Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy (DBT) was developed in the 1990s by psychologist Marsha Linehan, PhD, as a treatment for chronically suicidal individuals diagnosed with Borderline Personality Disorder (BPD). Since then, DBT has become widely recognized as the gold standard treatment for BPD, and extensive research has shown its effectiveness for many other conditions, including substance use disorders, depression, mood disorders, post-traumatic stress disorder (PTSD), and eating disorders.
The central goal of DBT is to help people reduce suffering and fully engage in life. Treatment is built on a collaborative relationship between therapist and client, where goals are set together and progress is actively tracked. Clients learn to decrease harmful or unhelpful behaviors and replace them with healthier, more effective ways of coping and relating to others.
Adaptations of DBT
DBT has been successfully adapted for different populations:
-
DBT-A (Adolescents): Tailored for teenagers and their families, this program focuses on helping adolescents manage intense emotions, navigate peer and family relationships, and build healthy coping skills. Parent involvement is an essential component.
-
DBT-C (for Children): Designed for children and families, focusing on emotional regulation, resilience, and strengthening family connections.
-
DBT-PE (Prolonged Exposure): An adaptation for individuals struggling with both trauma and emotion dysregulation. DBT-PE combines DBT’s skills for safety and stability with evidence-based Prolonged Exposure therapy, allowing clients to process traumatic memories in a structured, supportive way while continuing to build resilience and reduce harmful behaviors.
-
DBT-SUD (Substance Use Disorders): An adaptation that integrates standard DBT with strategies for addressing addictive behaviors. It focuses on reducing substance use, preventing relapse, and building healthier coping strategies, while treating underlying emotional and relational struggles.
-
RO DBT (Radically Open DBT) : Created for individuals with “overcontrolled” coping styles, such as chronic depression, anorexia, or obsessive-compulsive personality traits, who benefit from learning greater openness and flexibility.
Comprehensive DBT structure
1/ Individual Session
In weekly one-on-one sessions, clients work closely with a DBT therapist to identify personal goals, track progress, and apply DBT skills to the challenges they face in everyday life. These sessions are highly collaborative, focusing on what matters most to the client, whether that is reducing harmful behaviors, improving relationships, or managing emotions more effectively. Individual therapy provides a safe and supportive space to problem-solve, reflect, and tailor DBT strategies to each person’s unique needs.
2/ DBT Skills Training Group
Skills groups are a cornerstone of DBT and are structured like a class, with the therapist acting as a teacher and clients as active learners. Groups meet weekly to learn and practice skills across four modules: Mindfulness, Interpersonal Effectiveness, Emotion Regulation, Distress Tolerance. DBT skills training is highly structured, with handouts, homework, and real-world practice, ensuring that clients leave with tools they can use right away.
3/ Phone Coaching
One of the unique features of DBT is the availability of phone coaching between sessions. This allows clients to reach out to their therapist for support in applying DBT skills during real-life situations, particularly in moments of crisis or emotional intensity. The goal is not to “talk through the problem,” but to provide quick, skills-focused guidance that helps the client cope more effectively in the moment. Phone coaching bridges the gap between therapy sessions and everyday life, reinforcing skills when they are needed most.
4/ Therapist Consultation Team
DBT therapists participate in a consultation team, which is a group of DBT-trained clinicians who meet regularly to support one another and maintain the highest standards of care. The consultation team is not group therapy for clients but a professional forum where therapists review cases, share strategies, and ensure fidelity to the DBT model. This structure means that every client benefits from the collective wisdom and accountability of an entire team. It also helps therapists remain effective, balanced, and motivated, which translates into more consistent, compassionate, and evidence-based care for clients.
1.
Mindfulness
Learning to see the present
as it is.
2.
Emotion Regulation
Understanding emotions
and having better control expressing them.
3.
Distress Tolerance
Skills to accept and
survive crisis.
4.
Interpersonal Effectiveness
Skills to strengthen
and build quality relationships.
DBT skills group
Tuesday
12:00-1:00 PM on Zoom
Thursday
5:00-6:00 PM in-person
Friday
12:15-1:15 PM on Zoom
212-861-5496
