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A Brief Overview of Dialectical Behavioral Therapy (DBT)

Paula Gonzalez MA, LPC (Licensed Professional Counselor)

Dialectical Behavioral Therapy is more widely known as DBT and is an evidence based therapy that teaches a broad range of behavioral skills. The skills DBT teaches are to help clients reduce their symptoms and change their behavior. DBT is a form of talk therapy that resembles Cognitive Behavioral Therapy (CBT) but more of the focus on is changing behavior than on changing cognition.

DBT is used to treat borderline personality disorder, unstable relationships, substance abuse, anxiety, eating disorders and depression. DBT provides the therapist with a framework and the client with a variety of coping skills they can learn and incorporate into their daily life and potentially reduce their symptoms.

Are you wondering how DBT works?

Well, just like other talk therapy sessions DBT requires a minimum of 45-60 minutes per session weekly and like most skills take time, patience and practice to learn. DBT includes a wide variety of skills clients can use. But this brief overview will only cover a few very effective DBT skills.

Depending on the therapist and the client’s diagnosis a session of DBT may begin and end with mindfulness, and include any of the following skills:

  • Mindfulness
  • Distress Tolerance/Emotion Regulation
  • Interpersonal Effectiveness
  • Dialectical Thinking


The goal of mindfulness in DBT is to bring your focus to the present moment in time without judging. Learning and practicing the skill of bring your focus to the present moment increases control of your mind by observing a situation and your thoughts and not judging your thoughts just sitting with your thoughts and accepting them. Mindfulness is a uses skill that helps reduce the annoying problem of ruminating thoughts. Mindfulness also helps you experience reality as it is. When you are experiencing reality as it is, you can longer distort the future with erroneous predictions or forecast your assumption of how bad it could be. The use of mindfulness increases awareness and acceptance which brings me to the skill of
distress tolerance and emotional regulation.

Distress Tolerance/Emotional Regulation

Distress tolerance helps clients become more accepting and tolerant of distress. Distress and pain are simply a part of the human life experience that we cannot avoid. Therefore, learning skills that help you survive painful moments in life are crucial. The goals of distress tolerance are to provide clients with skills that replace impulsive behaviors, self-harm behaviors, substance use behaviors and suicidal behaviors. DBT helps clients establish new skills focused on improving their ability to identify or label their emotions and understand the purpose of emotions. The skill of being able to regulate our emotions increases emotional stability and increases the tolerance of distress.

Interpersonal Effectiveness

Mastering the skill of interpersonal effectiveness helps you get many of your wants and needs met the majority of the time in relationships. This skill set helps clients learn valuable communication skills which include: assertiveness, setting boundaries, building positive relationships, ending destructive relationships and learning how to negotiate within relationships.

Dialectical Thinking

Dialectical thinking teaches the skill of viewing problems or issues from different perspectives. Dialectical is the middle of two opposite thoughts and behaviors.
The goal of dialectical thinking is for the individual to not think in extremes, and to learn the skill of thinking through a problem and coming to a more balanced and less extreme thought to reduce behaviors that are problematic. Dialectical thinking also helps the individual think in a flexible way to see things from a different point of view. DBT helps change the individual’s thought process and ultimately their behavior.

If you are currently struggling with borderline personality disorder, unstable relationships, substance abuse, anxiety, eating disorders or depression feel free to contact any of our skilled and talented therapists here at Symmetry Counseling for help.

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