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What is DBT?

Writer's picture: Kiki FehlingKiki Fehling

Updated: 3 days ago

Dialectical Behavior Therapy (DBT) is a unique and powerful therapy. It's changed my life, and it's changed (and even saved) the lives of thousands of people. That's why I love telling people about it! Consider this post your DBT 101.


(tl;dr: DBT is a research-backed treatment that teaches dozens of coping skills. It can be helpful in treating BPD, (c)PTSD, self-harm, depression, anxiety, substance use, and other emotional struggles. It can help neurodivergent people, LGBTQ+ people, and people of various cultures, ethnicities, and languages.)


DBT Helps People Understand and Cope with Emotions

DBT was designed to help people dealing with intense emotions and impulsive behaviors (e.g., self-harm, disordered eating, substance abuse). It was originally studied as a treatment for borderline personality disorder (BPD), but it's now considered much more than that.

A large majority of DBT focuses on improving emotional regulation: how someone understands, uses, copes with, and lives in balance with their emotions.

DBT can be particularly helpful for highly sensitive or neurodivergent people who feel emotions easily or intensely. It can also help people who feel like they're totally at the mercy of their emotions (like many people with BPD).

If it sometimes feels like emotions are driving the car of your life, like you're just along for the ride, DBT can help put you back in the driver's seat. It does that, in part, by teaching DBT skills.


DBT Teaches Dozens of Skills

A key feature of DBT is DBT skills. These skills cover four main modules*:

  • Mindfulness. Skills for improving attention and increasing wisdom and peace. By practicing being in the present moment, exactly as it is, you can learn to live a more embodied, liberated, and authentic life.

  • Distress tolerance. Skills for coping with the most painful experiences in life. When you can't change reality or change how you feel about it, you can use distress tolerance skill to survive emotional crises without acting impulsively, dissociating, or suppressing.

  • Emotion regulation. Skills for understanding, feeling, using, and changing emotions. This module can help you better relate to and work with your emotions while increasing your overall resilience.

  • Interpersonal effectiveness. Skills for improving communication and relationships. You can learn how to better assert yourself and saying no, while still respecting the needs of other people and maintaining your self-respect.

By covering a wide array of topics and areas, DBT skills offer guidance in almost all areas of life. They offer small, tangible steps you can take to feel grounded when your world feels chaotic, unstable, or uncertain. In my experience, when life gets tough, it can be incredibly comforting to have the DBT skills in your back pocket.

*These definitions are based on what I wrote in my deck of DBT coping skill cards!


DBT Focuses on Building a Meaningful Life

By teaching concrete tools, DBT helps people eliminate emotional suffering and cultivate more joy. DBT does not guarantee a life without pain, however. It's not a suicide prevention program.

Rather, DBT offers a pathway to building a "Life Worth Living." Each person gets to define their own personal most-meaningful life, by identifying what makes them feel the most pleasure, fulfillment, and peace.


DBT is Evidence-Based and Flexible

DBT definitely helps many people. Decades of research show that comprehensive DBT can help people with BPD.

While DBT was originally created to help treat self-harm and BPD, research now shows that DBT can help people with major depressive depression, (c)PTSD, substance use disorders, ADHD, some eating disorders, and more. DBT skills alone are helpful for a lot of people, too.

Additionally, DBT therapists and researchers have put a lot of work into making DBT work for different people. DBT can be helpful for autistic people and ADHDers, for example. It can be helpful for LGBTQ+ people, too. And, it can be helpful for people all over the world, across various languages and cultures.


OK sure, sound great. But what actually is it?

Adherent, comprehensive DBT always includes four main parts: weekly individual DBT therapy, weekly DBT skills group (or some other form of dedicated skills learning), as-needed phone coaching between sessions, and weekly consultation team (for the therapist).

There are a ton of different guidelines, principles, structures, and techniques that make each of these individual components "real" DBT. (To learn more, check out this Psychology Today article.)

Traditional DBT takes at least six months, because that's how long it takes to go through one "round" of typical DBT skills group. Many people choose to attend group for multiple rounds, staying in comprehensive DBT for 12 or 18 months (or sometimes even longer).


Whoa. Do I really need all that?

It's understandable if you read the above and feel intimidated! Adherent DBT is a pretty hefty commitment in time, energy, and (possibly) money.

Good news: while some people need adherent DBT, many people don't.

Research shows that just learning DBT skills can improve mental health for a lot of people! Luckily, there are a ton of books, videos, online support groups, online forums, and other resources where you can learn the DBT skills in ways that are cheaper and easier to access than comprehensive DBT.

Please note: if you struggle with BPD, self-harm, heavy substance use, frequent dissociation, or impulsive behaviors that cause you problems, you are likely to benefit more from comprehensive DBT with a therapist (rather than self-learning DBT skills). But, DBT self-help could still support you! A licensed mental health professional could help you decide what treatment is best for you, too.


Where To Learn More about DBT

Check out this post from the University of Washington (where Dr. Marsha Linehan worked and where most of the original research on DBT was conducted).

If you're an audio/visual learner, I love this video. While it's specifically about DBT for adolescents, it provides a bunch of information relevant to traditional DBT for adults.

This podcast episode with my mentor Dr. Shireen Rizvi explains a lot of about DBT.

To find a DBT therapist, check out the "I'm trying to find a (DBT) therapist" section of my resources page.




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