Dialectical behavior therapy (DBT) is a type of talk therapy, developed by psychologist Marsha Linehan, that builds on cognitive behavioral therapy for people who feel emotions very intensely. It teaches four practical skill sets: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, while balancing acceptance of how you feel with real change.
Key takeaways
The Cleveland Clinic describes DBT as "a type of talk therapy (psychotherapy)" that is based on CBT but "specially adapted for people who experience emotions very intensely." It was developed in the 1970s by Marsha Linehan, an American psychologist.
The word "dialectical" sounds academic, but the idea is simple. Cleveland Clinic puts it this way: "'Dialectical' means combining opposite ideas." In DBT, the two ideas are acceptance and change. You learn to accept your feelings as real and understandable, and you also learn new ways to respond to them. The National Alliance on Mental Illness (NAMI) describes the therapist's role as helping "the person find a balance between acceptance and change."
According to NAMI, "Dialectical behavior therapy (DBT) was originally developed to treat chronically suicidal individuals with borderline personality disorder (BPD)." The National Institute of Mental Health (NIMH) notes that DBT "teaches skills to help people control intense emotions, reduce self-destructive behaviors, and improve relationships."
The research behind DBT is strongest in that original group. In a two year randomized controlled trial led by Linehan and published in Archives of General Psychiatry (2006), people receiving DBT "were half as likely to make a suicide attempt" as people receiving community treatment by experts. NAMI adds that "over time, DBT has been adapted to treat people with multiple different mental illnesses."
If you are thinking about suicide or harming yourself, call or text 988, the Suicide and Crisis Lifeline. If you are in immediate danger, call 911.
DBT skills are practical tools you can use in daily life. Behavioral Tech, which trains clinicians in DBT, and the Linehan Institute describe four skill sets.
Behavioral Tech defines mindfulness as "the practice of being fully aware and present in this one moment." It is the foundation for the other three skills. In practice, it can look like noticing "my chest is tight and I want to send that text" before you act, instead of after.
Behavioral Tech describes distress tolerance as "how to tolerate pain in difficult situations, not change it." The Linehan Institute frames it as building the ability "to tolerate and survive painful situations without making them worse." Some moments cannot be fixed right away. These skills help you ride out the wave without acting on an urge you will regret later.
Emotion regulation, in Behavioral Tech's words, is "how to change emotions that you want to change." The Linehan Institute adds that it means learning "how to understand, reduce vulnerability to, and change unwanted emotions." This often includes naming emotions more precisely and noticing what makes you more reactive, such as poor sleep or a long stretch of stress.
Behavioral Tech describes interpersonal effectiveness as "how to ask for what you want and say 'no.'" The Linehan Institute adds the goal of keeping relationships while preserving your self respect. These skills help when conversations keep turning into conflict.
Cleveland Clinic states that "DBT has proven to be effective for treating and managing a wide range of mental health conditions." Its list includes borderline personality disorder, self harm, suicidal behavior, PTSD, substance use disorder, binge eating disorder, bulimia, depression, and anxiety. NAMI notes that "most people who are treated with DBT have BPD as a primary diagnosis."
You do not need a diagnosis to wonder whether DBT skills could help. DBT may fit if your emotions feel too intense or change too fast to manage, you act on urges you later regret, or relationships keep ending in conflict. It also suits people who want practical, skills based work. Only a qualified mental health professional can assess what is going on for you, so treat this list as a reason to ask, not a diagnosis.
Standard, or comprehensive, DBT is a full program with several parts. Behavioral Tech describes four modes of standard outpatient DBT:
Cleveland Clinic notes that DBT "usually takes at least six months to a year."
To be clear about what Foundations offers: we provide individual counseling that teaches and practices DBT skills. We do not run a comprehensive DBT program, skills groups, or phone coaching. The skills group part of comprehensive DBT is offered by specialty DBT programs elsewhere. If ongoing self harm or suicidal behavior is part of the picture, a comprehensive program may serve you better, and your counselor can help you look for one.
In individual counseling that draws on DBT, sessions are usually practical and collaborative. A typical rhythm looks like this:
How long this takes depends on your goals and how quickly the skills start working in daily life. Your counselor will review progress with you and talk openly about when to space sessions out or finish.
DBT and cognitive behavioral therapy (CBT) are close relatives. NAMI explains that "DBT is heavily based on CBT with one big exception: it emphasizes validation, or accepting uncomfortable thoughts, feelings and behaviors instead of struggling with them." CBT focuses on how thoughts shape feelings and actions; our guide to cognitive behavioral therapy and emotional baggage walks through that idea. DBT adds acceptance and a structured set of skills for moments when emotions run high.
If anger is the emotion that tends to take over, our post on not letting anger turn you inside out is a good next read. If you want to start with the first DBT skill on your own, see our guide to mindfulness practices for busy people.
Sixteen Foundations counselors are listed on our Dialectical Behavior Therapy (DBT) page, and their training and experience with the model vary. Ask about a counselor's DBT background when you reach out. We will match you with a counselor who fits, and your first meeting with that counselor is a free consultation, a good time to talk through whether a DBT informed approach or another method fits you best.
Sessions are in person in Fort Collins, Loveland, and Windsor, or online in Colorado. If your first counselor is not the right fit, our Counselor Match Guarantee means we will find another counselor who is.
Dialectical behavior therapy (DBT) is a type of talk therapy, developed by psychologist Marsha Linehan, that builds on cognitive behavioral therapy. It helps people who feel emotions very intensely balance accepting their feelings with changing how they respond, using four skill sets you practice in daily life.
The four DBT skill sets are mindfulness (being aware of the present moment), distress tolerance (getting through painful moments without making them worse), emotion regulation (understanding and changing emotions you want to change), and interpersonal effectiveness (asking for what you need and saying no while keeping relationships and self respect).
DBT was originally developed for chronically suicidal people with borderline personality disorder. Cleveland Clinic notes it is also used for conditions such as depression, anxiety, PTSD, substance use, and some eating disorders. It may fit if your emotions feel too intense to manage or relationships keep ending in conflict.
DBT is built on CBT. NAMI explains that the big difference is that DBT emphasizes validation, accepting uncomfortable thoughts and feelings instead of struggling with them. DBT pairs that acceptance with a structured set of skills for moments when emotions run high.
Cleveland Clinic notes that a comprehensive DBT program usually takes at least six months to a year. Individual counseling that draws on DBT skills has no fixed length; it depends on your goals and how quickly the skills start working in daily life. Your counselor reviews progress with you regularly.
No. Foundations offers individual counseling that teaches and practices DBT skills, not a comprehensive DBT program with skills groups or phone coaching. If a full program would serve you better, your counselor can help you look for one. If you are in crisis, call or text 988.
Clinically reviewed by Chris Berger, M.A., LPC, NCC. Updated October 2026.
More on how counseling works: browse our Therapy Approaches guides.
We will match you with a counselor who fits, and your first meeting is a free consultation. Schedule your free consultation or call 970.227.2770.
If you are thinking about suicide or harming yourself, call or text 988, the Suicide and Crisis Lifeline. If you are in immediate danger, call 911.