What is Dialectical Behavior Therapy (DBT)?

Acceptance is the first step toward change.

Dialectical behavioral therapy (DBT) is effective in treating complex and ongoing mental health problems. DBT is effective in helping individuals who have an especially difficult time managing and regulating their emotions.

Dialectical means 'working or acting through opposing forces'. As the name suggests, this therapy works through using opposing strategies: acceptance and change. An individual accepts their experiences and behaviors as valid, but the individual must also accept change. Therefore, DBT takes a direct aim at self-acceptance and understanding personal challenges in conjunction with implementing and managing positive emotions and practicing new and enduring skills to regulate emotions.

During DBT sessions, we explore and understand the source of your emotional challenges. What triggers your emotions and why you are burdened with the challenge of emotion regulation.

This therapeutic process unfolds through several stages, depending on the severity of emotional dysregulation. The first stage addresses the individuals lack of emotional and behavioral self control, then therapeutic techniques are practiced to gradually restore control. The second stage acknowledges the individual’s desperation for change. Once life threatening or pathologic behavior is better controlled, emotional experience are discussed and reframed. The third stage addresses to challenge of how to live, redefine expectations in life, within a normative range of peace and contentment. The final stage is to consider deeper meanings in life within the context of future goals, significant others, or spiritual exploration.

These changes require a longer commitment to therapy (they cannot be effectively changed in a couple of sessions) and it may take 6 months (and up to a year) to instill effective and enduring change.

DBT is most effective for individuals struggling with BPD (borderline personality disorder), suicidality, self-harm, substance use and addictions, PTSD, MDD (major depressive disorder) and eating disorders.

DBT differs from CBT in that these therapies are specific to the intensity of the emotional or mental challenge being experienced.

DBT teaches acceptance, acknowledgement, change and the skillset to achieve this progression. DBT combines elements of CBT to help manage distress and regulate emotions.  

CBT is focused on addressing negative thoughts and behaviors and immediately redirects toward positive thought processes for emotional and behavioral change.