Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy, or DBT, is an evidence-based treatment designed to help individuals who experience intense emotions, difficulty managing distress, relationship challenges and patterns of impulsive or self-destructive behaviors.

DBT combines cognitive-behavioral strategies with mindfulness and acceptance-based practices. The term “dialectical” refers to the integration of two seemingly opposite ideas: acceptance and change. In DBT, the client works to accept themselves as they are, while also building skills to create meaningful change.

DBT was originally developed by Marsha Linehan, PHD, ABPP, and is now recognized as one of the most effective treatments for emotion dysregulation and high-risk behaviors.

Adherent DBT consists of several components: weekly individual therapy, weekly skills training groups, phone coaching and a DBT consultation team (supports the therapist and the treatment). Adherent DBT simply means that the therapist delivers DBT therapy in a way that strictly follows the established protocols, ensuring clients benefit from a structured, evidence-based approach to treatment.

DBT modules

DBT skills groups include five modules:

• Mindfulness skills: help to be present in the moment and gain the ability to recognize and understand signs of intense emotions.
• Emotion regulation skills: help to understand and cope with emotions through problem solving and self-soothing experiences to protect yourself from emotional extremes.
• Interpersonal effectiveness skills: help to interact effectively with others and to manage relationships.
• Distress tolerance skills: help to recognize and accept negative emotions without doing something to make things worse.
• Walking the middle path skills: help to balance differing points of view while learning to validate and accept themselves and others.

Who would benefit most from DBT?

Our team provides adherent DBT for adolescents and young adults at UF Health Psychiatry – San Jose. For adults, we offer a DBT skills training group at UF Health Psychiatry – Jacksonville.

Targeted behaviors include:

• Borderline Personality Disorder
• Chronic emotion dysregulation
• Depression and anxiety
• Impulsivity
• Self-harm behaviors
• Suicidal ideation
• Trauma-related symptoms

DBT prioritizes treatment targets in the following order:

• Life-threatening behaviors
• Therapy-interfering behaviors
• Quality-of-life interfering behaviors
• Skills acquisition

What to expect from DBT

DBT is a structured, skills-based treatment that helps individuals and families learn practical tools to manage intense emotions, reduce high-risk behaviors and improve relationships.

Clients will need to schedule an intake screening to determine if they meet eligibility requirements for the DBT program.

Adherent DBT typically includes weekly individual therapy and weekly skills training group. Treatment length varies depending on treatment goals and progress, though skills group often follows structured modules.

Weekly individual therapy sessions last about one hour. Skills group sessions also meet weekly and focus on teaching and practicing coping strategies. Clients are expected to practice skills outside of sessions.

Skills coaching may be available between sessions to help apply DBT skills in real-life situations.

Our therapists work collaboratively with clients to reduce life-threatening behaviors, therapy-interfering behaviors and quality-of-life-interfering behaviors, while building skills in mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness.

At the completion of DBT, clients often report improved emotional stability, greater confidence in managing stress, healthier relationships and an increased sense of hope and direction.