Dialectical Behavior Therapy
Build a life worth living.
Sometimes emotions feel so intense that they become difficult to manage. You may react in ways that make sense in the moment but create problems later, struggle to maintain relationships, feel trapped in all-or-nothing ways of thinking, or find yourself repeatedly returning to behaviors you want to change.
Dialectical Behavior Therapy (DBT) is a comprehensive, evidence-based treatment designed to help people build greater control over their behavior, navigate intense emotions, improve relationships, and create lives that feel meaningful and worth living.
At BonaVita Psychology, we provide DBT with close attention to the treatment as it was designed, while taking a compassionate, individualized approach to each person and family we work with.
What Is DBT?
DBT was originally developed by Marsha Linehan, PhD, for individuals experiencing chronic suicidality and borderline personality disorder (BPD). It has since been studied and adapted for a broader range of difficulties involving emotion dysregulation and behavioral dyscontrol.
DBT is based on a central idea of balancing acceptance and change. Treatment balances strategies for accepting yourself and your current experience with active strategies for changing behaviors that are causing suffering or getting in the way of the life you want.
DBT may be particularly helpful for people experiencing difficulties with:
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Intense or rapidly changing emotions
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Suicidal thoughts or behaviors
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Self-harm
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Impulsive behaviors
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Difficult or unstable relationships
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Anger and interpersonal conflict
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Rigid or all-or-nothing patterns of thinking
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Difficulty tolerating distress
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Difficulty identifying or effectively communicating needs
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Problems with mindfulness and staying present
Many people who seek DBT have a diagnosis of Borderline Personality Disorder (BPD), but a BPD diagnosis is not required. Whether DBT is appropriate depends on your particular difficulties, treatment goals, and the behaviors that are interfering with your life.
What Makes Comprehensive DBT Different?
DBT is sometimes used to describe therapy that incorporates DBT skills or principles.
Comprehensive DBT is different.
Comprehensive outpatient DBT is a coordinated treatment with several components that work together. When comprehensive DBT is recommended, treatment includes participation in all of its core modes:
Individual DBT Therapy
Individual therapy typically occurs once weekly and focuses on your specific treatment goals and behavioral targets. Together, you and your therapist identify the behaviors that most urgently need to change, understand what leads to them, and develop more effective alternatives.
DBT Skills Training
Skills training occurs weekly and teaches concrete strategies across four primary areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
For adolescents, skills training typically includes parents or caregivers so that the family can develop a shared understanding and language around DBT skills.
Between-Session Phone Coaching
Learning a skill in therapy is different from being able to use it during a difficult moment. Brief phone coaching with your individual therapist is available between sessions when needed to help you apply DBT skills in your everyday life.
DBT Therapist Consultation Team
DBT therapists participate in a regular consultation team with other DBT clinicians. Sometimes described as "therapy for the therapists," consultation team helps clinicians remain effective, adherent to DBT principles, and able to provide high-quality treatment.
Family & Caregiver Involvement
When appropriate, family or caregiver sessions may be incorporated into treatment to address patterns in the environment, improve communication, support skill use, and help create changes that extend beyond individual therapy.
What To Expect
DBT begins with a pre-treatment and assessment phase, typically lasting several sessions. During this time, your therapist will learn about the concerns bringing you to treatment, relevant history, current behaviors, previous treatment experiences, and your goals. Together, you will identify treatment targets, determine whether comprehensive DBT is the appropriate level of care, and establish a commitment to treatment.
From there, treatment progresses according to your needs. Early DBT focuses on gaining behavioral control and stability—reducing dangerous or ineffective behaviors while building skills to manage emotions, relationships, and difficult situations more effectively.
As greater stability is established, treatment may shift toward addressing underlying emotional suffering or trauma when appropriate. For those with PTSD or traumatic invalidation, Dialectical Behavior Therapy-Prolonged Exposure (DBT-PE) may be indicated at this stage. Later treatment increasingly focuses on building the relationships, goals, self-respect, independence, meaning, and fulfillment that make life worth living.
Throughout treatment, DBT is active, structured, and collaborative. You can expect to monitor important behaviors and emotions, practice new skills, examine what happens before and after problematic behaviors, and apply new strategies outside of therapy.
Your therapist's job is not to judge you for behaviors that may have developed as ways of coping or surviving. It is to understand those behaviors with you while helping you develop more effective ways of getting what you need.
Ultimately, DBT is about more than reducing symptoms. The goal is to help you build a life that you experience as worth living.
Ready to Get Started?
If you're interested in DBT for yourself or for your adolescent at BonaVita Psychology, contact us to learn more about our comprehensive DBT program, availability, and whether DBT may be the right treatment for you or your family.