Dialectical Behavior Therapy (DBT)

Building coping skills for emotional balance and navigating life’s challenges

Dialectical Behavior Therapy (DBT) is a structured, skills-based therapy designed to better help people manage intense emotions, improve relationships, reduce impulsive behaviors, and build a life that feels more stable and meaningful. Today, it's one of the most widely used and well-researched therapies available, and has been found to be highly helpful for anyone who experiences intense, overwhelming emotions.

By providing practical tools, DBT aims to help individuals decrease impulsive reactions driven by intense feelings and instead adopt effective strategies for creating a life that feels worth living. It highlights dialectics in our world–two things that seem opposite but can be true at the same time. It balances validation (“your emotions make sense”) with change (“and we also need to use coping strategies that help you move forward”). It’s highly practical, structured, and skills-focused.

What does DBT treatment include?

  • DBT individual sessions are often active, collaborative, and practical. Weekly sessions focus on applying skills to your current life events to reduce the frequency of behaviors that are actively being targeted for change. 

    • Creating a plan and agreement for how treatment can produce desired changes

    • Reviewing recent emotional or behavioral challenges

    • Identifying triggers and patterns

    • Learning and practicing new coping skills

    • Problem-solving difficult situations

    • Building emotional awareness

    • Developing healthier ways of responding to distress

  • DBT Skills Training Class is a structured group experience, taught more like a class than traditional group therapy, where participants learn and practice the four core DBT skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Sessions include teaching, discussion, real-life examples, and experimental exercises designed to help you apply the skills in everyday situations. Between sessions, participants complete practice assignments to strengthen skill use in daily life. Each week, members have the opportunity to review what worked, troubleshoot obstacles, ask questions, and receive feedback from facilitators. The class meets weekly in a small-group format, allowing space for individualized support, discussion, and active learning.

  • DBT Phone Coaching provides brief, between-session support to help you apply DBT skills in real time. You have access to your therapist outside of regular therapy sessions for focused guidance on using the skills you are learning in the context of everyday challenges, emotional distress, or emerging crisis situations. The goal of phone coaching is not ongoing therapy outside of session, but effectively implementing skills to reduce the likelihood of acting on ineffective urges or behaviors. Over time, phone coaching helps strengthen confidence and skill use in your day-to-day life.

Four Skills Modules

Mindfulness

The foundation of DBT. It teaches you to stay present with open, non-judgmental awareness of your mind, body, and surroundings—helping you notice when to use other skills.

Distress Tolerance

Skills for getting through difficult moments without making the situation worse by coping effectively and safely, particularly when problems cannot be solved immediately.

Emotional Regulation

Skills for understanding and managing your emotions effectively. It helps you change unhelpful patterns, reduce overwhelm, and respond to everyday challenges without being driven by emotional reactions.

Interpersonal Effectiveness

Skills for building healthy connections and communicating effectively. It helps you ask for what you need, set boundaries, maintain self-respect, and strengthen relationships.

What does a typical session look like?

  • You and your therapist review your diary card — a daily tracking tool used to monitor emotions, urges, behaviors, and DBT skill use throughout the week.

  • Using DBT’s treatment hierarchy, you and your therapist identify the most pressing issue to focus on — often a moment when emotions, behaviors, or interactions did not go as planned.

  • Together, you walk through the situation step by step (using a “behavior chain analysis”) to understand what led up to the problem, what happened in the moment, and what factors may have contributed.

  • You and your therapist identify where DBT skills could have been used differently (called a “solutions analysis”). You develop a plan for responding more effectively and often practice those skills together during the session.

  • You leave with a clearer understanding of what happened, a concrete plan for handling similar situations, and practice assignments designed to strengthen and reinforce your skills between sessions.

Who benefits most?

DBT offers support for those navigating emotional, behavioral, and relational hurdles. Originally created to address emotional dysregulation, this evidence-based approach is now frequently used to treat various transdiagnostic concerns.

This therapy might be beneficial if you:

  • Experience particularly intense or overwhelming emotions

  • Find yourself easily flooded by life events

  • Grapple with impulsive choices or reactions

  • Navigate frequent conflict or instability within relationships

  • Find it difficult to regulate your emotional responses

  • Feel trapped in patterns of self-blame, avoidance, or shame

  • Live with persistent stress or anxiety

  • Have a history of self-harming, suicidal thoughts, or risky behaviors

  • Worry about being left or abandoned

  • Feel disconnected from yourself or paranoid under pressure

  • Lack clarity regarding your current feelings or their origins

  • Experience uncertainty about your identity, values, or life path

  • Prefer a structured approach with concrete tools

  • Intense emotion & overwhelm: Feeling easily flooded, highly anxious, or disconnected under pressure.

  • Impulsive reactions: Struggling with risky behaviors, self-harm, or rapid, impulsive choices.

  • Relationship instability: Navigating frequent conflict, fear of abandonment, or boundary issues.

  • Identity & emotional confusion: Feeling trapped in shame, unsure of your identity, or unclear about your emotions.

  • A preference for structure: Wanting concrete, practical tools to navigate daily life.

Identification with every point listed is not required to benefit from treatment. If you find it challenging to understand, endure, or effectively navigate daily emotions, DBT can be a powerful resource.

  • Chapman, A. L. (2018). Phone coaching in dialectical behavior therapy. Guilford Press.

    Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

    Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

    Linehan, M. M. (2015). DBT skills training handouts and worksheets (2nd ed.). Guilford Press.

    Linehan, M. M., Comtois, K. A., Murray, A. M., Brown, M. Z., Gallop, R. J., Heard, H. L., Korslund, K. E., Tutek, D. A., Reynolds, S. K., & Lindenboim, N. (2006). Two-year randomized controlled trial and follow-up of dialectical behavior therapy vs therapy by experts for suicidal behaviors and borderline personality disorder. Archives of General Psychiatry, 63(7), 757–766. https://doi.org/10.1001/archpsyc.63.7.757

    Neacsiu, A. D., Bohus, M., & Linehan, M. M. (2014). Dialectical behavior therapy: An intervention for emotion dysregulation. In J. J. Gross (Ed.), Handbook of emotion regulation (2nd ed., pp. 491–507). Guilford Press.

    Panos, P. T., Jackson, J. W., Hasan, O., & Panos, A. (2014). Meta-analysis and systematic review assessing the efficacy of dialectical behavior therapy. Research on Social Work Practice, 24(2), 213–223. https://doi.org/10.1177/1049731513503047

    Psychwire. (n.d.). The four DBT skills modules. https://psychwire.com/free-resources/expert-insights/resource-1o224sc/the-four-dbt-skills-modules

    Rizvi, S. L., & Ritschel, L. A. (2014). Mastering the art of chain analysis in dialectical behavior therapy. Cognitive and Behavioral Practice, 21(3), 335–349. https://doi.org/10.1016/j.cbpra.2013.08.001

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