What is Dialectical Behavior Therapy?

Dialectical behavior therapy, often known as DBT, is a form of treatment that teaches people to regulate their emotions and better handle emotional distress.

The term “dialectical” refers to the integration of two opposing concepts. In DBT, the therapist aims to help their client let go of extreme reactions or beliefs and find a sense of balance. DBT can help people free themselves from the black-and-white, “all-or-nothing” thinking that often inspires unhealthy emotional responses.

Counselors who utilize DBT with clients focus on teaching behavioral changes. Through DBT, people learn skills and strategies that will help them handle difficult situations in a healthier way. Mastering essential problem-solving skills can be empowering, and this approach allows clients to take control of their lives and make positive changes. 

woman looking out at skyThe History of Dialectical Behavior Therapy

In the late 1980s, Dr. Marsha Lineman and her team were applying CBT to treat patients with Borderline Personality Disorder (BPD) and suicidal ideation. Disappointed in the results, they began incorporating additional skills-based techniques with the goal of helping their patients manage  emotional responses in a healthy manner. This modified approach proved successful, and today, DBT is often considered the gold standard for BPD treatment. It’s also been effective in treating a wide range of other conditions, including depression and anxiety. 

Numerous studies have demonstrated the effectiveness of DBT. In a study following 78 patients with BPD throughout one year of DBT, researchers found that 77% of the participants no longer met the criteria for BPD by the end of the year (Stiglmayr et. al. 2014). Furthermore, research has indicated that DBT combined with medication is a more effective treatment for individuals with depression than medication alone (Lynch et. al., 2006).

How Does DBT Work?

For people going through DBT, treatment primarily revolves around learning new skills. Overall, this approach to therapy aims to address emotional skill deficits in clients. Therapists will focus primarily on supporting clients in four specific areas; embracing the present moment through mindfulness, tolerating stressful situations, forming healthier relationships, and regulating painful emotions.

man smiling

The extent to which DBT may be incorporated into a client’s treatment plan is related to the person’s specific needs and goals. Some folks are able to benefit from learning DBT skills in the context of individual therapy sessions. For others, a therapist may refer them to a group DBT program, or an “adherent” DBT program, so that the client can learn and practice the skills in a more intensive format. In either individual or group treatment, people going through DBT might be given skills-based homework assignments to complete between sessions. 

DBT encompasses four distinct stages. In the first stage, the therapist helps their client shift from feeling out of control to gaining a sense of control. During the second stage, clients can begin to manage their emotional experiences. By the third stage, the client will define their own life goals and begin working towards these new objectives. Throughout the fourth and final stage, clients will develop a deeper capacity for joy.

Who Can Benefit From DBT?

People suffering from depression, anxiety, bipolar disorder, OCD, ADHD, or PTSD can find relief through DBT. Furthermore, DBT can help those dealing with substance abuse, eating disorders, or self-harm. 

Overall, DBT can be quite effective for people struggling with impulsivity or a lack of direction. The realization that you are in control of your emotions, and that you have agency over your own life, is one of the most valuable changes that DBT can bring about in your  life. 

Why We Offer Dialectical Behavior Therapy

At Affinity Psychological Services, we have several team members who specialize in treating clients with BPD, anxiety, bipolar disorder, and depression and incorporate DBT into their approach to therapy. Some of our therapists have also worked in DBT treatment centers.

Many people who struggle with their mental health feel like they have lost control over their own lives, which exacerbates the symptoms of their conditions. Through DBT, our counselors help their clients take action to improve their own lives and boost their self-esteem. This enables them to feel more in control of their situation. 

woman smiling in mirrorDBT can also be used for any client who  benefits from working on their emotional regulation skills. As we are a large practice with a growing team, we treat a wide range of clients, and we find that techniques drawn from DBT are exceptionally helpful for many people. DBT enables clients to go beyond self-reflection and focus on skills they can apply in every area of their lives. Mastering these behavioral skills can be highly empowering, and clients can gain confidence that serves them in their personal and professional endeavors.

You Can Gain Agency Over Your Emotions

If you’re interested in working with a therapist who specializes in dialectical behavior therapy, you can learn more about our approach to treatment by reaching out on our contact page. If you want to schedule your first appointment, you can go to our scheduling page to book a session at one of our locations in Edina, Plymouth, St. Cloud, or Bloomington.

teen girl staring at herself in a mirror smiling

How Is CBT Different Than DBT?

CBT is Cognitive Behavioral Therapy. It is a popular and effective form of short-term talk therapy for a wide range of mental health issues and disorders. The focus during CBT treatment is on your distorted thought patterns. Changing them can go a long way in changing what emotions you feel and what behaviors you choose.

DBT is Dialectical Behavioral Therapy. It’s also a form of talk therapy that’s popular and effective for many problems — but not quite as short-term as CBT. DBT will focus on distorted thinking patterns but the next steps are different. Rather than removing such thoughts, the goal is to develop balance around them.

