Dialectical Behaviour Therapy (DBT)
“You are not defective. You are struggling.”
— Marsha M. Linehan
Dialectical Behaviour Therapy (DBT) is an evidence-based treatment designed for people who experience emotions intensely and have not found lasting relief through traditional therapy alone. It offers a structured, skills-based approach to building stability, safety, and a life worth living.
What Is DBT?
DBT was originally developed by psychologist Dr. Marsha Linehan for individuals with chronic suicidal ideation and borderline personality disorder. It has since been shown to be effective for a wide range of mental health concerns involving emotion dysregulation.
DBT is principle-driven, skills-based, highly structured, and collaborative. It was designed for people with heightened emotional sensitivity who have often lived in environments that did not adequately support their emotional needs.
The Core Dialectic:
Acceptance and Change
At the heart of DBT is a central dialectic: acceptance and change are both necessary.
DBT helps you accept yourself and your current reality while actively working toward meaningful, sustainable change. Acceptance is not resignation. It is the foundation that makes change possible.
In DBT, we often say: feel first, then do something different.
What DBT Aims to Help You Build
DBT's overarching goal is to help you build a life worth living — guided by long-term values rather than short-term relief.
DBT supports:
Greater emotional stability and clarity
Improved relationships and communication
Reduced behaviours that interfere with safety and quality of life
Increased self-awareness and intentional choice over time
The Four Core DBT Skills
Mindfulness:
Present-Moment Awareness
Mindfulness is the foundation of DBT. It teaches you to notice thoughts, emotions, and sensations in the present moment without judgment or impulsive reaction — creating the space needed for all other DBT skills to work.
Distress Tolerance:
Crisis Survival Skills
Distress tolerance skills help you get through moments of intense emotional pain without making the situation worse. Rather than trying to fix or avoid distress, these skills focus on surviving crises safely and reducing impulsive behaviours that create longer-term problems.
Emotion Regulation:
Understanding and Working With Emotions
Emotion regulation skills help you understand what you're feeling, why you're feeling it, and how to respond more effectively when emotions run high. This is not about suppressing emotions — it's about understanding how they work, recognizing patterns, and reducing the intensity of emotional suffering over time.
You'll learn to:
Identify and name emotions more accurately
Understand what triggered an emotional response
Check the facts of a situation to see whether an emotion fits the context
Reduce emotional vulnerability by taking care of your body and basic needs
Use strategies such as opposite action when emotions don't fit the facts
Interpersonal Effectiveness:
Relationships and Self-Respect
Interpersonal effectiveness skills help you ask for what you need, set boundaries, manage conflict, and maintain relationships without sacrificing your values or well-being. Over time they support clearer communication, reduced resentment, and stronger connections.
Who DBT Can Help
DBT may be appropriate if you are experiencing:
chronic emotion dysregulation
self-harm or suicidal ideation
eating disorders or disordered eating
trauma or complex trauma
depression or anxiety
unstable relationships or fear of abandonment
chronic shame, emptiness, or identity confusion
DBT can be effective for adolescents, young adults, adults, parents, and families when the structure and level of care are a good fit.
What Is Comprehensive DBT?
Not all DBT is the same. Comprehensive DBT includes four integrated components that work together as a coordinated treatment.
Individual Therapy
Weekly one-to-one sessions focused on current challenges, reducing behaviours that interfere with safety and quality of life, and applying DBT skills to real-life situations.
Skills Training Group
A structured group where clients learn and practice the four core DBT skill areas. Groups are educational and skills-focused rather than process-oriented.
Phone Coaching
Time-limited support outside of sessions to help clients use DBT skills in the moment, when emotions are high and real-life challenges arise. Phone coaching is designed to support skill use, not replace therapy.
Therapist Consultation Team
The therapist participates in a regular DBT consultation team to support treatment adherence, effectiveness, and clinician accountability.
Together, these four components help skills move from the therapy room into real-life situations, where change actually happens.
Comprehensive DBT is offered when clinically indicated, particularly for individuals experiencing chronic self-harm, suicidal behaviours, eating disorders, or repeated crises.
DBT-Informed Therapy vs. Comprehensive DBT
DBT-informed therapy may include DBT principles or skills without all four components. Comprehensive DBT was designed as a package, when needs are high, the full structure matters. We assess together what level of support is the right fit.
What to Expect in DBT
DBT is active and participatory. Skills are practiced between sessions using tools such as diary cards and real-life application. Therapy is collaborative, validating, and direct. You will be supported, and you will be challenged, in service of your goals.
A Note on Values, Faith, & Spirituality
For clients for whom faith or spirituality is meaningful, there is room to explore how values, belief, and mental health intersect — always guided by the client and never imposed. My role is to support safety, skill-building, and dignity while respecting each person's values and worldview.
Is DBT Right for Everyone?
DBT is intensive and requires commitment. It may not be appropriate if someone is in active psychosis, there is severe cognitive impairment, substance use prevents meaningful participation, or consistent attendance and skills practice are not currently possible. This does not reflect failure, only fit.
After DBT
After completing comprehensive DBT, many people transition to less intensive therapy, continue practicing skills independently, or return for booster sessions during new challenges. The goal is independence, not endless therapy.
Ready to Learn the Skills?
If you’re ready to move beyond survival and begin building a life that feels more stable and meaningful, DBT may be a good fit.