Dialectic Behavior Therapy

Illustration DBT Skills: Mindfulness, Emotional Regulation, Distress Tolerance, Interpersonal Effectiveness.

Dialectical Behavior Therapy (DBT) is a highly researched, effective therapy practice that helps treat those suffering from mental health stressors. These stressors include symptoms such as anxiety, intense emotional reactions, uncontrolled anger, feelings of panic, substance misuse, and/or interpersonal conflicts. DBT offers practical skills to help us enhance our self-acceptance, navigate difficult emotions, improve relationships, and cope with distressing situations. As it empowers us to make positive changes, this approach can help individuals create the life they want and deserve.

How it works

Finding Balance: Dialectical Behavior Therapy (DBT)

Created in the 1970’s by Marsha Linehan, DBT is an evidenced-based treatment that mixes elements of cognitive-behavioral therapy (CBT) with concepts from Eastern mindfulness practices. It is effective in treating anyone struggling with managing feelings and emotions, including those with mental health conditions like depression, anxiety, post-traumatic stress disorder (PTSD), or eating disorders. In addition, it can treat people who struggle with problematic substance abuse, and/or compulsive gambling. Dialectical Behavior Therapy is also the leading therapy approach for teens and adults who struggle with self-injury and/or suicidal ideations.

5 Core Components of DBT

Dialectical Behavior Therapy (DBT) focuses on Mindfulness, Emotional Regulation, Distress Tolerance, and Interpersonal Effectiveness. When applying DBT strategies to children, adolescents, and their families, there is a 5th component – Walking the Middle Path.

  1. Mindfulness is the practice of learning to be aware in the present moment, focusing your mind, and directing your attention to what is happening for you right in this minute. This practice can help you decrease confusion within and about yourself. Mindfulness increases your awareness of your feelings and thoughts which allows you to manage them differently and more effectively.
  2. Distress Tolerance promotes learning to accept the current situation ‘as is’ while tolerating your emotional response and sitting in the discomfort of something you may not want, not like, want to get away from, or want to change. When we can decrease our unhelpful reactions, impulses, resistance, and be present by practicing helpful skills, we can feel better. 
  3. Emotion Regulation can increase your understanding of your emotional experiences, provide strategies to help you accept your emotions, and also reduce emotional intensity by using certain learned skills. Learning about and developing skills that will lower the intensity of our overwhelming emotions and promote healthy regulation when we are angry, sad, grieving, lonely, disrespected, or are feeling misunderstood can enhance our overall wellness.
  4. Interpersonal Effectiveness can help you and your family member or partner learn how to set boundaries, balance priorities, and build self-respect. Interpersonal effectiveness increases your ability to keep important relationships steady and to gain the skills needed to decrease interpersonal conflicts, problems, and misunderstandings.
  5. Walking the Middle Path (For Teens and Parents) assists families in creating healthy interactions and caring relationships. By establishing a bridge of connection based on mutual respect and cooperation, parents and teens work together to understand, align with, and support each other.

Goals of Dialectical Behavior Therapy (DBT)

DBT therapy helps individuals achieve balance among opposing forces, feelings, and beliefs (dialectics) in order to improve mental wellness. This therapeutic approach focuses on validating your feelings while helping you increase your awareness of unhelpful thoughts and behavior patterns.

Three States of Mind

Your mind has three states: the reasonable mind, the emotional mind, and the wise mind. Everyone possesses each of these states, but most people tend to gravitate toward a specific one.

DBT wise mind – the synthesis of the two opposites: the reasonable mind and the emotion mind

Rational Mind

  • Approaches experience intellectually
  • Uses knowledge & past experience
  • Uses facts, research, & planning
  • Focused

Wise Mind

  • Intuitive experience & thinking
  • Balance of Rational & Emotional Mind
  • Living mindfully

Emotional Mind

  • Approaches experience emotionally
  • Uses only emotions to make decisions
  • Reactive
  • Tells us how we feel
  • Uses core psychological needs

Our therapists teach various DBT skills to children, teens, and adults that help them to:

  • Develop insight into their motivations and responses 
  • Understand their emotions, beliefs, and thoughts
  • Identify the most effective actions they can take to help calm their distressing emotions
  • Create a personalized plan to help emotionally navigate challenging experiences
  • Collaborate and develop actionable steps that both parent and teen can take to create beneficial solutions for each person 

For example, a skill like COPE AHEAD can help prevent and calm your emotional response in a stressful situation. This technique asks you to imagine how you might feel in a future situation and identify available options to navigate that situation. This exercise enhances your ability to make informed and thoughtful decisions in an emotionally-charged situation. It can also help you avoid saying or doing things that aren’t beneficial for you or the people around you. 

When children and teens learn DBT skills with their parents and/or in a group setting with other peers, powerful change and growth emerges.

Further Reading & Resources

Meet our Therapists

Health and Healing Therapy’s therapists provide a safe, supportive environment to help clients identify unhelpful patterns of thought or behavior which are often problematic within their relationships and methods of coping.

A quiet office with two round teal chairs.

Create the life you want and deserve.

You don’t have to suffer alone. Our therapists can help you Grow, Heal, and Thrive.