Is CBT Sometimes Used as a Catch-All Phrase?

Yes, there are a few different types of CBT and that includes DBT. Thus, when differentiating between them, it’s crucial to know in advance that some people use the acronym CBT to describe any type of talk therapy that, for example, takes place over a limited period of time and emphasizes cognition over emotions. Therefore, for the purposes of this discussion, we’re using the traditional definition of Cognitive Behavioral Therapy as it compares to Dialectical Behavioral Therapy.

So, How Is CBT Different Than DBT?

CBT and DBT share these philosophies and approaches:

  • Identifying and exploring negative thoughts and behaviors
  • Increasing one’s self-awareness in daily life
  • Developing productive new behaviors and patterns

But they have some core differences when it comes to attaining such goals, e.g.

  • Through practice, CBT guides you to create positive change by recognizing the cycle of thought-emotion-action. By addressing a distorted thought, you can reimagine what emotions and actions are possible. The guiding principle, you might say, is logic.
  • DBT introduces more of an acceptance mindset. You learn that negative moments are inevitable. Hence, learning how to accept and tolerate them reduces the impact of the emotions created and leaves room for healthier behaviors in response. With DBT, the guiding principle is mindfulness.

Treating Particular Illnesses

CBT is particularly effective in the treatment of:

  • Depression
  • Phobias
  • Anxiety
  • Sleep issues
  • Obsessive Compulsive Disorder (OCD)
  • Post-traumatic Stress Disorder (PTSD)

DBT was initially designed to treat those with Borderline Personality Disorder. It’s now also been deemed effective for:

  • Sexual trauma
  • Eating disorders
  • Self-harming behaviors
  • Chronic thoughts of suicide

teen girl staring at herself in a mirror smilingTreatment Methods and Goals

As mentioned above, CBT treatments are usually shorter than DBT. Also, CBT does not automatically include a group therapy component while DBT does. In group therapy, DBT patients work on skills training.


CBT is the more goal-oriented approach of the two. Put simply, the goals relate to:

  • Guiding clients to learn how to recognize thought distortions and the behavior they provoke
  • Develop the tools needed to adjust to the distortions that kick off the negative cycle

In DBT, the goals are more fluid but share some similarities with CBT goals, e.g.

  • Acceptance
  • Emotional regulation
  • Controlling destructive behavior

Is CBT or DBT Right For You?

As you can probably discern from all of the above, it’s now about one treatment being “better” than the other. Each situation, each client, and each therapist brings with them unique factors. You will need to identify elements like:

  • Symptoms
  • Treatment history
  • Goals
  • Personal circumstances like scheduling and time constraints

The best first step is to reach out and speak with a mental health professional. This will be the ideal setting to learn more about both Cognitive Behavioral Therapy and Dialectical Behavioral Therapy. You can share about yourself and ask relevant questions about the therapist’s approach and philosophy. From there, you can work together to choose the next steps on your path to healing and recovery. Let’s connect and talk soon!

woman twirling around in a field of sunflowers

What Is DBT Used For?

Dialectical Behavioral Therapy (DBT) is a form of talk therapy. More specifically, it falls under the umbrella of Cognitive Behavioral Therapy (CBT). Thus, both approaches aim to address distorted thought patterns as a way of preventing unhealthy behaviors. What sets DBT apart is its focus on acceptance. Throughout the treatment process, a DBT therapist will encourage you to accept who you are right now.

This is why “dialectical” is in the title. You are being asked to simultaneously create change while accepting yourself as you are. This concept reassures clients that they are not uniquely flawed even as they strive to address their challenges.

Some DBT Basics

You are being guided to identify and accept negative thoughts, feelings, and behaviors. At the same time, DBT teaches you the skills you need to manage these issues. From this foundation, you are well-positioned to create the positive changes you desire.

Generally speaking, DBT treatment:

  • Individual therapy
  • Group training
  • Phone coaching (if needed)
  • Homework (including “diary cards” of emotions, urges, etc.)

How Does DBT Work?

Those undergoing DBT treatment will learn four ways to develop productive life skills. These are:

  • Distress tolerance: Problems and the distress they cause are inevitable. Hence, DBT helps you navigate these experiences without defaulting to coping choices like self-injury, self-medication, or other impulsive choices.
  • Emotion regulation: Once again, strong emotions are unavoidable. They become manageable when you are able to recognize them, name them, and adapt them. DBT is a powerful avenue in this direction.
  • Mindfulness: Instead of using the past as your compass, mindfulness eases you into being attentive to the present moment. This is precisely where the solutions lie.
  • Interpersonal effectiveness: DBT helps you combine the above three skills into practical applications. These might include dealing with conflict and finding healthy ways to be assertive.

