Dialectical Behavior Therapy dbt therapy man sitting in therapist office

Dialectical Behavior Therapy (DBT) Treatment and Benefits

What is dialectical behavior therapy (DBT)?

Dialectical behavior therapy (DBT) is a modified type of cognitive behavioral therapy (CBT). Its main goals are to teach people how to live in the moment, develop healthy ways to cope with stress, regulate their emotions, and improve their relationships with others.

DBT was originally intended to treat borderline personality disorder (BPD), but it has been adapted to treat other mental health conditions. It can help people who have difficulty with emotional regulation or are exhibiting self-destructive behaviors (such as eating disorders and substance use disorders. This type of therapy is also sometimes used to treat post-traumatic stress disorder (PTSD).

“Dialectical” means combining opposite ideas. DBT focuses on helping people accept the reality of their lives and their behaviors, as well as helping them learn to change their lives, including their unhelpful behaviors.

What Can Dialectical Behavioral Therapy Help With?

DBT was developed in the late 1980s by Dr. Marsha Linehan and colleagues when they discovered that cognitive behavioral therapy (CBT) alone did not work as well as expected in patients with BPD. Dr. Linehan and her team added techniques and developed a treatment to meet the unique needs of these individuals. Dialectical behavior therapy (DBT) is especially effective for people who have difficulty managing and regulating their emotions.

Though developed with BPD in mind, has proven to be effective for treating and managing a wide range of mental health conditions, including:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Bipolar disorder
  • Borderline personality disorder (BPD)
  • Eating disorders (such as anorexia nervosa, binge eating disorder, and bulimia nervosa)
  • Generalized anxiety disorder (GAD)
  • Major depressive disorder (including treatment-resistant major depression and chronic depression)
  • Non-suicidal self-injury
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorder
  • Suicidal behavior


It’s important to note that the reason DBT has proved effective for treating these conditions is that each of these conditions is thought to be associated with issues that result from unhealthy or problematic efforts to control intense, negative emotions. Rather than depending on efforts that cause problems for the person, DBT helps people learn healthier ways to cope.

Benefits of Dialectical Behavioral Therapy

In DBT, the patient and therapist work to resolve the apparent contradiction between self-acceptance and change to bring about positive changes in the individual in treatment. Part of this process involves offering validation, which helps people become more likely to cooperate and less likely to experience distress at the idea of change.

In practice, the therapist validates that an individual’s actions “make sense” within the context of their personal experiences without necessarily agreeing that the actions are the best approach to solving a problem.

Each therapeutic setting has its own structure and goals, but the characteristics of DBT can be found in group skills training and individual psychotherapy.

  • Acceptance and change: Patients learn strategies to accept and tolerate life circumstances, emotions, and themselves. They will also develop skills that can help make positive changes in their behaviors and interactions with others.
  • Behavioral: Patients will learn to analyze problems or destructive behavior patterns and replace them with more healthy and effective ones.
  • Cognitive: Patients will focus on changing thoughts and beliefs that are not effective or helpful.
  • Collaboration: Patients will learn to communicate effectively and work together as a team (therapist, group therapist, psychiatrist).
  • Skill sets: Patients will learn new skills to enhance their capabilities.
  • Support: Patients will be encouraged to recognize positive strengths and attributes and develop and use them.

How does dialectical behavior therapy (DBT) work?

The main goal of therapists who use dialectical behavior therapy (DBT) is to strike a balance between validation (acceptance) of who you are and your challenges and the benefits of change. Your therapist will help you learn new skills to improve emotion regulation.

The structure of dialectical behavior therapy can vary some from therapist to therapist, but, in general, DBT involves these four types of sessions:

  • DBT pre-assessment.
  • Individual therapy.
  • Skills training in groups.


DBT pre-assessment

Your therapist may offer an assessment before starting DBT. They’ll determine how suitable DBT is for you by asking you questions and explaining how DBT works. If you decide that DBT is the right therapy for you, they’ll ask you to commit to the treatment and the length of treatment.


