What Is DBT Therapy?

Emotional dysregulation is a common but challenging mental health concern connected with conditions like attention-deficit hyperactivity disorder (ADHD), borderline personality disorder (BPD), and substance use disorders. Dialectical behavior therapy (DBT) is a form of psychotherapy that can help participants self-regulate and manage symptoms of these disorders and other mental health challenges through acceptance and change. Below, explore an overview of DBT, the benefits of DBT techniques, and options for DBT in the United Kingdom. 

What Is DBT and How It Differs from CBT?

Dialectical behavior therapy is often described as a specialized form of care that grows out of cognitive behavioural therapy, yet it moves in a slightly different direction by blending acceptance with gradual change.

While many people are familiar with CBT as a structured talking therapy that examines thoughts and behaviors, DBT tends to place greater emphasis on steady emotional awareness and the cultivation of specific skills for managing moments of overwhelm. These skills,often practiced through mindfulness, interpersonal strategies, and distress-tolerance exercises, encourage participants to notice their inner experiences before shifting them with gentle change techniques. 

Because of this blend of acceptance and action, DBT may feel particularly supportive for individuals who experience strong emotional swings and benefit from methods that acknowledge their feelings while guiding them toward healthier responses.

What is dialectical behavior therapy (DBT)?

Emotional regulation is a skill that can improve one’s mental well-being, physical health, and overall ability to function. However, certain mental health concerns can make controlling emotions more difficult, potentially leading to unhelpful behaviors, interpersonal conflict, and worsening psychological challenges. Dialectical behavior therapy (DBT) is a modality that may aid clients in practicing emotional regulation and developing coping skills for stressful situations. 

Psychologist Marsha Linehan developed DBT in the 1970s and 1980s as a treatment for people who were at risk of self-harm due to borderline personality disorder. In addition to personality disorders, DBT can treat mood disorders, ADHD, eating disorders, substance use disorders, and related mental health conditions.   

How DBT compares to other types of therapy for mental health 

DBT was developed based on the principles of cognitive-behavioral therapy (CBT). However, certain key skills differ from CBT and other modalities. DBT is unique in its focus on managing complex emotions. In contrast, modalities like cognitive-behavioral therapy often emphasize an individual’s thoughts and behaviors. 

Another difference between DBT and other therapies is the focus on mindfulness. DBT was one of the first forms of psychotherapy to utilize mindfulness, which helps participants develop an increased awareness of the present. Since DBT was developed, several other modalities have been adapted to include mindfulness principles. 

Borderline personality disorder, depression, and beyond: Mental health conditions DBT can treat

Initially created for people living with borderline personality disorder, DBT has been modified to help people living with varied mental health concerns. The following are some of the most common disorders DBT can treat. 

Borderline personality disorder

Borderline personality disorder (BPD) is a serious mental health condition marked by trouble with emotional regulation, impulsive behaviours, and strained relationships. According to the UK’s National Institute of Health and Care Excellence, DBT is a first-line treatment for individuals with BPD. 

Depression

Depressive episodes often involve intense feelings of sadness, emptiness, and hopelessness. Through greater understanding and acceptance, DBT can help participants better express these difficult emotions. In one study, researchers found that DBT led to a reduction in depressive symptoms through improvements in emotional processing. 

Anxiety

Principles of DBT

An overarching goal of DBT is acceptance of one’s strong emotions. DBT providers help participants achieve this through four primary techniques: mindfulness meditation, emotional coping, interpersonal skills, and distress tolerance. 

Mindfulness

Mindfulness is a form of meditation that helps people remain present and focused. Enhancing awareness of one’s thoughts, feelings, and surroundings can help individuals better identify and regulate emotions. 

An example of a mindfulness exercise involves sitting or lying in a quiet place while focusing on thoughts, physical sensations, or emotions. If the participant’s thoughts wander, they can gently bring them back to the present. If the individual experiences intense emotions, they can note them without judgment. 

Emotional regulation

DBT providers help participants develop tools to identify and manage their emotions. One of the most common emotional regulation techniques involves processing strong feelings through a diary. For example, a counsellor may prompt their client to journal about emotions they feel throughout the week. 

Interpersonal skills

Because emotional dysregulation can lead to fraught relationships, interpersonal effectiveness is a key component of DBT. DBT counsellors help participants develop skills like meeting their needs, resolving conflict, and being assertive. 

An example of an interpersonal effectiveness technique is DEAR MAN, an acronym meant to help people ask for what they need. Through the DEAR MAN approach, clients are encouraged to: 

• Describe their situation
• Express their emotions regarding these circumstances
• Assert themselves
• Reinforce the benefits of the request
• Mindfully focus on their objectives
• Appear confident
• Negotiate to come to a beneficial agreement

Distress tolerance

Difficulty navigating stressful situations can lead to unhelpful expressions of emotions, negative thoughts, and self-destructive behaviours. Learning to respond to life challenges healthily is a core goal of DBT. For example, a therapist may help their client practice breathing exercises, which they can employ when they’re experiencing anxiety at work.

