You can learn to manage intense emotions, handle conflict without shutting down, and steady your mood using practical skills from dialectical behavior therapy (DBT).
DBT teaches clear tools for mindfulness, emotion regulation, distress tolerance, and relationship skills so you can feel more in control of daily life.
This article will show how DBT works, where it helps most (like anxiety, depression, life transitions, and relationship stress), and what to expect when you start treatment.
If you want in-person care near Chicago or mostly virtual sessions, Tides Mental Health offers experienced DBT-based support to help you begin.
Defining Dialectical Behavior Therapy
DBT teaches skills to help you manage intense emotions, handle crisis moments, and build better relationships.
It blends acceptance and change so you can reduce self-harm, cope with anxiety or depression, and improve daily functioning.
Origins and Development
DBT was developed in the late 1980s by psychologist Marsha Linehan.
She created it after finding standard CBT did not fully help people with chronic self-harm and suicidal behavior.
Linehan combined behavioral science with eastern mindfulness practices to form a structured program.
Early research tested DBT mainly with adults diagnosed with borderline personality disorder.
Over time, clinicians adapted DBT for related problems: severe emotion dysregulation, PTSD, eating disorders, and mood disorders.
Today you can access DBT skills through individual therapy, skills groups, and phone coaching.
Tides Mental Health offers DBT-informed care, with most sessions available virtually and in-person services in the Chicago area.
Core Principles
DBT rests on a few clear principles: balance acceptance with change, teach concrete skills, use a structured treatment format, and emphasize a validating therapeutic stance.
Acceptance means acknowledging your current feelings without judgment.
Change means learning new behavioral and thinking patterns to reduce harmful actions.
The therapy focuses on four skill modules: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
Each module teaches step-by-step strategies—like grounding practices, tracking emotions, crisis survival skills, and assertive communication.
You practice these skills both in sessions and in real-life moments.
Unique Features
DBT differs from other therapies because it combines skills training with active support and coaching.
You get weekly individual sessions plus a group skills class.
Therapists use phone coaching between sessions to help you apply skills during crises.
DBT teams follow a clear hierarchy of treatment targets so therapy stays focused on safety and quality of life.
The model also emphasizes therapist consultation to keep clinicians effective and consistent.
If you want DBT for anxiety, depression, life transitions, or relationship issues, Tides Mental Health provides DBT-based options with mostly virtual care and Chicago-area in-person sessions.
How Dialectical Behavior Therapy Works
DBT teaches clear skills you can use to manage strong emotions, tolerate crises, and improve relationships.
It combines structured skill lessons, individual coaching, and practical work on problems you bring to therapy.
Therapeutic Structure
DBT has four core skill areas: mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.
You learn these in a skills group that meets weekly, with lessons, practice exercises, and homework to apply skills between sessions.
Individual therapy complements the group by focusing on your personal goals and using skills to solve current problems.
Sessions usually follow a set weekly schedule so you build momentum and see steady progress.
Phone coaching or messaging is often available so you can get skill prompts during real-life crises.
This helps you use DBT tools in the moment rather than only talking about them later.
Stages of Treatment
DBT typically progresses through stages that match your needs.
Early work targets behaviors that put you at immediate risk, such as self-harm, suicidal thinking, or severe avoidance.
You and your therapist set clear, measurable targets and track them each week.
Once safety improves, treatment shifts to reducing behaviors that interfere with quality of life—substance use, relationship patterns, or emotional reactivity.
Later stages focus on building life goals like work, study, or stable relationships.
Treatment length varies by need, often months to a year.
You can expect regular reviews and adjustments based on your progress.
Role of the Therapist
Your DBT therapist teaches skills, coaches you in real situations, and helps prioritize change targets.
They use validation to show they understand your feelings and push for change when patterns harm you.
Therapists work within a team model to stay effective and avoid burnout; that team consultation keeps care consistent and evidence-based.
At Tides Mental Health, therapists offer both virtual sessions (60–70% of care) and in-person work in the Chicago area (30–40%).
You can choose the format that fits your life while still getting the same structured DBT approach.
Key Components of DBT
DBT focuses on clear skills you can use to manage intense emotions, handle crisis moments, improve relationships, and build mindful awareness.
Each skill set teaches concrete steps you can practice in daily life.
Mindfulness Techniques
Mindfulness in DBT trains you to notice the present without judging it.
You learn to focus on breath, bodily sensations, or current tasks to reduce ruminating thoughts.
Practice includes short exercises you can do anywhere, like a one-minute breath check or naming five things you see.
You also learn “what” and “how” skills: the “what” skills (observe, describe, participate) teach how to notice experience.
The “how” skills (non-judgmentally, one-mindfully, effectively) teach the stance you take while noticing.
These skills help you pause before reacting and choose actions that fit your goals.
Regular practice lowers emotional reactivity.
Use brief daily exercises and longer guided sessions in therapy or virtual meetings to strengthen attention and reduce impulsive behavior.
Distress Tolerance Skills
Distress tolerance teaches ways to survive crises without making things worse.
