Therapy Approaches: What is DBT?
A Quick Look at Dialectical Behavior Therapy
Do you feel that you have “big emotions”? Maybe you have felt trapped by the same emotional or relational patterns that have done you more harm than good? Perhaps Dialectical Behavior Therapy (DBT) could be a helpful mental health counseling approach that can help you understand yourself more and provide skills that can change those unhelpful cycles.
The Big Ideas Behind DBT
First off, what does dialectics mean? It is the core concept that two opposing ideas can co-exist. For the DBT framework, those two ideas are acceptance and change. DBT helps to foster a balance of experiencing radical acceptance of your current reality or past pain and taking steps of change toward reducing unhelpful patterns and cultivating adaptive ones.
DBT is also defined by the skill modules it teaches to reach this balance. These modules include mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation skills. Mindfulness and distress tolerance skills help you to experience radical acceptance, while interpersonal effectiveness and emotional regulation skills help you with those actionable steps of change.
What DBT Looks Like in Session
Early sessions will focus on building the therapeutic relationship and your therapist getting a clear understanding of what is bringing you to therapy. Afterwards, both of you will be diving into the unhelpful patterns you have noticed by identifying triggers, your reactions to them, and the aftermath of your reactions. There will also be a focus on teaching and guiding you through each of the four skill modules.
Later on, there will likely be between-session tasks for you to practice applying the skills when you experience distress outside of the therapy room, so that you can talk about what it was like using them and whether it was helpful with your therapist in your next session. This framework is meant for collaboration, so while your therapist is providing you guidance and support, it is also important for you to engage with the therapy process so that you can reap the most benefits from it.
Who Might Benefit Most from DBT
An interesting fact about DBT’s origin was that it was created for the purpose of treating individuals diagnosed with borderline personality disorder (BPD) or experiencing suicidal thoughts/behaviors. However, the use of DBT has expanded, and there has been evidence for its effectiveness for individuals who have depression, anxiety, PTSD, substance use disorders, and eating disorders.
What Makes DBT Helpful
One of the most beneficial contributions from DBT is its toolbox of practical skills to help individuals navigate diverse life challenges. The mindfulness skills module can guide you how to be more present and truly experiencing the here-and-now. The distress tolerance skills module helps you to feel capable of surviving those waves of pain, so that you don’t make rash decisions that make things worse in the heat of the moment. The interpersonal effectiveness skills module teaches you how to set boundaries or make requests that show you have respect for yourself and others in your relationships. Lastly, the emotional regulation skills module assists you with understanding your emotions and learning how to manage them in a way that you don’t feel controlled by them.
What to Keep in Mind
While DBT is an evidence-based mental health counseling approach, it is still not a one-size-fits-all approach. For instance, the dialectical concept can be difficult to approach for certain clients who only want to focus on change more than acceptance or conversely. Another potential drawback for some clients is that it also requires time outside of the therapy room to practice the learned skills in order to see whether it is effective. This is why your therapist should always tailor a plan with your preferences, needs, and goals in mind.
Key Takeaways
DBT is an evidence-based approach that promotes having a balance of acceptance and change in the therapeutic journey. DBT also provides a multitude of skills that can help individuals learn how to break free from harmful patterns they feel stuck in and how to feel more control of their emotions and actions.
If you are looking for therapy in Tallahassee, FL, and are curious if DBT could help you, then please feel free to contact us at Bloom and Heal to ask any questions and help you get started!
Sources and Further Reading
Boustani, M., Mazzone, E., Hodgins, J., & Rith-Najarian, L. (2026). Dialectical behavior therapy programming for adolescents: A systematic review and meta-analysis of clinical and implementation outcomes. Journal of Clinical Child and Adolescent Psychology, 55(2), 225–240. https://doi.org/10.1080/15374416.2024.2426142
Linehan, M.M. & Wilks, C.R. (2015). The course and evolution of dialectical behavior therapy. American Journal of Psychotherapy, 69(2). https://doi.org/10.1176/appi.psychotherapy.2015.69.2.97
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