DBT Skills Training: Practical Tools for Daily Life

DBT skills training focuses on equipping participants with practical tools that can be applied in everyday situations, offering a framework for responding to emotional challenges more effectively. 

Through guided practice, individuals learn specific skills in areas like mindfulness, distress tolerance, and interpersonal communication, which encourage navigating life in a healthy way rather than reacting impulsively.

Over time, this repeated practice can foster positive changes in emotional regulation, self-awareness, and relationships, creating a stronger sense of control and resilience. By integrating these techniques into daily routines, participants gradually cultivate a more fulfilling life, where difficult emotions are met with clarity and intentionality rather than avoidance or overwhelm.

How therapeutic treatment through DBT works

DBT may be offered via individual and group sessions. The process often begins with an initial assessment. During this session, the provider and client may discuss the individual’s mental health concerns, review the suitability of DBT, and develop treatment objectives. 

One-on-one sessions with a therapist usually occur weekly and are typically 50 to 60 minutes long. A primary goal of this phase of DBT is to help the participant acknowledge their emotions. This step is often achieved through a diary or diary cards, in which clients can record their feelings throughout the week. During individual therapy, the professional may ask the client to discuss their experiences from the previous week with thoughts of self-harm, emotional dysregulation, or relationship conflict.  

Participants also meet in a DBT skills group each week. These sessions, which are normally one to three hours long, help group members learn coping techniques through exercises and lessons.   

Coaching & Support Outside Sessions

In DBT, support is extended beyond the therapy room to help participants navigate real-life challenges as they arise, often through telephone coaching or phone coaching. This approach allows individuals to reach out to trained therapists during moments of heightened emotion or uncertainty, offering guidance on applying the skills learned in sessions to immediate situations. 

By providing this bridge between structured therapy and everyday life, the method can reinforce learning and foster consistency, helping participants progress steadily through the recovery process.

This ongoing connection encourages a sense of safety and accountability, supporting the development of practical coping strategies that can be used when emotions feel overwhelming or situations feel unmanageable.

DBT for Co-Occurring Challenges

Dialectical behavior therapy (DBT) can be particularly supportive for individuals facing multiple overlapping difficulties, such as substance abuse and eating difficulties including binge eating.

In these contexts, participants often struggle with feelings of being a bad person or unworthy, which can intensify cycles of self-criticism and maladaptive coping.

DBT provides strategies to manage overwhelming emotions without resorting to harmful behaviors, offering a structured way to respond to intense urges with awareness and self-compassion. 

By integrating emotional regulation, mindfulness, and interpersonal skills, the approach encourages a gentler, more practical path toward understanding triggers and creating sustainable coping mechanisms, helping individuals navigate these co-occurring challenges with greater confidence and resilience.

How to Find DBT Services in Your Local Area

Locating dialectical behavior therapy in a local area often begins with exploring clinics, counseling centers, or online platforms that offer therapy specifically tailored to emotional regulation and coping skills.

Many participants find it helpful to connect with trained therapists who specialize in DBT, as their expertise ensures a structured approach to developing specific skills for managing intense emotions. 

Research shows that both in-person and online DBT programs can effectively support individuals dealing with borderline personality disorder, anxiety, or co-occurring conditions, offering practical tools to navigate daily challenges.

By reaching out to reputable providers or consulting NHS and private directories, individuals can find options suited to their schedule and preferences, fostering a supportive path toward emotional resilience.

Options for DBT in the UK

For residents of the United Kingdom, there are several options for DBT therapy, including but not necessarily limited to the following. 

Psychotherapy and the NHS

Psychotherapy through the NHS is free, making it a helpful option for many UK residents. You can request a referral from your general practitioner if you’d like to pursue DBT through the NHS. You can also find a provider through the NHS talking therapy service. 

DBT therapy online

Online therapy platforms allow UK residents to easily connect with mental health providers who can help them utilize DBT skills. With online platforms, participants can engage in DBT exercises without having to leave home. 

Treatment through an individual practice

Though these options may be more expensive, an individual practice or clinic may provide a DBT programme that fits your needs. You can go directly to a mental health professional or find a counsellor through your medical insurance provider. 

Participating in DBT and other types of therapy online

A growing number of studies suggest that online therapy is an effective method of conducting dialectical behavior therapy. In a study on the effects of online therapy, researchers found that a DBT-based programme improved emotional regulation—as well as executive functioning—in participants.