You learn short-term strategies to get through painful moments when you can’t change the situation right away.
Techniques include distraction, self-soothing, improving the moment, and radical acceptance.
Distraction shifts focus to neutral or positive tasks for a set time.
Self-soothing uses the five senses—listen to calming music, hold a warm drink, or look at a comforting image.
Improving the moment combines imagery, meaning, and relaxation to reduce immediate distress.
Radical acceptance means acknowledging reality to stop fighting what you cannot change.
These skills are practical for panic, urges to harm yourself, or intense grief.
Practice them in real situations and review what worked in therapy sessions, including virtual check-ins with Tides Mental Health.
Emotion Regulation Strategies
Emotion regulation gives you tools to understand and change how emotions arise and fade.
You learn to identify emotions precisely, track triggers, and test beliefs that fuel strong feelings.
Skills include building positive experiences, reducing vulnerability (sleep, diet, exercise), and using opposite action when emotions drive harmful behavior.
You also practice checking facts: ask if your feelings match the facts and what evidence supports a different action.
Planning ahead helps—for example, schedule pleasant activities when you feel low or use grounding techniques when anxiety spikes.
These strategies lower the intensity and length of painful emotions.
Apply these skills to anxiety, depression, life transitions, or relationship conflict.
Your therapist will help tailor habits and homework to your schedule, whether you meet in person in Chicago or virtually.
Interpersonal Effectiveness Models
Interpersonal effectiveness trains you to get what you want, keep relationships healthy, and maintain self-respect.
You learn clear communication patterns: state your goal, describe the situation briefly, express your feelings, and ask for what you need.
Practice scripts and role-plays help you build confidence.
Skills include DEAR MAN (describe, express, assert, reinforce, stay mindful, appear confident, negotiate) for asking or saying no.
GIVE (gentle, interested, validate, easy manner) focuses on keeping relationships positive.
FAST (fair, apologize when needed, stick to values, truthfulness) preserves self-respect during conflict.
Use these models in work, family, and couple conversations.
Tides Mental Health teaches these skills in individual and group formats, helping you practice both online and in Chicago-area clinics.
Applications and Effectiveness
DBT helps you manage intense emotions, reduce self-harm, and improve relationships.
It applies to a range of problems and has clear research showing benefits for many people.
Conditions Treated
DBT treats problems tied to emotion regulation and risky behaviors.
It is most established for borderline personality disorder (BPD), where it cuts suicidal behavior and self-injury.
You can also use DBT for long-term depression, severe anxiety, and post-traumatic stress disorder when emotional instability drives symptoms.
You may find DBT helpful during big life transitions that raise stress or cause relationship conflict.
Therapists often adapt skills training for couples and family counseling to teach clear communication, boundaries, and problem-solving.
Tides Mental Health offers mostly virtual services (about 60–70%) and in-person care in the Chicago area (about 30–40%), with plans to expand into child and adolescent therapy.
Evidence-Based Outcomes
Research shows DBT reduces self-harm, suicide attempts, and psychiatric hospital stays.
Randomized trials and meta-analyses report improved emotion regulation, fewer emergency visits, and better treatment retention for adults with BPD.
Studies also show moderate benefits for PTSD and substance-use problems when DBT skills are included.
Effect sizes vary by condition and program type, but consistent findings support DBT as an evidence-based choice.
If you seek services, Tides Mental Health provides DBT-informed care you can access virtually or in person in Chicago, so you can start skill-based work that targets measurable symptom reduction.
DBT in Different Settings
DBT uses structured, practical formats to teach skills and offer support.
You’ll find focused one-on-one work, group lessons for practicing skills, real-time coaching for crises, and team support that keeps therapists effective and consistent.
Individual Therapy
In one-on-one DBT, you meet weekly with a trained therapist for about an hour.
You and your therapist set clear, measurable goals tied to your life — like reducing self-harm urges, managing anxiety attacks, or improving mood.
Sessions focus on applying DBT skills to problems you face that week.
Your therapist helps you practice mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness in ways that fit your daily life.
Individual therapy also reviews crisis plans and tracks progress with homework and skills practice.
If you work with Tides Mental Health, most individual sessions are virtual (about 60–70%), with in-person options available in the Chicago area.
Group Skills Training
Group skills training meets once a week in a class-like setting to teach the four core DBT modules: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
Groups use clear lessons, worksheets, and role-plays so you can practice skills with others who share similar goals.
These groups let you see how skills work in real interactions and get feedback from peers and the leader.
Tides Mental Health runs groups mainly online, with some in-person groups in Chicago.
Groups often follow a handout or workbook so you can practice between meetings.
Phone Coaching
Phone coaching gives you moment-to-moment help using DBT skills during a crisis or when a strong emotion hits.
You can call or message your DBT therapist to get short, focused coaching on what skill to use and how to use it right then.
Coaching is practical and time-limited.
The coach helps you choose a concrete skill (for example, a grounding exercise or a specific breathing pattern) and guides you through it.
