Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy designed to help people manage intense emotions, improve relationships, and build healthier coping skills. Originally developed by psychologist Marsha Linehan in the late 1980s, DBT was created to treat individuals with borderline personality disorder (BPD), but it is now used for a variety of mental health issues, including anxiety, depression, post-traumatic stress disorder (PTSD), eating disorders, and substance use.
The term “dialectical” means combining opposite ideas. In DBT, the key dialectic is acceptance and change—helping clients accept themselves as they are while also working toward positive change. This balance is the heart of DBT and is woven throughout its techniques and philosophy.
DBT helps people:
- Regulate strong emotions
- Tolerate distress without harmful behaviors
- Communicate more effectively
- Live more mindfully and in the present moment
It is especially useful for people who feel overwhelmed by emotions, have difficulty controlling impulses, or experience frequent relationship conflicts.
The structure of DBT
DBT is more structured than many other forms of therapy. It typically includes four key parts:
Individual therapy – One-on-one sessions with a therapist to work through personal issues, monitor progress, and apply DBT skills to daily life.
Skills training group – Clients meet in a group setting to learn and practice core DBT skills. These are more like classes than therapy groups.
Phone coaching – Clients can call their therapist between sessions for support in using DBT skills during real-life situations.
Therapist consultation team – Therapists meet with other DBT providers for support and supervision, ensuring high-quality care.
This structure creates a strong support system that helps clients stay engaged and make progress.
The four DBT skills modules
DBT teaches practical life skills, broken into four main modules:
Mindfulness
Mindfulness helps clients become more aware of the present moment. It teaches them to observe their thoughts, emotions, and surroundings without judgment. This skill is the foundation of DBT and supports all the other modules.
Distress tolerance
This module teaches how to survive emotional crises without making the situation worse. Clients learn healthy ways to cope with pain and distress, such as using grounding techniques, distraction, and radical acceptance when emotions feel unbearable.
Emotion regulation
Emotion regulation helps clients understand their feelings and reduce emotional vulnerability. Skills include identifying emotions, increasing positive experiences, and using tools like opposite action to shift intense moods.
Interpersonal effectiveness
This module teaches how to communicate clearly, set boundaries, and maintain healthy relationships. Clients learn how to ask for what they need, say no with confidence, and manage conflict without damaging relationships.
These skills are taught in a step-by-step way, giving clients the tools they need to respond to life more calmly and effectively.
Who can benefit from DBT?
DBT was first created for people with borderline personality disorder, but it is now used to help individuals with:
- Self-harm or suicidal thoughts
- Intense mood swings
- Eating disorders
- PTSD and trauma
- Substance abuse
- Depression and anxiety
It is especially helpful for those who feel emotions more intensely than others and have a hard time managing them without impulsive actions or relationship struggles.
Benefits of DBT
- Teaches practical coping skills that can be used in everyday life
- Builds emotional resilience and reduces harmful behaviors
- Improves relationships through healthy communication
- Offers structure and support, which can help clients stay committed to therapy
- Backed by research, showing positive results in treating a wide range of disorders
Conclusion
Dialectical Behavior Therapy offers a powerful, skill-based approach for managing emotions and building a more balanced life. By combining acceptance with change, DBT helps individuals create emotional stability, improve their relationships, and respond to life’s challenges with greater strength and awareness. For those who feel overwhelmed or stuck in unhealthy patterns, DBT offers a clear path forward—one skill at a time.