was initially developed to treat people with BPD, especially those at risk of self-harm or suicidal behaviors. However, over time, DBT has proven effective for a variety of other conditions as well, including:
- Chronic suicidal ideation
- Self-harm behaviors
- Substance use disorders
- Post-traumatic stress disorder (PTSD)
- Eating disorders
- Mood disorders (such as depression and bipolar disorder)
- Impulse control issues
- Adolescents with emotional dysregulation
It’s especially beneficial for individuals who feel their emotions are overwhelming, are unpredictable or lead them to take actions they later regret.
Core Principles of DBT
There are several guiding principles behind DBT therapy:
- Validation and acceptance. Recognizing and accepting your emotions and behaviors without harsh judgment
- Change and problem-solving. Learning new skills to replace unhelpful behaviors and create healthier responses
- Dialectics. Encouraging flexibility; seeing the gray areas instead of rigid black-and-white thinking
- Mindfulness. Learning to stay present and aware in the moment without becoming overwhelmed
What Happens in DBT Therapy?
DBT is more structured than many other forms of talk therapy. A full DBT program typically includes four components:
- Individual therapy. You meet weekly with a DBT-trained therapist to talk about current challenges, apply DBT skills and create strategies for change.
- Group skills training. This isn’t group therapy in the traditional sense. Instead, it’s more like a classroom where you learn and practice DBT skills. Groups usually meet weekly and cover four core skill sets (see below).
- Phone coaching. In many DBT programs, clients can reach out to their therapist between sessions for brief support when trying to apply DBT skills in real-life situations.
- Therapist consultation team. Therapists who practice DBT participate in consultation teams to support each other, avoid burnout and stay committed to providing the highest level of care.
Some individuals may participate in modified DBT programs, especially if a full program isn’t available in their area.
The Four Core Skill Sets in DBT
DBT teaches a set of practical, actionable skills you can apply to everyday life. These are the four key areas:
- Mindfulness. The foundation of DBT. Mindfulness helps you stay present, become more aware of your thoughts and emotions and avoid getting swept away by intense feelings.
- Distress tolerance. These skills help you survive a crisis without making the situation worse. Instead of reacting impulsively to pain or discomfort, you learn tools to tolerate it in healthy ways.
- Emotion regulation. This area teaches you how to understand your emotions, reduce emotional vulnerability and respond to feelings in a balanced way.
- Interpersonal effectiveness. These are skills for maintaining healthy relationships. You learn how to ask for what you need, set boundaries and say no — all while maintaining respect for yourself and others.
How Long Does DBT Take?
A standard DBT program is typically 6 months to a year, but it can vary depending on individual needs. Because DBT is skills-based and often involves both individual and group components, it can be more time-intensive than other therapies.
That said, many people report noticeable improvements in emotional control, relationship stability and self-awareness within the first few months.
Is DBT Effective?
DBT is highly effective, especially for individuals with borderline personality disorder, suicidal ideation or chronic self-harming behaviors. It’s also shown promise for other mental health conditions, particularly those that involve mood swings, emotional outbursts or difficulties in relationships.
DBT can lead to:
- Decreased suicidal behavior
- Reduced self-injury
- Fewer hospitalizations
- Better emotional regulation
- Improved quality of life
- Stronger relationships
Many people who haven’t found success in traditional therapy discover the structure and skill-building of DBT provide the results they’ve been looking for.
What Makes DBT Unique?
Compared to other therapies, DBT offers:
- A clear roadmap with specific skills and goals
- Emphasis on nonjudgmental acceptance and self-compassion
- Tools for emotion regulation, not just emotional awareness
- Support for real-life application through phone coaching
- A community aspect via group skills training
This combination of support, structure and real-world applicability is what makes DBT stand out.
Can You Practice DBT on Your Own?
Some DBT techniques can be practiced through self-help workbooks, apps and online courses. However, for individuals with complex emotional needs or chronic conditions, working with a DBT-trained therapist is recommended.
If you’re interested in starting on your own, consider exploring:
- The DBT Skills Training Workbook by Matthew McKay and Jeffrey C. Wood
- Online DBT resources from reputable mental health organizations
- Mobile apps that guide you through DBT skills
Still, a therapist can help you understand how to personalize DBT to your specific needs and challenges.
How to Find a DBT Therapist
Finding a therapist who’s trained in dialectical behavior therapy is key. Not all mental health professionals offer DBT, and because the therapy is intensive, it’s important to find someone who’s familiar with the model.
You can start by:
- Asking your primary care provider for a referral
- Searching through directories
- Contacting local mental health clinics or university counseling centers
- Looking for certification or training in DBT as part of the provider’s credentials
Teletherapy options have expanded access, so don’t be afraid to explore remote DBT therapy if it’s not available locally.
Final Thoughts
DBT is more than just a form of therapy; it’s a skill set for life. For individuals who feel overwhelmed by emotion, trapped in cycles of self-harm or stuck in difficult relationship patterns, DBT offers real hope and tangible tools.
If you or someone you love is struggling with emotional regulation, contact the Mental Health Hotline to talk to someone who can help.
