What the Heck is DBT?
Dialectical Behavior Therapy (DBT) was originally developed to treat chronic suicidality and self-harm, and is most often associated with Borderline Personality Disorder (BPD). In the 90s, the field lacked a structured, evidence-based treatment that could meet the complexity of this population — so Marsha Linehan built one.
Since its creation, DBT has evolved — and its reach has expanded. While it was built for suicidality and BPD, it’s now recognized as one of the most effective treatments for emotion dysregulation more broadly. That includes people who feel everything intensely, who struggle with relationships, who act impulsively when distressed, and who genuinely want to change but don’t know how.
At the heart of DBT is the dialectic—a core tension between two ideas that seem opposite but are both true: acceptance and change. DBT teaches that patients can learn to fully accept themselves as they are and still work toward meaningful change. Clinicians are trained to hold this dialectic with patients in every interaction, validating their experience without losing sight of what needs to change. That balance is woven into every aspect of the treatment.
What makes DBT so distinguishable is that it’s a comprehensive, coordinated treatment with multiple components that work together to support real, lasting progress. Adherent DBT requires all four core components — and to provide true DBT (not a knockoff version), all four are required:
1. Individual Therapy
This is where the patient and therapist work one-on-one to reduce self-destructive behaviors, strengthen skill use, and shift patterns that keep them stuck.
2. DBT Skills Group
This isn’t group therapy. It’s more like class. Patients learn and practice skills across four modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
3. Phone Coaching
In-the-moment support outside of sessions. Patients can call their therapist for brief coaching on how to apply DBT skills when it actually matters — not just in the office, but in real life.
4. DBT Consultation Team
Therapists need support, too. The consultation team is where DBT providers meet regularly to maintain fidelity to the model, avoid burnout, and keep doing effective work with complex cases.
At DBT HQ, we provide adherent, evidence-based DBT for adolescents, adults, and families — both in-person at our Southfield, Michigan office and via telehealth across Michigan, New Jersey, and New York. While some people benefit most from the full DBT program, not everyone needs comprehensive DBT to make meaningful change. That’s why we also offer a range of behavioral therapies — including Acceptance and Commitment Therapy (ACT), Exposure and Response Prevention (ERP), and CBT for Eating Disorders and Insomnia — all tailored to meet your individual needs and goals.
Want to explore what kind of support might be the best fit? Click below to book a free consultation — we’d be happy to connect.
And stay tuned: next up, we’re breaking down what DBT looks like specifically for adolescents and their families.
