What is DBT?

Dialectical Behavior Therapy (DBT) is an evidence-based form of cognitive-behavioral therapy to treat borderline personality disorder and chronic suicidality (Linehan, 1993). At its core, the "dialectical" approach focuses on the balance between two seemingly opposite ideas: acceptance and change. It teaches individuals that it is possible to accept themselves as they are while simultaneously working to change unhelpful behaviors. The treatment is structured around 4 primary skill modules—mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness—all aimed at helping patients manage intense emotions, improve relationships, and build "a life worth living" (Linehan, 1993).

Courtesy of Therahive (2025)

  • Traditionally, the DBT modality is composed of 4 components: 

    1. Weekly Individual Therapy: You meet one-on-one with a therapist for 50–60 minutes. These sessions follow a "treatment hierarchy," prioritizing safety (reducing self-harm or suicidal thoughts) first, followed by behaviors that interfere with therapy, and finally improving overall quality of life.

    2. Weekly Skills Training Group: This is a 1.5–2.5 hour "class" where you learn the four core DBT modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. It is focused on building your capabilities rather than processing trauma or past events.

    3. Phone Coaching: Your individual therapist is often available between sessions for brief (few-minute) phone calls. This "in-the-moment" coaching helps you apply skills to real-world crises before you resort to old, unhelpful behaviors.

    4. Therapist Consultation Team: This is a "therapy for the therapist" meeting where your DBT providers meet weekly to support each other and ensure they are following the treatment model correctly.

  • During your program, you will likely use specific tools to track progress:

    1. Diary Cards: A daily log where you track your emotions, urges, and which skills you used that day.

    2. Behavioral Chain Analysis: A step-by-step breakdown of a specific event or behavior to understand exactly what triggered it and where you could have used a skill to change the outcome.es here

  • Courtesy of Rutgers University DBT Training Clinic (DBT-RU)