What's Dialectical Behavior Therapy? Developing Your Understanding

Medically reviewed by Andrea Brant, LMHC
Updated May 16, 2023by BetterHelp Editorial Team

Sometimes, painful emotions and conflicts can take a lot out of a person. If you’ve been wondering what type of therapy can help with these emotions, you may have heard about dialectical behavioral therapy, or DBT. DBT can help people build valuable skills to handle challenging emotions and improve their relationships. Below, we’ll look at DBT, how it is used, and the benefits of this type of therapy.

What Is Dialectical Behavior Therapy?

Are You Interested In Learning More About When DBT Is Used?

Dialectical behavior therapy, or DBT, is a type of psychotherapy that aims to teach group skills to help people learn and utilize skills that they need to create a more fulfilling life. It was developed by Marsha Linehan, who used it initially for those who had borderline personality disorder (BPD), and it now can be used for a majority of the population for other disorders, especially those that cause self-destructive behaviors. DBT aims to give a person new skills that they can use to manage intense negative emotions.

DBT tends to focus on four key elements:

  • Mindfulness, which focuses on improving someone's ability to be present in the moment
  • Distress tolerance, which is geared toward increasing tolerance for negative emotion, rather than trying to escape it
  • Emotional control, which is a strategy used to manage and change emotions that are intense and create problems in a person's life
  • Interpersonal effectiveness, or behavioral skills that allow someone to communicate with others in a way that's assertive while maintaining self-respect and strengthening relationships.

When Is DBT Used?

DBT was originally used to treat BPD. But, it can help treat those who experience depression, post-traumatic stress disorder (PTSD), binge eating, generalized anxiety disorder, bulimia, bipolar disorder, eating disorders, and substance use. DBT is similar to cognitive behavioral therapy (CBT), but it is specially adapted for the needs of people with intense, often-uncontrollable emotions. 

Rather than trying to change the emotions, DBT teaches strategies for coping with them in healthy ways. DBT skills are taught in telephone crisis coaching because the coping skills learned in DBT therapy can be applied immediately to prevent harmful behavior like self injury*.

One study on the benefits of comprehensive DBT therapy for patients with bulimia found that the participants had significantly decreased bulimia nervosa symptoms after learning emotional regulation skills. However, more research needs to be done on how suitable DBT therapy is for eating disorders. 

DBT skills are thought to help people control their emotions, develop more tolerance of distress and negative emotion, remain present in the moment, improve communication, and interact with others better. Anyone can benefit from learning the skills taught in DBT therapy, but especially people who experience intense emotions. 

  • If you are experiencing a crisis text HOME to 741741 to contact the Crisis Text Line 

Why Does DBT Focus On Skill Development?

Rather than just addressing problems, DBT teaches skills because behaviors that are problematic can start to evolve as unhealthy coping mechanisms. While addressing problems can provide temporary relief, it's often not helpful in the long term. DBT therapists teach their clients healthy coping skills and mindfulness skills to help them notice and respond to intense emotions in a healthy way. 

To provide effective treatment, DBT assumes that clients are trying as best as possible but that they need to learn behaviors in different contexts. The word “dialectical” means to combine opposites. DBT therapy can teach people how to accept their intense emotions without reacting to them in a maladaptive way. People with borderline personality disorder and other mental health conditions may engage in self injury and other harmful behaviors. DBT teaches skills to stop unwanted behaviors and replace them with positive coping skills.

Dialectical behaviour therapy focuses on helping people make positive changes in their life by regulating intense emotional reactions. DBT aims to teach these different skills, which may allow a person to navigate situations in everyday life or manage challenges that get too big. These skills, according to Linehan, can be a huge part of building a fulfilling life. Being fully aware of their emotions can help people with personality disorders manage intense emotions in day to day life. 

How Does DBT Work?

DBT is mainly categorized as cognitive therapy. Cognitive therapy is a form of talk therapy that focuses on how cognitive distortions, or negative thought patterns, can impact behavior. Since it was originally used for those with BPD, we’ll explore how it works with those who have BPD.

