Dialectical Behavior Therapy (DBT) Skills

Dialectical behavior therapy (DBT) is a form of evidence-based talk therapy that helps individuals identify problematic thought patterns and emotions, both in individual and in group sessions.

What is DBT?

Dialectical behavior therapy (DBT) is a type of talk therapy designed to help individuals with mental health conditions learn how to understand and regulate their emotions. The goal is to encourage self-acceptance and improve interpersonal relationships through validation and behavior changes.

DBT involves individual therapy, group skills training, and ongoing coaching. The one-on-one time is usually a weekly session with a psychiatrist, psychologist, or therapist, while supported groups are interactive sessions that allow people to practice their DBT skills in a safe environment.

What does dialectical mean?

Dialectics is about holding two opposite thoughts in balance and accepting that they can both be true at the same time. One of the most important dialectics in DBT is acceptance and change.

Examples of dialectical frameworks of thinking include 

  • I need help and I don’t know where to start
  • I want to make new friends and I am shy
  • I self-harmed today and I want to stop
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How does DBT work?

Dialectical behavior therapy focuses on better understanding and balancing opposite perspectives. With this form of therapy, you’ll learn how to better regulate your emotions through accepting who you are, understanding your current challenges, and embracing the potential benefits of change. DBT also encourages people to avoid an “either-or” outlook and other black-and-white thought patterns which can limit your thinking.

In general, DBT focuses on this change via several types of sessions:

Individual therapy

Through weekly one-on-one sessions with a trained therapist, you’ll have an opportunity to dissect leading issues in your life and explore methods for how to handle them.

Skills training

Skills training is an opportunity to learn and practice various DBT skills in a group setting.

Supported groups

The group setting is an opportunity to reinforce the skills you’ve learned in DBT by applying them to relationship-building and communication.

The skills taught in DBT

DBT is taught as a series of skills to help individuals manage uncomfortable thoughts, feelings, and behaviors. Some of these skills include: 


One of the core components of DBT is building mindfulness skills that help you become aware and accepting of the current moment. DBT teaches mindfulness from two perspectives: what to focus on and how to be more mindful.

The “what” skills encourage a person to remain in the present, to be aware of their emotions and thoughts, and to separate their emotions from thoughts. The “how” skills focus on how to employ mindfulness skills and to tune into the present moment. 

Distress tolerance

Distress tolerance teaches individuals how to use healthy coping techniques to navigate difficult situations. Instead of defaulting to destructive behaviors such as self isolating or self-harm, distress tolerance empowers people to accept the current situation and adopt a more positive long-term outlook. This is useful when you’re feeling physical or emotional pain, or when you’re finding it hard to be productive.

Several examples of distress tolerance skills are:

  • Self soothing
  • Paced breathing and muscle relaxation
  • Weighing pros and cons
  • Radical acceptance (accepting reality as it is)
Teen and therapist talking about DBT skills

Interpersonal effectiveness

Interpersonal effectiveness combines social skills, listening skills, and assertiveness training to empower individuals to better understand their needs and communicate that information to others.

Goals for interpersonal effectiveness include learning how to: 

  • Ask for things that you want or need
  • Work through challenging and conflict 
  • Say no when appropriate
  • Improve your self-respect 

Emotional regulation

Emotional regulation offers people a chance to deal with their emotions before those emotions lead to unhealthy feelings or behaviors. This component of DBT teaches a person that they have the power to choose to recognize and change their emotions in order to avoid giving into emotional urges.

Who benefits from DBT?

DBT was originally developed in the 1980s to treat suicidal individuals with borderline personality disorder (BPD). Since then, DBT continues to be a leading treatment for individuals with a primary diagnosis of BPD.

It’s also been adapted to help people with other mental health conditions, including:

DBT has been found to reduce

  • Suicidal ideation 
  • Treatment dropout
  • Hospitalization 
  • Substance use disorders
  • Depression
  • Hopelessness
  • Anger

How do I know if DBT is right for me?

Not sure if DBT is right for you? DBT is considered a suitable treatment for individuals who feel that their emotions are often overwhelming, debilitating, or interfering with work, school, or goals. It’s also suited for people who have:

  • Strong emotions, difficulty with relationships
  • Behavioral problems
  • Difficulty managing their own thoughts
  • A desire to have a more meaningful life

Other reasons to consider DBT include:

  • Diagnosis of borderline personality disorder
  • Struggles with self-harm or chronic thoughts of suicide
  • Severe mood swings
  • Overwhelming feelings of hopelessness or emptiness
  • Identity issues
  • Alcohol and drug abuse, unsafe sexual behavior, or other high-risk behaviors 
Teen participating in DBT Skills therapy

How to handle an emergency

Dialectical behavior therapy is an effective solution for treating a variety of mental health conditions and symptoms—including self-harm and suicide attempts.

Some people may see improvement within a few sessions, but others require long-term therapy before experiencing benefits. If you’re having suicidal thoughts or require immediate support, visit your local emergency department or crisis center, or call one of the following resources:

Deciding to start dialectical behavior therapy (DBT) or any other type of therapy takes courage. Charlie Health’s team of compassionate mental health professionals is here to listen to your needs, answer your questions, and match you with an appropriate care plan. We offer over 20 different DBT groups for adolescents enrolled in our virtual IOP based on their unique mental health needs and goals. Learn more today.

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Comprehensive mental health treatment from home

90% of Charlie Health clients and their families would recommend Charlie Health