DBT is a comprehensive therapy combining cognitive-behavioral techniques with mindfulness practices. Developed by Dr. Marsha Linehan in the late 1980s and originally created to treat borderline personality disorder, DBT has since been adapted to address a wide range of mental health issues characterized by emotional dysregulation and impulsive behaviors.
The skills taught in DBT fall into four modules: mindfulness (focusing on the present moment non-judgmentally), distress tolerance (coping with crisis situations without making them worse), emotion regulation (understanding and managing intense emotions), and interpersonal effectiveness (navigating relationships assertively and effectively).
This may be a good fit if…
- ✓Emotions arrive fast and at full volume, and take a long time to come down
- ✓You act in ways during a crisis that you regret once it passes
- ✓Relationships run hot and cold and you are not sure why
- ✓You have been told you are too much, or you have concluded it yourself
- ✓Self-harm, suicidal thinking, or impulsive behaviour is part of the picture
Key benefits
Skills for the moment it is actually happening
Distress tolerance skills are built for the twenty minutes when everything is at its worst and you would otherwise do something damaging. They are deliberately simple, physical, and possible to use when your thinking has narrowed.
It holds both sides
The dialectic at the centre of DBT is that you are doing the best you can and you need to do better. Therapies that only validate can leave you stuck; therapies that only push feel like blame. Holding both is the mechanism, not a slogan.
Built for the hardest presentations
DBT was developed for chronically suicidal clients with borderline personality disorder, a group most treatments excluded. It has since been adapted for substance use, eating disorders, and adolescents, and remains the best-evidenced treatment for emotion dysregulation.
You learn the skills as skills
Skills training is taught explicitly, in modules, with practice between sessions, rather than hoped for as a by-product of a good therapeutic relationship.
How DBT works
The Four DBT Skill Modules
A practical toolkit for big emotions, taught and practiced in session and at home.
Mindfulness
Notice without reacting
Distress Tolerance
Survive crisis without making it worse
Emotion Regulation
Understand and shift emotion intensity
Interpersonal Effectiveness
Ask, say no, keep self-respect
The Dialectic at the Heart of DBT
Two things are true at once: you are doing the best you can, and you can do better.
Acceptance
Mindfulness and distress tolerance. Seeing the moment as it is, and getting through it without making it worse.
Change
Emotion regulation and interpersonal effectiveness. Building the skills to shift what you feel and how you ask for what you need.
How we offer DBT at Crown Counseling
Comprehensive DBT is a package: weekly individual therapy, a weekly skills group, phone coaching between sessions, and a consultation team for the clinicians. Not every practice can staff all four, and we will tell you plainly which parts we can provide and which we would refer out for.
- Individual DBT with a clinician trained in the model
- DBT-informed individual work where a full programme is not the right fit
- Diary cards and behavioural chain analysis as standard
- An honest referral when what you need is a full comprehensive programme
DBT-informed is not the same as DBT
A lot of therapists use DBT skills without delivering the model, and that can be genuinely useful. It is not the same treatment, and the research on outcomes is based on the full package. We use the phrase DBT-informed when that is what we mean, so you can tell the difference and make your own decision.
What to expect
DBT typically consists of individual therapy sessions, group skills training, and phone coaching for crisis situations. The full DBT program usually lasts at least six months to a year, though elements of DBT can be incorporated into other treatment approaches for those unable to commit to a full program.
- 1
An assessment covering current risk, not only history
- 2
Agreement on a target hierarchy: life-threatening behaviour first, then anything that disrupts therapy, then quality of life
- 3
A diary card tracking urges, emotions, and skill use between sessions
- 4
Chain analysis of a specific incident rather than a general discussion of the week
- 5
Skills taught across four modules: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness
- 6
A commitment of at least six months for a full course
Ready to start?
Tell us a little about yourself and we will match you with a clinician trained in DBT.
Get matched →Therapists trained in DBT
Sarie KorfLicensed Master Social Worker
Hannah KrausLicensed Master Social Worker
Chanah FaygenLicensed Master Social Worker
Rikal KahanovLicensed Master Social Worker
Jacqueline MizrachiLicensed Master Social Worker
Jennifer AghavianLicensed Master Social Worker
Alexa GoldfederLicensed Master Social Worker
Sara BlumLicensed Master Social Worker
