Dialectical Behavior Therapy (DBT) is a structured, evidence-based therapy that combines cognitive-behavioral techniques with mindfulness-based practices to help people regulate intense emotions, tolerate distress, improve interpersonal effectiveness, and build a life worth living. It was originally developed for borderline personality disorder but now has strong clinical evidence for a wide range of conditions involving emotional dysregulation.
What Does Dialectical Mean in DBT?
The word dialectical refers to the central therapeutic tension in DBT: accepting the person exactly as they are right now while simultaneously working toward change. This balance of acceptance and change distinguishes DBT from CBT, which focuses more heavily on cognitive and behavioral change without the same explicit acceptance framework.
This balance is particularly important for people who have struggled with feelings of invalidation, shame, or the sense that their emotional experiences are excessive or abnormal.
What Are the 4 Core Skill Modules in DBT?
DBT is structured around 4 distinct skill modules:
- Mindfulness: the foundational module, teaching present-moment awareness and non-judgmental observation of thoughts and emotions
- Distress Tolerance: skills for surviving crisis moments without making them worse through impulsive or harmful behavior
- Emotional Regulation: skills for identifying, understanding, and modifying intense emotions before they drive problematic behavior
- Interpersonal Effectiveness: skills for communicating needs, maintaining relationships, and setting boundaries while preserving self-respect
What Conditions Does DBT Treat?
DBT has demonstrated effectiveness for:
- Borderline personality disorder (BPD)
- Chronic suicidal ideation and self-harm behaviors
- Binge eating disorder and bulimia
- Substance use disorders
- Treatment-resistant depression and bipolar disorder
- PTSD with significant emotional dysregulation
How Is DBT Structured?
Full DBT typically includes 3 components delivered simultaneously: individual therapy sessions for personalized skill application, skills training groups where clients learn and practice the 4 modules, and phone coaching available between sessions for real-time skill support during crises.
At Los Angeles Mental Health and Wellness Center, DBT is integrated into individual therapy sessions that draw on the full DBT skill framework, tailored to each client's presenting needs and goals.
How Does DBT Work Alongside Other Therapies?
Mindfulness coaching directly reinforces the mindfulness module of DBT, building present-moment awareness that underpins every other DBT skill. Many clients also benefit from EMDR therapy alongside DBT, with each modality addressing different dimensions of trauma and emotional regulation.
Is DBT Available Through Telehealth?
Telehealth therapy is equally effective as in-person care for the majority of mental health presentations, including those treated with DBT. At Los Angeles Mental Health and Wellness Center, both in-person and telehealth DBT options are available, providing flexible access for clients throughout the Los Angeles area and California.