A Comprehensive Guide to This Evidence-Based Approach for Emotional Regulation and Resilience
Dialectical Behavior Therapy (DBT) is one of the most widely studied and highly effective psychotherapies for people who struggle with emotion regulation, self-destructive behaviors, and interpersonal conflict. Originally developed to treat borderline personality disorder (BPD), DBT has since been adapted to support individuals with a range of mental health challenges—including anxiety, depression, PTSD, and substance use disorders.
At City Behavioral Health, we offer Comprehensive DBT as a core component of our treatment model, adhering to the gold-standard protocols developed by DBT founder Dr. Marsha Linehan.
What Does “Dialectical” Mean?
The word dialectical refers to the idea that two seemingly opposite things can both be true at the same time. In DBT, this concept plays out in the balance between:
- Acceptance (acknowledging your current thoughts, emotions, and behaviors)
- Change (working toward healthier behaviors and thought patterns)
This dialectical framework helps clients move beyond black-and-white thinking and find a more flexible, effective way of relating to themselves and others.
A Brief History of DBT
DBT was developed in the late 1980s by psychologist Marsha Linehan, PhD, to treat chronically suicidal individuals—many of whom met criteria for BPD. Standard therapies were failing this population, so Dr. Linehan created a treatment that combined cognitive-behavioral interventions with mindfulness and validation techniques.
Since then, DBT has evolved into a structured, evidence-based therapy used across a wide variety of clinical settings.
According to the National Center for Biotechnology Information (NCBI), DBT has demonstrated efficacy in reducing self-harm, suicidal ideation, and hospitalizations. Source: https://www.ncbi.nlm.nih.gov/books/NBK279297/
Who Can Benefit from DBT?
DBT is especially effective for individuals who:
- Experience intense emotions or mood swings
- Struggle with self-harming or impulsive behaviors
- Feel chronically invalidated or misunderstood
- Have difficulty in relationships
- Live with PTSD, BPD, depression, or substance use challenges
- Engage in frequent emotional outbursts or withdrawal
At City Behavioral Health, DBT is often recommended for clients seeking practical tools, emotional insight, and structured support.
The Four Core Components of DBT
CBH’s Comprehensive DBT program includes all four pillars originally developed by Dr. Linehan:
1. Individual Therapy
Weekly one-on-one sessions help clients apply DBT skills to their personal challenges, track progress, and process emotional experiences in a safe space.
2. Skills Training Group
These weekly group sessions teach clients how to build life-enhancing skills across four key modules:
- Mindfulness: Being present without judgment
- Distress Tolerance: Coping with crisis without making things worse
- Emotion Regulation: Understanding and managing emotional responses
- Interpersonal Effectiveness: Navigating relationships and asserting needs
3. Phone Coaching
Clients can access their therapist between sessions for real-time support in applying DBT skills to daily life challenges—like managing conflict, urges, or emotional distress.
4. Consultation Team
CBH therapists meet weekly as a DBT consultation team to ensure fidelity to the model, receive peer support, and troubleshoot complex clinical situations. This ensures consistent, high-quality care.
What Makes DBT Different?
- Validation + Accountability: DBT doesn’t push change without first honoring your experience. This dual focus fosters motivation and reduces shame.
- Skills-Based: DBT gives clients tools they can actively practice and apply in everyday life.
- Structure + Flexibility: DBT follows a proven framework but allows for adaptation to individual needs.
- Strong Research Base: DBT has been tested across diverse populations and clinical conditions.
The Department of Veterans Affairs and Department of Defense both list DBT as a Level 1 treatment for emotion dysregulation, suicidal ideation, and complex comorbidities. Source: https://www.ncbi.nlm.nih.gov/books/NBK107208/
What to Expect at City Behavioral Health
Our Comprehensive DBT program is tailored to the needs of each client and may include:
- DBT for adolescents or adults
- Parent DBT skills groups
- DBT-informed family therapy
- Integration with The Nimble Track or in-home services for higher levels of support
We emphasize fidelity to the model while remaining nimble in how we deliver care. Whether you’re joining a skills group or working one-on-one with a DBT-trained therapist, you’ll be supported by a team that understands how to guide change with compassion and clarity.
Final Thoughts
DBT offers more than symptom management—it’s a pathway to building a life worth living. Through practical skills, structured support, and deep personal insight, clients can gain control over their emotions, improve relationships, and reduce harmful behaviors.
If you’re ready to begin DBT at City Behavioral Health, our team is here to help you take the first step.
Sources:
- National Center for Biotechnology Information. Dialectical Behavior Therapy Overview. https://www.ncbi.nlm.nih.gov/books/NBK279297/
- VA/DoD Clinical Practice Guidelines. Borderline Personality Disorder Treatment. https://www.ncbi.nlm.nih.gov/books/NBK107208/
