If you have heard of Dialectical Behaviour Therapy (DBT) but are not sure what it actually involves, you are not alone. You may have seen DBT mentioned online, heard it recommended by a mental health professional, or come across individual skills such as mindfulness or distress tolerance. But what is DBT, and how can it help?

DBT is a structured form of psychological therapy that helps people develop practical skills for managing emotions, coping with difficult situations and building a life that feels more meaningful. It combines acceptance and change, helping people recognise their experiences as they are while also learning new ways of responding.

What is DBT?

DBT stands for Dialectical Behaviour Therapy. It was developed by psychologist Dr Marsha Linehan and was originally designed to support people experiencing difficulties with intense emotions and suicidal behaviour. Since then, DBT has been researched extensively and adapted for a range of mental health difficulties.

A central idea in DBT is that two things can be true at the same time. You can accept yourself as you are and still want to make changes. You can be doing the best you can and still need to learn new skills. This is the meaning of “dialectical”: bringing together ideas that may initially seem to be opposites.

Rather than simply asking someone to think differently, DBT focuses on developing practical skills that can be used in everyday life.

What does DBT help with?

DBT can help people who experience emotions very intensely or find it difficult to manage distress. It can also be useful when difficulties with emotions affect relationships, decision-making or day-to-day life.

DBT was initially developed for people with borderline personality disorder (BPD), and it has a strong evidence base for this population. It has also been adapted for other difficulties, including eating disorders, substance use and difficulties with emotional regulation.

Importantly, you do not need to have a particular diagnosis to benefit from learning DBT skills. The approach focuses on specific patterns and difficulties rather than defining someone by a diagnosis.

What are the four main DBT skills?

A standard DBT programme teaches four main sets of skills:

Mindfulness helps you become more aware of what is happening in the present moment. You learn to notice your thoughts, feelings and surroundings without automatically reacting to them.

Distress tolerance focuses on surviving difficult moments without making things worse. These skills can be particularly helpful when emotions are overwhelming and you need to get through a crisis safely.

Emotion regulation helps you understand and manage emotions more effectively. You learn skills for identifying emotions, reducing vulnerability to intense emotions and changing emotions when appropriate.

Interpersonal effectiveness focuses on relationships and communication. These skills can help you ask for what you need, set boundaries, maintain relationships and navigate conflict while respecting both yourself and other people.

Together, these skills provide a toolkit for responding more effectively to challenging situations.

How does DBT work?

Traditional DBT usually combines several different components. These can include weekly individual therapy, skills training in a group, between-session telephone coaching and a therapist consultation team.

Each part has a different purpose. Individual therapy focuses on applying DBT to your own goals and difficulties. Skills training provides structured opportunities to learn and practise skills. Coaching can help you use those skills when difficulties arise between sessions, while the consultation team supports therapists in delivering effective DBT.

DBT is active and collaborative. You are not simply expected to talk about your difficulties each week. Instead, you work with your therapist to identify patterns, practise skills and make changes that move you towards your goals.

Is DBT about accepting everything?

No. Acceptance is an important part of DBT, but acceptance does not mean giving up or deciding that difficult circumstances are acceptable.

DBT teaches radical acceptance, which means acknowledging reality as it is, rather than fighting against facts that cannot be changed. This can create space to decide what you can do next.

The balance between acceptance and change is at the heart of DBT. Sometimes you need to work towards changing a situation or behaviour. At other times, acceptance is the most effective response. Often, both are needed.

Could DBT be right for me?

Learning DBT skills can be helpful if you want to understand your emotions better, cope more effectively with distress or improve your relationships. A DBT assessment or pre-treatment process can help determine whether a full DBT programme is appropriate for your needs and goals.

DBT is not about becoming someone else or never experiencing difficult emotions. Instead, it aims to help you build the skills to respond to those emotions more effectively and create a life worth living.

If you are wondering what DBT is, the simplest answer is this: DBT is a practical, structured therapy that combines acceptance and change to help people manage difficult emotions, improve relationships and build lives that feel more fulfilling.

 

 

 

 

 

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Dialectical Behaviour Therapy

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