What Is DBT?
Dialectical Behavior Therapy was developed by Marsha Linehan for people with Borderline Personality Disorder (BPD) and chronic suicidal behavior. It has since been adapted for eating disorders, substance abuse, and anyone struggling with intense emotions.
"Dialectical" refers to balancing opposites: acceptance AND change. You accept yourself as you are while also working to change destructive patterns.
The Four DBT Skill Modules
1. Mindfulness
The foundation of DBT. Learning to observe thoughts and emotions without judgment, stay present, and participate fully in the moment.
2. Distress Tolerance
Skills for surviving crisis moments without making things worse. Includes TIPP (Temperature, Intense exercise, Paced breathing, Progressive relaxation), distraction techniques, and radical acceptance.
3. Emotion Regulation
Understanding emotions, reducing vulnerability to emotional dysregulation, and changing unwanted emotions. Includes opposite action and building positive experiences.
4. Interpersonal Effectiveness
Skills for maintaining self-respect while navigating relationships. Includes DEAR MAN (asking for what you need), GIVE (maintaining relationships), and FAST (self-respect).
Full DBT vs DBT-Informed
Comprehensive DBT includes:
- Weekly individual therapy
- Weekly skills group (2-2.5 hours)
- Phone coaching for crisis moments
- Therapist consultation team
DBT-informed therapy uses DBT skills without the full structure. More accessible but less intensive. Many online therapists offer DBT-informed approaches.
Who Benefits from DBT?
- Borderline Personality Disorder
- Chronic suicidal ideation or self-harm
- Eating disorders (especially bulimia, binge eating)
- Substance use disorders
- Intense emotional reactions that feel uncontrollable
- Difficulty with relationships
Finding DBT
Note: Full comprehensive DBT is rarely available online. Most online options are DBT-informed individual therapy.