All of the above falls into four clear stages:

  1. Identify and treat the highest priority issues (like self-harm or suicide attempts)
  2. Cultivate skills that increase your quality of life (see the list directly above this one)
  3. Improving both your self-esteem and your relationships
  4. Living a life that includes fulfilling relationships and more overall joy

Unlike CBT, DBT is not a short-term treatment. It runs a course that can range from six months to a year. However, it has a solid track record for treating a wide range of issues and conditions.

woman twirling around in a field of sunflowersWhat Is DBT Used For?

Anyone with emotional regulation issues would be well-served to explore DBT as an option. More specifically, it can be effective in treating conditions like:

  • Borderline Personality Disorder (BPD)
  • Post-Traumatic Stress Disorder (PTSD)
  • Substance abuse
  • Self-injury and impulsive behaviors
  • Suicidal behavior
  • Depression
  • Anxiety
  • Eating disorders (e.g. binge eating disorder and bulimia)
  • Relationship problems
  • Attention-Deficit/Hyperactivity Disorder (ADHD)

DBT has become a front-line, go-to choice for challenging, high-risk patients — including those with multiple diagnoses. In the case of BPD (Borderline Personality Disorder) Dialectical Behavioral Therapy is endorsed by the American Psychiatric Association. Patients with BPD, when treated with DBT, have shown results like:

  • Fewer and shorter hospitalizations
  • Sticking to treatment longer
  • Reduction in suicidal behavior
  • Decreased anger
  • Better functioning in social settings

How Can Patients Improve Their Results With DBT?

  • Be ready and committed to participating in therapy
  • Do your homework
  • Maintain a strong desire to create the positive changes you seek
  • Not overly dwelling on the past
  • Be willing to work in a group setting

Is DBT Right For You or Someone You Know?

Are you struggling with negative and extreme emotions? Have you been able to find ways to control your thoughts, feelings, and actions? DBT is designed to guide you toward the healthiest way to manage such problems. You probably have questions. we’re here to help you find the best possible answers. Reach out to us soon to learn more about DBT.

woman looks stressed

How Can DBT Help With Bipolar Disorder?

I suppose we should commence by clarifying the terms in question. DBT is Dialectical Behavioral Therapy. It is specifically designed to address one’s difficulty with regulating their emotions. Bipolar disorder (BD) was once called “manic depression.” It can be recurrent and disabling due to its episodes of depression and mania. Someone with BD may experience extreme mood swings. This, of course, involves difficulty with regulating emotions.

Thus, you can already see why DBT is so often suggested for people with BD. DBT is a form of Cognitive Behavioral Therapy. It helps people identify negative thought patterns in the name of creating positive behaviors.

A Little More About Bipolar Disorder

BD is a chronic mental health condition. Its hallmark extreme mood swings most often begin in a person’s teenage or young adult years. However, they can start at any age. This illness varies widely from person to person in terms of what symptoms arise and how severe they are

A crucial component of BD to bear in mind is that those with the disorder are frequently unaware of how extreme their behavior is. To many of them, they feel as if the people in their lives are overreacting or persecuting them. This is why the identification of negative thought patterns is so important with DBT.

DBT’s Four Core Skills and Bipolar Disorder

For the sake of this post, I’ll focus primarily on DBT’s four core skills training:

  • Mindfulness
  • Distress tolerance
  • Emotional regulation
  • Interpersonal effectiveness

Let’s explore how each skill can be helpful for anyone struggling with Bipolar Disorder.


This skill helps us stay in the present moment. So much of your emotional regulation relates to you not living in the past or fearing the future. When a person is mindful, they can more clearly name their emotions — along with the behaviors and thoughts those emotions can provoke. From such a perspective, it is easier to manage the highs and lows.

Distress Tolerance

BD causes distress. Often, it causes a lot of distress. Learning to cope with this distress is a powerful step toward emotional regulation. You become less susceptible to impulsive and often harmful reactions. Also, you can better understand what others see when interacting with you.

woman looks stressedEmotional Regulation

There is a balance you must seek. You want to validate what you feel and why. At the same time, you wish to prevent your emotions from escalating to the point of dysfunction. But how do you know which emotions represent your authentic state of mind? DBT is an effective method for striking this delicate but essential balance.

Interpersonal Effectiveness

Bipolar Disorder can be tough on your relationships. Whether it be friends, family, co-workers, neighbors, or partners — the challenges abound. So, you’re working to become more mindful. Your tolerance for distress feels higher as you strive to regulate negative emotions. Now it’s time to put all of this to work in your interpersonal life.

Interpersonal effectiveness skills help you reduce the potential damage BD can cause. In addition, they empower you to repair the relationships that have already suffered.

How Does This Journey Begin?

Bipolar Disorder cannot be treated with self-care. You will need the intervention and support of a trained mental health professional. BD also cannot be cured but it can be effectively treated and managed. But I can imagine you have questions. You may have lots of questions. Such a dialogue is a great place to start.

Take another look at the four core skills above. If this type of change is what you seek and what you need, we should talk very soon. Let’s connect for a free and confidential consultation  for dbt therapy. Bring all your questions with you!