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What is DBT?

Extreme emotional dysregulation can make it nearly impossible for a young person to tolerate traditional therapy because the introspection it requires can trigger powerful reactions, making things worse instead of better.

Dialectical Behavioral Therapy, or DBT, combines the basic strategies of cognitive-behavioral therapy with eastern mindfulness practices. DBT is based on the idea that opposites can coexist and be synthesized. This strategy is very useful for young women experiencing mood disregulation and impulsivity. DBT calls on the individual to accept current reality while maintaining a strong and conscious commitment to change.

DBT is a synthesis of several therapeutic approaches and was designed primarily to treat disorders involving emotional dysregulation—including borderline personality disorder and extreme emotional lability or volatility. In contrast to free-flowing and introspective talk therapies, DBT is a highly structured approach to treatment.

A DBT course of therapy typically focuses on a specific set of skill modules, such as:

  • Mindfulness: focusing the mind, directing attention, understanding how you feel
  • Emotional Regulation: reducing emotional intensity
  • Distress Tolerance: reducing impulsivity, crisis management
  • Interpersonal Effectiveness: keeping relationships steady, getting what is needed, and maintaining self-respect

DBT is based in part on the idea that, unlike the black and white thinking that often accompanies emotional dysregulation, opposites can actually coexist and be synthesized. Working patiently to foster this “shades of grey” approach to thinking has proven quite effective for adolescents experiencing mood dysregulation and impulsivity. DBT emphasizes taking responsibility for one’s problems and examining how one habitually deals with conflict and negative feelings. Goals of DBT include identifying maladaptive coping patterns and providing adaptive coping strategies to promote emotional well-being. DBT calls on the client to accept today’s reality while maintaining a strong and conscious commitment to change.

DBT has also been modified so that it can be used with a wide range of difficulties such as eating disorders, substance use, self-harm, and anger management. DBT targets issues that cause intense distress and teaches practical skills for dealing with these issues that allow the young person to avoid habitual and self-defeating behaviors. DBT helps young people understand that on the one hand, they are doing the best they can right now, but on the other hand, there is great hope for specific and positive change.