Understanding Dialectical Behavior Therapy (DBT): A Comprehensive Guide

Dialectical Behavior Therapy (DBT) is a skills-based treatment designed to help people manage intense emotions. Also, it helps them improve relationships and make lasting changes in their lives. Dr. Marsha Linehan developed this type of therapy. It grew out of cognitive behavioral therapy and is now one of the most researched approaches for people struggling with emotional regulation and relationships.

Key Takeaways

1. DBT blends acceptance and change: validating experiences and acceptance of who you are and how you are doing at this point in time, while equally working to give you the skills you need to create meaningful and lasting change.

2. Comprehensive DBT has four parts: individual therapy, skills group, phone coaching, and a therapist consultation team.

3. Skills Group works like an interactive and engaging workshop: covering five distinct skills modules including mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path.

4. Phone coaching supports real life: helping clients apply skills during moments of crisis or stress as they happen in real time

5. DBT helps with high-intensity emotions: reducing impulsivity, strengthening relationships, and addressing challenges like fear of abandonment or hopelessness.

At its core, DBT blends acceptance, validating a person’s experiences with change. Clients going through DBT learn concrete skills to navigate life, emotions, and interpersonal relationships more effectively. The combination is what makes DBT unique and especially helpful for people who have big emotions and sometimes react impulsively under stress.

What Makes DBT Comprehensive?

DBT isn’t just one therapy session each week. Standard, comprehensive DBT includes four parts that work together to create lasting change:

1. Individual Therapy

Individual DBT sessions focus on the most pressing problems in a clear order: safety first, then therapy-interfering behaviors, quality-of-life issues, and finally working to increase mastery of skills. Tools like diary cards and behavioral chain analysis help identify patterns and opportunities for skill use. Sessions typically run 45 minutes and balance acceptance with active change strategies.

2. DBT Skills Group

Skills Group is often described as an interactive class rather than group therapy. Meeting weekly, the group covers the full DBT curriculum over about four months. Participants learn practical tools across five modules:

• Mindfulness – staying present and aware.

• Distress Tolerance – surviving crises without making things worse

• Interpersonal Effectiveness – improving communication and relationships

• Emotion Regulation – better understanding and managing emotions

• Walking the Middle Path – finding balance instead of “all-or-nothing” thinking, and learning to get “unstuck” and better understand the people around you.

3. Phone Coaching

Real life doesn’t wait for a therapy appointment. DBT includes between-session phone coaching so clients can reach out when they need help most. Coaching is brief and focused on applying skills in the moment—whether that means preventing a harmful behavior, managing a crisis, or practicing asking for help.

4. Therapist Consultation Team

DBT also supports therapists through weekly consultation team meetings. This ensures clinicians stay true to the model, receive peer support, and provide the highest quality care. Behind every DBT therapist is a team working together to maintain effectiveness.

Who DBT is For

DBT is a structured, skills-based therapy designed for people who experience emotions with high intensity and feel stuck in painful relationship patterns. At its core, DBT is most effective for individuals who struggle with:

• Difficulties in interpersonal relationships

• Impulsivity and acting quickly under stress

• Fear of abandonment

• The long-term impact of chronic invalidation

• Lack a stable sense of self

• People who feel regularly hopeless and overwhelmed by emotions

Rather than a general-purpose therapy, DBT is a targeted intervention. It helps clients build skills that balance acceptance and change so they can manage emotional intensity and create healthier, more stable relationships.

Work With Me

Dialectical Behavior Therapy has grown into one of the most trusted approaches for treating emotional and relational challenges. Its unique balance of acceptance and change, combined with structured skills training, makes it a powerful resource for people who want to better manage emotions, improve relationships, and move toward a more fulfilling life.

Let’s work together. I’d love to speak with you and share with you how I can help you. Schedule a call with me here.

Additional DBT Research I Recommend

Here are additional DBT research pages I recommend that you read. 

1) This is the core research supporting DBT.

2) This is the website for the primary DBT institution.