Individual DBT therapy

Individual DBT therapy sessions have the following goals:

  • To help keep you safe by reducing suicidal and self-harming behaviors, if applicable.
  • To limit behaviors that get in the way of productive therapy.
  • To help you reach your goals and improve your quality of life by addressing what’s blocking your progress, such as mental health conditions or relationship issues.
  • To help you learn new skills to replace unhelpful behaviors.


Your therapist will likely ask you to keep a journal to track your emotions and actions and to look for patterns of behavior. You’ll bring this diary with you to your sessions so you and your therapist can decide what to work on for each session.


DBT skills training in groups

In group sessions sessions, your therapist will teach you skills in a group setting. This isn’t to be confused with group therapy, in which you discuss your problems with others. Think of it more like a teaching and learning session in a classroom setting.

DBT skills aim to help enhance your capabilities in day-to-day life. The four skills your therapist will teach include:

  • Mindfulness: This is the practice of being fully aware and focused in the present instead of worrying about the past or future.
  • Distress tolerance: This involves understanding and managing your emotions in difficult or stressful situations without responding with harmful behaviors.
  • Interpersonal effectiveness: This means understanding how to ask for what you want and need and setting boundaries while maintaining respect for yourself and others.
  • Emotion regulation: This means understanding, being more aware of and having more control over your emotions.


What are the benefits and risks of dialectical behavior therapy (DBT)?

Dialectical behavior therapy (DBT) has been proven to help people with their mental health conditions in several studies. For people with borderline personality disorder, in particular, DBT results in:

  • Less self-harm behavior and anger.
  • Fewer days of inpatient hospitalization.
  • Less drug and alcohol misuse.
  • Improved depressive symptoms.


However, DBT isn’t for everyone, and it can be very difficult. DBT is more likely to work for you if you:

  • Are committed to making positive changes.
  • Are ready to fully commit to therapy and do homework assignments.
  • Are ready to focus mostly on your present and future, rather than your past.
  • Feel able to do some sessions in a group with others.

How long will I need dialectical behavior therapy?

Dialectical behavior therapy (DBT) usually takes at least six months to a year. However, each person is unique, and mental health conditions are complex. You shouldn’t expect to be completely free of symptoms or no longer have problematic behaviors after one year of DBT. Many therapists believe that the treatment for borderline personality disorder, in particular, can often take several years. Try not to get discouraged by how long it may take to be able to better manage your emotions and have a better quality of life. The important thing is that you’re seeking help. Any progress is good progress.

How to Get Started With Dialectical Behavior Therapy

The best way to find out if DBT is right for you is to ask your provider, current therapist, or another trusted mental health professional to refer you to a colleague who specializes in DBT. You may also find online therapists who offer DBT therapy. A professional who is trained in the method  will evaluate your symptoms, treatment history, and therapy goals to see if DBT might be a good fit.

Dialectical behavior therapy (DBT) is an effective treatment to help people who experience very intense, negative emotions. Although it may be difficult and time-consuming to find the right DBT therapist for you, it’s important to keep trying. The sooner you can start therapy — and stay committed to it — the sooner you’ll have an improved quality of life.

Dialectical Behavior Therapy with Healing Minds

Healing Minds is adding a second location in Reno, which will operate solely as a center for dialectical behavioral therapy, or DBT. The new Healing Minds will be located on Reno Corporate Drive across from the new Sierra Medical Center. The second location will operate solely as a center for dialectical behavioral therapy, or DBT.

This new center is just one of the ways Healing Minds continues to lead the way for mental health in Northern Nevada. We employ a dedicated team of counselors and therapists in Reno, NV, who share a deep commitment for helping individuals and families rebuild and improve their lives. Our team offers a range of services to treat mental health issues, including individual therapy, group therapy, DBT, family counseling, and Telehealth therapy. At Healing Minds, we believe that everyone can benefit from therapy and our mission is to become a resource for mental health and stability in our community.

Our new location is slated to open in early 2023. Stay tuned for more updates on our new DBT center and reach out to get started on your mental health journey today.

Schedule an Appointment

At Healing Minds, we have therapists that can help you deal with difficult times and mental health issues using DBT. Working with a therapist can make the difference you need to step towards a full, whole life once again.  

Please reach out to schedule a therapy appointment with a trained practitioner.  We offer in person or Telehealth therapy from the comfort of your own home.