Dialectical Behavioral Therapy

What exactly is DBT?

Dialectical Behavior Therapy (DBT) is a unique type of therapy that's focused on learning very specific skills to give you new methods for creating a life you actually want to be living.

In addition to exploring your thoughts and emotions like traditional therapies, in DBT your behaviors and physical urges also get specific attention. Whether it's online DBT or in-person, your urges and behaviors are closely tracked to really understand what is working and not working in your life on a daily basis.

DBT has been extensively researched since its creation in the late 1980’s by Marsha Linehan, PhD, ABPP. Marsha Linehan originally developed DBT to treat chronically suicidal individuals and those diagnosed with Borderline Personality Disorder (BPD). DBT is now recognized as the gold standard psychological treatment for those dealing with the symptoms of Borderline Personality.

Years of research has shown that DBT is also highly effective in treating a wide range of issues such as anxiety, depression, mood disorders, emotional management difficulties, substance misuse/abuse, post-traumatic stress disorder (PTSD), and eating disorders, among others.

What does DBT include?

Comprehensive DBT ("full model" DBT) includes weekly individual DBT therapy sessions and a weekly DBT skills class.

Both of these elements are provided by a DBT intensively trained therapist with a therapist having 40+ hours of DBT training.

DBT skills classes are where you learn new strategies for handling your emotions, coping with life difficulties, and navigating relationships.

DBT individual therapy sessions are where you learn to tailor those skills to your unique life and needs.

It takes 6 months to get all the way through the DBT skills content. And depending on the person, it may take more than 6 months in order to repeat the program for full skills absorption & application (the average according to research from the Linehan Institute is 1.3 years).

DBT

Current availability:

I am full for new individual DBT clients. The next live cohort of my 8-week online DBT course starts April 30, 2025. Learn more.

What are the DBT skills?

Both online DBT and in-person DBT include the same set of skills when doing "full model" DBT treatment.

There are 4 sections taught in the DBT skills classes and reinforced in the individual sessions.

Mindfulness Skills

Mindfulness is about learning to better manage your attention. One goal with mindfulness is to focus on the present, rather than dwelling on past pain or worrying about future problems (this just makes the present even harder!).

As a regular practice, mindfulness increases your ability to focus your attention...where you want to, when you want to. Mindfulness skills help you to notice your thoughts and emotions and then control and regulate your thoughts and emotions.

Mindfulness improves your ability to be more “present” in your daily life so that you can notice and change the things you need in order to make it the life you want to be living. Read more about mindfulness.

Emotion Regulation Skills

The emotion regulation DBT skills are all about understanding, managing, and responding effectively to your emotions. Emotion regulation skills will equip you to recognize and validate your own emotions as an important part of the human experience.

You will learn how your emotions bring you valuable information about your own needs and the needs of others in situations and relationships.

The DBT Emotion Regulation skills offer you strategies to feel more in control of your emotions on a daily basis, by learning how to change and regulate your feelings. You might be interested in my 8-week online DBT course that focuses explicitly on these DBT emotion regulation skills.

Distress Tolerance Skills

The DBT Distress Tolerance skills will help you to endure bad, painful, intense, and difficult situations (which are inevitable in life!) without making them worse. It's a set of strategies to help you tolerate very upsetting things long enough to survive them instead of turning to unhealthy behaviors or damaging relationships.

The DBT Distress Tolerance skills offer you actionable steps to notice and regulate extreme reactions in upsetting situations and learn how to make effective choices when under duress. You'll learn how to navigate an intense emotional reaction in an overwhelming situation without losing sight of what you really want in the long term.

Learn about a quick Distress Tolerance skill you can use right now.

Interpersonal Effectiveness Skills

The interpersonal effectiveness DBT skills are the relationship tools. They are all about interacting with others in healthy & ideal ways. In online DBT or traditional DBT, you learn to effectively manage your relationships with improved communication and emotional connection.

You'll also learn how to improve or keep your boundaries, assertiveness, and self-respect so you can more often get what you need in relationships and interactions.

The DBT Interpersonal Effectiveness skills include how to negotiate successfully in conversations and relationships with others by asking for what you want and need, or by saying no even when it's hard. There are also some specific strategies for creating new healthy relationships and ending destructive ones.

aerial view of treetops depicting ability to overcome emotional overwhelm through DBT online counseling at mckenziecounseling.org

Your success matters.

We will use proven therapeutic techniques to make progress at a pace that feels comfortable and sustainable for you.

Online DBT with me

I provide individual online DBT therapy sessions as part of the "full model" treatment approach. Folks I work with can choose to learn the DBT skills through a skills class (either online DBT or in-person) or can choose for me to teach the DBT skills individually. During a consultation call, we'll discuss the best approach for you.

Currently I'm offering an abbreviated 8-week online DBT emotion regulation course which includes Mindfulness skills, the Emotion Regulation skills, and some Distress Tolerance content. It's not the full DBT content, but is a good match for some people.

My Dial Down Anxiety with DBT online course curriculum is detailed here.

What will online DBT do for me?

DBT can help you feel more able to control your thoughts, emotions, and reactions (your behaviors).

The DBT strategies enable you to understand yourself and others much more deeply. Your behaviors will start to make sense and feel more manageable. You will feel more equipped to make the changes you want in your life.

Online DBT can also greatly enhance your ability to communicate and interact with others in ways that work in both the short and long term.

Most participants in DBT find that by using the skills, they feel stronger & calmer and are more able to manage life's stressors without feeling overwhelmed, breaking down, or over-reacting.

DBT Resources

If you want to get started on your own, the following resources, books and websites are great options:

Grab a FREE download of my 3 Mindful Moments daily practice routine. This daily routine will help you get started with emotion regulation and boost your emotional awareness for easier coping. It's one of the tools I include in my 8-week online DBT emotion regulation course.

The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation, and Distress Tolerance by Matthew McKay (best book when trying to learn on your own)

DBT® Skills Training Handouts and Worksheets, Second Edition by Marsha M. Linehan (best book when in therapy with a trained DBT therapist; there is a lot of content that is best when taught/explained)

r/dbtselfhelp/ - Reddit's anonymous online community dedicated to online DBT resources and self-help with a wealth of information compiled in their FAQ/wiki

Now Matters Now - free videos and resources teaching online DBT skills especially helpful for suicidal thinking and intense emotions. Topics include Mindfulness, Mindfulness of Current Emotion, Distraction Techniques, Relationship topics, Problem Solving, Opposite Action and Paced-breathing.

Note that the above book links are affiliate links and if you make a purchase I may receive a small commission.