Dialectical Behavior Therapy, or DBT, is a type of CBT therapy that helps people learn how to manage intense emotions, improve their relationships, and build a more stable and fulfilling life. Originally developed by psychologist Dr. Marsha Linehan, DBT was first created to treat people with borderline personality disorder (BPD), but today it is used to help people of all ages and with a variety of mental health challenges, including depression, eating disorders, post-traumatic stress disorder (PTSD), and substance use issues.
DBT combines elements of two approaches: acceptance and change. The “dialectical” part refers to finding a balance between accepting oneself while also working to change harmful behaviors. This is done through five key areas, called “modules,” which form the foundation of DBT:
- Mindfulness – Learning how to stay present in the moment and observe your thoughts and feelings without judgment.
- Distress Tolerance – Building skills to cope with crisis situations and emotional pain without making things worse.
- Emotion Regulation – Understanding and managing intense emotions, so they feel less overwhelming.
- Interpersonal Effectiveness – Learning how to communicate more clearly and assertively while maintaining healthy relationships.
- Walking the Middle Path – A module especially useful for teens and families, but helpful for anyone. It focuses on reducing “all-or-nothing” thinking, encouraging flexible thinking, validating others while still holding boundaries, and finding balance between independence and connection. It’s about meeting in the middle rather than swinging between extremes.
A “full model” DBT program typically includes several parts:
- Individual therapy (one-on-one sessions with a trained DBT therapist)
- Skills training groups (similar to a class, where clients learn and practice DBT skills)
- Phone coaching (where clients can contact their therapist between sessions for help using skills in real-life situations)
- Consultation team (a group of DBT therapists who meet regularly to support each other and ensure they’re providing the best care)
Therapists at The Concord Center who provide DBT go through foundational training, which is an in-depth process that teaches them how to deliver the therapy in a structured and effective way. This training also emphasizes the importance of therapists staying supported and emotionally grounded themselves, which is why the consultation team is such an important part of the model.
DBT is especially helpful for people who feel emotions very strongly and may have trouble managing those emotions in healthy ways. It offers concrete tools and strategies that can be practiced and used in everyday life. With commitment and the right support, DBT can help individuals build a life that feels more stable, meaningful, and under control.