People who have BPD can have extreme emotions, which can be difficult to manage. These can be intense, uncontrollable emotions that become a problem when someone with BPD is interacting with other people, including friends, romantic partners, and even their own family.

Individual therapy in a DBT program tends to be influenced by philosophy of dialectics, which often focuses on balancing behavioral opposites. A therapist might work with you to find different ways to balance different perspectives that are influencing you. This work may help you to avoid extremes in the way you think. In clinical psychology, DBT training may provide you with distress tolerance skills, coping skills, and thought reframing.

What To Expect From DBT

This type of therapy may consist of both group work and one-on-one sessions. The therapist may occasionally seem like a coach to the client. The goal of individual therapy sessions is to keep the person motivated, help them apply the learned skills in their life, and address any obstacles that might arise during treatment. Therapists may use a variety of methods including role-playing, behavioral experiments, and homework assignments. Doing any homework assignments the therapist assigns can help you get the most out of DBT therapy. 

There may be one or more licensed mental health professionals involved in treatment. Some facilities offer a consultation team to provide comprehensive DBT treatment. The DBT consultation team may include a primary healthcare provider, behavioral tech, nurses, therapists, and other professionals. The following are some skills that you may work on during DBT.


During DBT sessions, a therapist may help a client become more mindful of any triggers that cause emotional distress or any situations that can cause a desire to lash out and an inability to accept change. Accepting change tends to be a significant part of this type of therapy.

Distress Tolerance

When it comes to the skill of distress tolerance, the therapist may focus on helping the person try to tolerate negative emotions. Oftentimes, a person may flee negative situations or lash out, which tends to breed more negativity. With DBT, a therapist may help the client to tolerate their current emotions and handle distress more skillfully.

Emotion Regulation

Emotion regulation skills consist of strategies that can be used to help a person become more emotionally balanced. Managing emotions can help prevent blowups, allowing them to harness control over their emotions.

Interpersonal Effectiveness

Interpersonal effectiveness training aims to help a person become more assertive in their relationships. This component of DBT may help them to get better at communicating and have a stronger, healthier relationship not just with themselves, but also with other people.

Group Training

This group aspect of DBT focuses mostly on learning how to practice these skills. The one-on-one aspect of training tends to focus on the why, but group work allows you to practice your skills. Other people have their own experiences, and they may know of something that can help you cope with challenging situations better. Also, group work can give you a better, more reliable support network. Usually, one trained therapist leads all of this work and they practice different skills and exercises with group participants. 

The group component of DBT usually lasts about two hours, with the group meeting weekly for approximately six months, depending on the needs that people have. DBT can be conducted in different ways, depending on the participants and the therapist. Some people don't need skills groups, but others may find that they work better with others. 

Group therapy can have many benefits, including social support and encouragement from the other group members. Practicing the skills learned in DBT with others can help increase self esteem and confidence. However, how suitable DBT group therapy is for people may depend on several factors. People with social anxiety or privacy concerns may feel uncomfortable in a group setting and prefer individual DBT therapy. The effectiveness of group sessions may depend on the participant’s willingness to participate. 

Get Help With A Therapist Trained In DBT

If you’re interested in trying DBT, you can search for "DBT therapy near me" with an experience in this therapeutic modality. Alternatively, you might try DBT through online therapy, which research has shown to be just as effective as in-person therapy. With an online therapy platform like BetterHelp, you can speak with a licensed therapist without leaving home, which may be more comfortable than going to a therapist’s office if this is your first time trying therapy. 

With BetterHelp, you can communicate with a DBT therapist via phone or video chat at a time that suits your schedule. Also, you can contact your therapist in between sessions via in-app messaging, and they’ll get back to you as soon as they can.

Are You Interested In Learning More About When DBT Is Used?


Whatever personal challenges you’re experiencing at the moment, you don’t have to face them alone. You can be matched with a BetterHelp therapist with training and experience in dialectical behavioral therapy (DBT). Take the first step toward improved emotional balance and reach out to BetterHelp today.

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