Are DBT Skills for Anxiety Effective? Why Experts Say Yes

In the United States, almost one-third of young people and adults experience some kind of anxiety disorder in their lifetimes. Because anxiety is such a common experience, dozens of therapeutic modalities and forms of medication are available for treatment. But where can someone turn when the tried-and-true options don’t provide much relief?

For people with generalized anxiety disorder who don’t benefit from the gold-standard treatment of cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT) skills—a treatment typically offered for people with borderline personality disorder (BPD) and suicidality—may help.

Can DBT skills be used to help with anxiety?

Although cognitive behavioral therapy (CBT) is considered the gold standard for anxiety treatment, researchers and mental healthcare providers have incorporated DBT skills into the theoretical toolbox for symptom management in generalized anxiety disorder.

What’s unique about DBT skills compared to CBT, which DBT was in part modeled after, is the focus on change and acceptance. Like CBT, DBT skills can help better manage distressing thoughts and feelings. However, DBT skills emphasize accepting and validating those thoughts and feelings. DBT skills also prioritize emotional regulation, which can be especially helpful when dealing with high acuity anxiety levels.

There is also evidence that many DBT skills—mindfulness practice, distress tolerance, and emotional regulation—are helpful for anxiety among young people and the larger population. Additionally, because the development and fine-tuning of social skills aren’t always present in standard CBT protocols for generalized anxiety disorder, the DBT skill interpersonal effectiveness may be particularly beneficial for relationship challenges caused or exacerbated by the condition.

As a modular therapeutic approach, DBT skills can be combined with other modalities or exercises to personalize a care plan for the individual. 

A quick explainer on anxiety

Feeling stressed, worried, or fearful is an unfortunate fact of life. Everyone experiences some anxiety symptoms, often marked by increased blood pressure, sweating, and shaking. Some people may experience situational anxiety triggered by dating, public speaking, flying on airplanes, or other potentially stress-inducing events.

However, if those feelings of anxiety repeatedly disrupt life, school, work, or relationships, they may have reached the level of an anxiety disorder. 

The broader category of anxiety disorders includes: 

• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Panic disorder
• Post-traumatic stress disorder (PTSD)
• Separation anxiety disorder
• Social anxiety disorder (aka social phobia)
• Anxiety disorders related to phobias

Social anxiety disorder, separation anxiety disorder, and phobia disorders are more common in young people, while panic disorder and generalized anxiety disorder are rare.

As distressing as persistent symptoms of anxiety can be, they are treatable. When needed, psychotherapy and medication are considered the most effective treatment.

What is dialectical behavior therapy?

This article focuses on one specific type of psychotherapy: dialectical behavioral therapy (DBT). 

Initially, DBT was developed and evaluated by Marsha Linehan, Ph.D., to support people experiencing suicidality or who had been diagnosed with borderline personality disorder. It has since become an option for various mental health conditions.

The “dialectical” in DBT refers to accepting and holding space for two opposite truths. Dialectical thinking is a helpful framework to counteract all-or-nothing, black-and-white thinking—a common cognitive distortion that can intensify anxious thoughts.

DBT typically uses individual therapy, group skills training, phone support, and a consulting care team. 

Dialectical behavioral skills

In a group setting, people are introduced to a series of skills to help them manage uncomfortable thoughts, feelings, and behaviors. These include: 

‍Mindfulness: Mindfulness is a practice that helps with self-awareness and acceptance of whatever you’re feeling and experiencing—even if it seems negative. Mindfulness can be practiced through meditation or even on a walk outside. All that’s required is an open mind and the desire to be present.

‍Distress tolerance: Anxiety is just one of the many distressing feelings someone can experience. Sitting with acute distress is about using healthier coping skills rather than self-isolation or self-harm. Distress tolerance skills incorporate techniques such as self-soothing (e.g., engaging the senses to relax), paced breathing, and progressive muscle relaxation.

‍Interpersonal effectiveness: When someone’s more aware of their feelings and needs, learning to communicate that to others is essential. Interpersonal effectiveness involves asking for what you need, working through conflict with loved ones, and creating boundaries.

‍Emotional regulation: Through working on emotional regulation, people can learn to better control the intensity of emotions. If negative emotions become intense, emotional regulation can help you lessen that intensity before it triggers unwanted urges. 

DBT skills for anxiety at Charlie Health

Charlie Health offers a virtual Intensive Outpatient Program (IOP) for young people ages 11-30 who are dealing with mental health conditions that impact their daily life. Our expert team of clinicians chooses from a range of modalities, including dialectical behavior therapy (DBT) skills, to personalize a care plan that’s right for you or your child.

At Charlie Health, we offer more than 20 different DBT groups matched based on mental health history, care needs, and treatment goals. We offer DBT skills training alongside individual therapy and family therapy led by practitioners specializing in DBT, cognitive behavioral therapy (CBT), and many additional evidence-based modalities for anxiety, depression, substance use, and other mental health conditions.

With Charlie Health, young people can get the high acuity support they need without taking time off school, work, or other day-to-day activities. Compassionate care for anxiety is within reach.

Get in touch today to learn more about Charlie Health’s IOP and whether it’s right for you or your child.