What Is Dialectical Behavior Therapy (DBT)?

Dialectical Behavior Therapy (DBT) is a highly effective, evidence-based form of cognitive-behavioral therapy (CBT) designed to help people manage intense emotions, reduce self-destructive behaviors, and improve relationships. Originally developed to treat borderline personality disorder (BPD), DBT has since been adapted to support individuals facing a wide range of mental health challenges.

What DBT Helps Treat

DBT is now used to treat many mental health conditions, including but not limited to:

• Borderline personality disorder (BPD)
• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder
• Eating disorders (anorexia, bulimia, binge eating)
• Generalized anxiety disorder (GAD)
• Major depressive disorder (including treatment-resistant and chronic depression)
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Substance use disorders
• Self-harming behaviors
• Suicidal ideation
• Low self-esteem and difficulties with emotional regulation

Core Components of DBT

DBT focuses on building four key skill areas:

1. Mindfulness – Learning to live in the present moment and develop awareness without judgment.
2. Distress Tolerance – Building healthy coping strategies to manage pain and stress without resorting to harmful behaviors.
3. Emotion Regulation – Understanding and managing intense or overwhelming emotions.
4. Interpersonal Effectiveness – Improving relationships through assertiveness, boundary-setting, and communication skills.

How DBT Works

DBT is structured and skills-based, typically delivered in two formats:

• Individual Therapy: One-on-one sessions with a trained DBT therapist to personalize and apply skills to your daily life.
• Group Skills Training: Facilitated group sessions where participants learn and practice DBT skills through instruction, role-playing, and homework.

Some programs also include phone coaching and team consultation to support clients and clinicians in maintaining DBT principles between sessions.

Key Principles of DBT

• Acceptance & Change: Balancing self-acceptance with motivation to make positive life changes.
• Behavioral Focus: Identifying and replacing harmful patterns with healthier coping strategies.
• Cognitive Strategies: Challenging and reframing unhelpful thoughts and beliefs.
• Skills Building: Learning new tools to manage emotions and relationships more effectively.
• Strength-Based Support: Highlighting personal strengths and encouraging personal growth.

Frequently Asked Questions About DBT 

Do I need a diagnosis to benefit from DBT?

No. While DBT was originally developed for borderline personality disorder, it is now used to support people with a wide range of emotional, behavioral, and relational challenges—even without a formal diagnosis. If you’re struggling with intense emotions, self-defeating behaviors, or relationship difficulties, DBT may be a helpful tool.

Can I join the group only and not the individual portion?

Yes. Clients who are already working with an individual therapist—either at Pillars or with an outside provider—can opt to participate in the group-only portion of the DBT-Informed Program.

This allows you to build DBT skills in a structured group setting while continuing your individual therapy elsewhere. With your consent, our group leaders can coordinate care with your individual therapist to ensure consistency and support.

Is DBT only for people with borderline personality disorder?

Not at all. DBT has been successfully adapted for many conditions, including anxiety, depression, trauma, eating disorders, ADHD, and more. At Pillars of Wellness, our DBT-informed program supports clients with diverse needs and goals.

What’s the difference between DBT and CBT?

CBT (Cognitive Behavioral Therapy) focuses on identifying and changing unhelpful thoughts and behaviors. DBT builds on CBT, but adds skills related to mindfulness, emotion regulation, distress tolerance, and acceptance. It’s especially helpful for people who feel overwhelmed by intense emotions.

What happens in a DBT group session?

In DBT group sessions, you’ll learn and practice specific skills—like how to tolerate distress, manage emotions, or communicate more effectively. Sessions may include worksheets, role-plays, homework, and real-life examples to help you apply skills between sessions.

How long does DBT last?

At Pillars of Wellness, we offer a 12-week DBT-informed treatment program focused on building core skills. Some clients continue with longer-term individual therapy or repeat skill-building cycles based on their needs and goals.

Can I do DBT alongside individual therapy?

Yes. Many clients participate in DBT groups while continuing their regular therapy sessions. Our team can help coordinate care to make sure your treatment is consistent and supportive.

Is DBT covered by insurance?

In many cases, yes. DBT services may be covered under your behavioral health benefits. Contact our office or your insurance provider to confirm your plan’s coverage for group or individual therapy.

Interested in DBT?

If you’re looking for support with emotional regulation, relationship struggles, or harmful behavior patterns, DBT may be a powerful and structured way to regain control and build a more balanced life.

Our 12-week DBT-informed treatment program at Pillars of Wellness offers a structured path for learning and applying DBT skills in a supportive environment.

[Click here to learn more about our 12-week DBT program]