What Is DBT? A Beginner’s Guide to Dialectical Behavior Therapy

Mental health awareness has come a long way, and more people are now exploring therapy, asking better questions, and getting curious about what healing can actually look like. Because of this, you may have heard of "DBT" and wondered what it's all about. If this is the case, then you're in the right place.

Dialectical Behavior Therapy (DBT) is one of those powerful treatment approaches that has helped thousands of people find stability, emotional clarity, and stronger relationships. But what exactly is it? Who is it for? And what makes it different from other types of therapy?

What Is Dialectical Behavior Therapy?

Dialectical Behavior Therapy, or "DBT" for short, is a type of talk therapy designed to help people manage intense emotions, improve relationships, and build a life worth living.

DBT was developed in the late 1980s by psychologist Dr. Marsha Linehan, who wanted to create a therapeutic approach that helped individuals struggling with suicidal thoughts and Borderline Personality Disorder (BPD). What emerged was a blend of cognitive-behavioral strategies (changing how you think and behave) with mindfulness and acceptance techniques rooted in Eastern philosophies.

The "dialectical" part refers to the idea of balancing two opposing forces: accepting yourself as you are while also working to change behaviors that are hurting you. 

DBT vs. CBT: What's the Difference?

Cognitive Behavioral Therapy (CBT) is one of the most well-known and widely used forms of talk therapy. It helps people recognize and reframe unhelpful thoughts that influence their emotions and behaviors. But while CBT focuses on changing thought patterns, DBT focuses on accepting them and building healthier skills to manage them. DBT adds an emphasis on mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. It was originally created for individuals who experience intense emotions or struggle with chronic relationship challenges, especially those who didn't fully benefit from CBT alone.

Think of it this way:

CBT says, "Let's challenge that thought and change it."

DBT says, "Let's accept that thought, feel it, and choose a skillful way to respond."

They're both incredibly useful tools, and in many cases, therapists blend techniques from both. 

Who Can Benefit from DBT?

While dialectical behavior therapy was originally created for people with Borderline Personality Disorder (BPD), its effectiveness quickly caught on for a wider range of mental health struggles. Today, this type of therapy is used to help people dealing with:

• Anxiety
• Depression
• PTSD
• Substance use
• Eating disorders
• Self-harm and suicidal thoughts
• Emotional dysregulation

What techniques does Dialectical Behavior Therapy (DBT) use?

There are specific techniques that make Dialectical Behavior Therapy (DBT) unique from other therapeutic approaches. While there are many tools therapists may use, most DBT work is centered around building practical, repeatable skills to help you navigate daily challenges with more clarity and control.

The Core Skills

Mindfulness

Mindfulness is the foundation of DBT skills training. It teaches you how to be fully present in the moment rather than getting stuck in past regrets or future worries. This core skill can support every other area of your life, from managing emotions to improving relationships.

When practicing mindfulness, you'll learn to:

• Observe your thoughts, feelings, and surroundings without immediately reacting or judging
• Describe what you notice using clear, non-judgmental language
• Participate fully in the present moment without distractions

Distress Tolerance

Distress tolerance skills are those that help you get through emotionally intense moments without making the situation worse. The DBT therapy techniques, like this one, offer immediate, practical strategies to help you handle pain and stress when emotions feel like too much.

Distress tolerate teaches:

• ACCEPTS for distraction: Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, Sensations
• Self-soothing using your five senses to bring calm to your system (e.g., 5 things you can see, 4 things you can hear, 3 things you can touch, etc.).

Emotion Regulation

This DBT technique focuses on helping you better understand, manage, and respond to your emotions. The goal isn't to get rid of feelings but to respond to them with more awareness and control.

Some Dialectical Behavior Therapy techniques and tools for emotion regulation include:

• Identifying and naming emotions without judgment
• The STOP skill (i.e., Stop, Take a step back, Observe, Proceed mindfully)
• The ABC PLEASE strategy to reduce vulnerability:
  • Accumulate positive experiences
  • Build mastery
  • Cope ahead
  • PLEASE (treat Physical iLlness, balance Eating, Avoid substances, maintain good Sleep, and get Exercise)

Interpersonal Effectiveness

These skills are all about navigating relationships and social interactions successfully. They help you ask for what you need, say "no" effectively, set boundaries, manage conflict constructively, and maintain self-respect and healthy relationships. 

Key techniques include:

• DEAR MAN for assertive communication:
  • Describe, Express, Assert, Reinforce, Mindful, Appear confident, Negotiate
• GIVE to maintain healthy relationships:
  • Be Gentle, show Interest, Validate, use an Easy manner
• FAST to preserve self-respect:
  • Be Fair, don't Apologize unnecessarily, Stick to values, and be Truthful

DBT uses a combination of therapy techniques as part of your skills training to help you reinforce and apply what you learn. A standard program usually involves these 4 components of DBT, each serving a specific function:

1. Individual Therapy

You'll meet with a therapist for one-on-one sessions, focusing on your personal goals and challenges. Your therapist will help you track behaviors and emotions (often using a diary card), problem-solve tricky situations, and build on your skills each week.

2. Group Skills Training

Think of this like a class, not group therapy. You'll meet with others to learn new skills, practice them in a supportive environment, and discuss how they apply to your daily life.

3. Phone Coaching

Sometimes, you need help IN the moment. DBT offers access to phone coaching so you can get real-time support using the skills you've learned when life gets overwhelming.

4. Therapist Consultation Team

Even the therapists get support and training! DBT includes a built-in network for therapists to stay grounded, encouraged, and up-to-date.

Key Takeaways

Dialectical Behavior Therapy isn't a quick fix, but it's a powerful one. It focuses on four key areas and uses a structured approach to teach you practical skills to help you manage emotions, navigate relationships, and handle stress in healthier ways. While it shares some similarities with CBT, DBT focuses on the balance between acceptance and change. 

If you're dealing with big emotions or high-stress situations, it might be time to talk to a licensed therapist and see if DBT might be a good option for you. Remember, all therapists are different. (See if you can find your perfect fit here!) While some therapists may incorporate DBT skills into their therapy with clients, a formal DBT treatment program is official and structured. So, if you feel that DBT is the best fit for you, make sure your therapist is formally certified in DBT.

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