DBT, or dialectical behavior therapy, is an evidence-based form of psychotherapy originally developed by psychologist Marsha Linehan in the 1980s to treat borderline personality disorder. It has since been adapted and validated for a wide range of mental health conditions including depression, PTSD, eating disorders, substance use disorder, bipolar disorder, and anxiety. The name reflects the therapy's foundational concept: dialectics, the idea that two seemingly opposing truths can coexist. In practice, DBT teaches people to accept themselves as they are while simultaneously working toward meaningful change.
How DBT Differs From CBT
DBT is built on a foundation of cognitive behavioral therapy and shares CBT's focus on identifying and changing unhelpful thought patterns and behaviors. The key difference is that DBT adds a substantial emphasis on acceptance, validation, and emotional regulation that CBT does not include. CBT primarily asks: what are you thinking and how can we change it? DBT asks: how can you accept and validate your current experience while also developing the skills to respond differently? This dual emphasis on acceptance and change is particularly effective for people who have found standard CBT insufficient because they felt their emotional experience was not being acknowledged.
The 4 Core Skill Modules of DBT
DBT is structured around 4 skill modules that clients learn and practice over the course of treatment. Mindfulness is the foundational module, teaching clients to observe their thoughts, emotions, and sensations in the present moment without judgment. Distress tolerance provides tools for surviving crisis moments without making the situation worse. Emotion regulation helps clients understand the function of their emotions, reduce vulnerability to intense emotional reactions, and build positive experiences. Interpersonal effectiveness teaches skills for asserting needs, maintaining relationships, and navigating conflict while preserving self-respect.
What a Typical DBT Program Looks Like
Comprehensive DBT includes weekly individual therapy sessions with a DBT-trained therapist, weekly skills training group sessions with other clients, and phone coaching access between sessions for real-time support during difficult moments. The group sessions function more like a structured class than a traditional support group: the therapist teaches specific skills from the 4 modules, and clients practice them through exercises and homework assignments. Individual sessions then apply those skills to the specific situations the client is navigating in their life. This combination of learning and application is what distinguishes DBT from other therapy formats.
Who Benefits Most From DBT
DBT was developed specifically for people with borderline personality disorder, a condition characterized by intense and rapidly shifting emotions, unstable relationships, impulsivity, and self-harming behavior. It has the strongest evidence base for this population. Beyond BPD, research supports DBT as an effective treatment for suicidal ideation and behavior, chronic depression that has not responded to other treatments, binge eating and bulimia, PTSD, and substance use disorders where emotional dysregulation is a primary driver of use.
People who tend to respond best to DBT are those who experience emotions intensely, have a history of difficulty in relationships, feel invalidated by traditional therapy approaches, or have not achieved lasting improvement from CBT alone. If you have been told your emotions are too reactive or have struggled to implement cognitive strategies under emotional pressure, DBT's explicit focus on emotional intensity is likely a better fit than generic talk therapy.
How Long DBT Takes
A full DBT program typically runs 6 months to a year, with some clients continuing individual sessions after completing the skills group portion. Research shows that the majority of clients with borderline personality disorder who complete a full year of DBT no longer meet diagnostic criteria for the condition. Outcomes for other conditions tend to show significant improvement within 6 months of consistent engagement. One aspect of DBT that distinguishes it from other therapy formats is the homework component. Clients keep a daily diary card tracking specific emotions, urges, and behaviors that are the focus of treatment. These cards are reviewed at the start of each individual session and guide the session's priorities. The data collected over weeks gives both the client and therapist a precise, evidence-based picture of how symptoms are changing and which skills are producing the most impact. DBT is a skills-based therapy, which means the more consistently skills are practiced between sessions, the more quickly they become automatic and available under stress. Many clients continue individual sessions after completing the formal DBT program for maintenance, application of skills to new life challenges, and deeper work on the underlying experiences that originally contributed to emotional dysregulation.
Work With LA Mental Health and Wellness Center
Our clinicians are trained in DBT and integrate it with other evidence-based approaches to treat the full clinical picture. Learn more about our work on understanding CBT and DBT.
DBT is particularly powerful when combined with other therapies that address underlying trauma. Read about how EMDR therapy works and how it complements DBT.
To schedule a consultation and discuss whether DBT is right for your situation, contact us here.