What is Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT) is a structured, skills-based form of cognitive behavioural therapy. It was developed by psychologist Marsha Linehan in the late 1980s, initially for people experiencing intense emotions and self-harm, and has since been adapted for many other concerns. The word “dialectical” refers to its central balance: accepting yourself as you are while also working toward change. In its standard form, DBT combines weekly individual therapy with a skills-training group, though some settings offer adapted or shorter versions. It is well supported by research, particularly for difficulties involving emotion regulation.
How Does DBT Work
DBT teaches practical skills across four areas:
- mindfulness, for staying present and aware
- distress tolerance, for getting through crises without making them worse
- emotion regulation, for understanding and managing intense feelings
- interpersonal effectiveness, for communicating needs while maintaining relationships and self-respect
DBT is often delivered through a combination of individual therapy and skills training, with practice between sessions. Treatment is structured and usually follows a clear sequence.
How DBT Helps
DBT aims to help people manage intense emotions, reduce harmful behaviours, and build more stable relationships. Because it is skills-based, clients learn specific strategies they can apply in everyday situations and continue to use over time, once the skills are learned. Research supports its effectiveness for reducing self-harm and emotional crises and improving day-to-day functioning.
Learn more: Linehan Institute — What is DBT?
Who Can Benefit from DBT
DBT was originally developed for borderline personality disorder and is now used for a range of concerns, including:
- intense or rapidly shifting emotions
- self-harm and self-destructive patterns
- difficulty maintaining relationships
- the emotional aspects of addiction or disordered eating
People often turn to DBT when emotions feel like they arrive faster and bigger than they can manage: when a small trigger leads to a reaction that’s hard to come back from, or when relationships keep ending up in the same painful place. It can help when other talk therapies haven’t given you enough to hold onto in the hardest moments.
DBT asks for a genuine commitment to learning and practising skills, and it tends to suit people who want concrete tools rather than insight alone. It is used with adults and adolescents, and the skills are designed to be useful in everyday life, not only in session.
You don’t have to choose an approach on your own. Your therapy also likely won’t include just one approach. DBT is often used alongside other approaches, shaped around what fits for you. Learn more about our approach to care.
Therapy most often includes multiple approaches, shaped around what best fits for you. Your counsellor will work with you to design an approach that meets your needs.
Finding the Right Fit
Research consistently shows that a safe, trusting therapeutic relationship is one of the strongest predictors of positive outcomes in counselling. When helping you find a therapist, we consider:
- Your goals, concerns, and preferences
- Your past experiences with counselling (if any)
- Therapist expertise and clinical focus
- Personality, pace, and working style
- Therapeutic orientation and flexibility
Some clients come in knowing they are interested in a particular approach. Others have no idea where to begin—and both are completely valid. You do not need to choose a modality to start counselling. Our role is to help guide the process and support you in finding a therapist who feels like a good fit.
You can also explore therapist profiles on our Meet the Team page.
Frequently Asked Questions About Therapeutic Approaches
No. Many clients begin therapy without any knowledge of modalities. Your therapist will guide the process and adapt the work to what’s most helpful for you.
No. Therapists at River’s Edge work integratively, drawing from multiple evidence-based approaches as therapy unfolds.
Yes. If you have experience with or interest in a particular modality, we’re happy to take that into account when matching you with a therapist.
That’s very common. Therapy itself is a collaborative process of discovering what supports change for you.
Different approaches can be helpful for different people and concerns. Research shows that the quality of the therapeutic relationship and a flexible, responsive approach are key factors in effective therapy.