DBT: The Basics

DBT: The Basics

Guest post by Ashlyn Mayhall, LPC

If you’ve gone poking around the therapy world looking for the right fit, you may have noticed that there are 1. MANY different modalities to choose from and 2. Most of them just go by a cluster of letters. Today we are looking at DBT: Dialectical Behavioral Therapy. 

What is DBT:

Often considered the cousin of CBT (Cognitive Behavioral Therapy--another cluster that deserves its own article), DBT combines mindfulness and acceptance skills with behavioral management techniques to increase self-acceptance and self-responsibility in clients that struggle with emotional regulation. Traditionally paired with personality disorders, it’s important to note that everyone experiences emotional dysregulation at times and therefore DBT is accessible to a variety of clients and worth looking into.

D: Dialectical

Dialectics is a philosophical standpoint that proposes the existence of opposites in the same space. In moments of dysregulation, it is easy to find yourself stuck in a black-or-white perspective--“I’m right about this and they are wrong”. By taking a dialectic perspective, the “black and white” is mediated and different points of view can be considered. You can be both right and wrong about a situation. In therapy, this yields a foundation of assumptions that are held to increase self-acceptance and self-responsibility. Some of those assumptions include:

*You are doing the best that you can and you can do better.

*It is not your fault that things are the way they are and it’s your responsibility to fix it for yourself.

*You are stuck and somewhat comfortable in certain habits, and you want to change.

B: Behavioral

How you handle life, for better or worse, can be boiled down to the habits that were formed early on. A child expressing their needs can be met with a few varying responses: validation, invalidation, and neglect of those needs. Having emotional needs validated and met teaches a child how to safely communicate needs and regulate emotions, while invalidation and neglect often teaches a child to suppress those needs or be louder in the demand. Overtime, this becomes engrained in the nervous system as a behavioral habit of emotional dysregulation. (This often can be found in childhood but can also be seen in invalidating or neglectful communities such as school, church or workplaces). These habits often get in the way of relationships, making it difficult to trust others and feel safe with those you want to be close to.

The behavioral part of DBT includes picking out these bad habits and course correcting, making new choices for the behavior while validating what led to the behavior being formed in the first place. This often includes specific skills to be used in place of the habitual behavior. These skills range from self-management (mindfulness, emotional regulation) to relational management (distress tolerance, interpersonal effectiveness).

T: Therapy

Normally, I wouldn’t define the “T” portion of therapy, but DBT does do things a little differently. In traditional DBT, the T includes a therapy team consisting of an individual therapy, a skills trainer, the doctors and medical staff if any are involved, and (behind the scenes) other DBT therapists that may be pulled in for consultation. Having a team on board allows for a well-rounded treatment plan as well as accountability and effectiveness from the therapist because there are more eyes involved. Thankfully, for small communities DBT is amendable to a smaller team including a client’s individual therapist and their participation in a Skills Training Group.

Skills Training Group

A skills training group is exactly what it sounds like. A group of peers, all struggling with emotional dysregulation and the habits that keep them stuck in the cycle (you are doing the best that you can), come together with the goal of learning new skills (and you can do better) lead by a skill trainer who models the skills in real time and helps guide the group along the way. These skills fall into the following categories: Mindfulness, Emotional Regulation, Distress Tolerance, and Interpersonal Effectiveness. Weekly, participants learn and hone these skills with the support of their peers and a skills group trainer.

Skills training is open and accessible for anyone—these aren’t necessarily mental health skills but more “doing life” skills that are particularly helpful in moments of dysregulation. In the name of accessibility, research has shown that participants who only participated in a Skills Training Group still saw improvement in their symptoms. This gives hope to those who can’t commit to weekly individual therapy or are afraid that they are alone in their struggles!

Kranz Psychological Services will be hosting a 13 week skills training group running from September 15^th to December 9^th. If you find yourself stuck in bad habits that impact your emotional responses or your relationships, then I hope to see you there!

References:

Linehan, M. (2025). DBT skills training manual. The Guilford Press.

Van Dijk, S. (2013). DBT made simple: A step-by-step guide to dialectical behavior therapy. New Harbinger Publications.