Tides Mental Health offers phone coaching to help you manage anxiety, severe mood swings, or risky urges between sessions.
Therapist Consultation Teams
Therapist consultation teams meet regularly so DBT therapists stay effective and consistent.
These meetings focus on case consultation, skill-building for therapists, and keeping treatment aligned with DBT principles.
When your therapist participates in a consultation team, you gain a therapist who reflects on tough cases, reduces burnout, and follows a clear treatment plan.
Tides Mental Health requires therapists to join these teams to maintain high-quality care, whether sessions are virtual or in-person in Chicago.
Adaptations and Innovations
DBT has changed to fit different delivery methods, age groups, and cultures while keeping its core skills.
You can access DBT in person or online, find programs for teens, or use versions shaped to match cultural values and language.
Online and Digital DBT
You can take DBT in virtual formats that match how many people now prefer care. At Tides Mental Health, most offerings are virtual (about 60–70%), with in-person sessions available in the Chicago area for skills groups or individual work.
Online DBT uses live video for individual therapy and skills groups. Secure messaging is used for coaching between sessions, and digital workbooks are provided for homework.
These tools help you practice mindfulness, distress tolerance, emotion regulation, and interpersonal skills in real situations. Virtual delivery keeps treatment structured: weekly individual therapy, weekly skills group, phone coaching, and a therapist consultation team.
You still track behaviors, use chain analyses, and build behavioral targets, but you do it over video and with digital worksheets. Digital options increase access when travel or scheduling is hard.
They also let you bring skills into your home, work, or school context right away.
DBT for Adolescents
DBT adapts for teens by involving families and focusing on development tasks like school, peer relationships, and identity. You and your teen work on the same core skills, but sessions add parent coaching and family skills training to support change at home.
Program structure often includes skills groups for teens and a parallel group for caregivers. Therapists teach concrete skill steps, use shorter practice tasks, and set clear behavior targets that fit school and family life.
DBT for adolescents addresses self-harm, suicidal thoughts, severe mood swings, and substance use when present.
Culturally Adapted DBT
Cultural adaptations keep the core DBT principles but change language, examples, and delivery to match cultural values. Therapists assess beliefs about emotion, family roles, help-seeking, and stigma before tailoring the program.
Adaptations may alter metaphors, use community-relevant examples, shift session timing, or add family or community leaders to increase trust and fit. This makes skills like emotion regulation and interpersonal effectiveness feel relevant and usable in your cultural context.
If you prefer care that respects your cultural background, ask Tides Mental Health about adapted DBT options and in-person services in Chicago.
Challenges and Considerations
DBT can help with strong emotions and relationship difficulties, but it also raises practical and clinical issues you should know about before starting.
Barriers to Access
Many people struggle to find trained DBT clinicians nearby. Certified DBT providers are limited, and waitlists can be long in the Chicago area.
You can access care sooner through telehealth — about 60–70% of sessions at Tides Mental Health are virtual — which reduces travel and scheduling barriers. Cost and insurance can block treatment.
DBT often involves weekly individual therapy, skills groups, and phone coaching, which increases time and expense. Ask your insurer about coverage and check whether sliding-scale or self-pay options exist.
Time commitment and consistency matter. DBT requires regular attendance and homework.
If your schedule or work makes weekly groups hard to attend, discuss a flexible plan with the clinician or use virtual group options.
Limitations of DBT
DBT focuses mainly on emotional regulation, crisis skills, and interpersonal effectiveness. It works well for borderline personality disorder and self-harm behaviors, and helps with anxiety or depression when emotion dysregulation is central.
However, DBT is not a one-size-fits-all treatment for every mental health problem. DBT requires skilled therapists who stick to the model.
Poor implementation or partial programs (for example, without phone coaching or group skills training) reduce effectiveness. Ask whether your provider follows standard DBT components and has DBT training.
You may need additional or different treatments for issues like severe psychosis, active substance dependence, or primary medical problems. Tides Mental Health offers assessment to match you with appropriate care and can combine DBT skills with other therapies when needed.
Finding and Starting DBT
Finding the right DBT provider matters. You can look for therapists who list DBT on their profile and ask about their training, experience, and how they deliver sessions.
Tides Mental Health offers DBT for adults, focused on anxiety, depression, life transitions, and couples or family work. Most sessions are virtual (about 60–70%), with in-person options in the Chicago area (about 30–40%).
Plans include expanding to child and adolescent therapy.
When you contact a DBT program, ask these clear questions:
- Is the therapist DBT-trained or supervised in DBT?
- Do you offer skills training groups and individual therapy?
- How long is treatment, and how often are sessions?
- Are sessions virtual, in-person, or a mix?
Starting DBT often means a brief intake and commitment to regular sessions. You will begin learning core skills: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
You may join a skills group and have weekly individual sessions. Homework and practice between sessions are expected.
If cost or access is a concern, ask about sliding scale fees, insurance, or virtual-only options.
Reach out to Tides Mental Health to ask about availability, scheduling, and whether their current programs match your needs.