Is Dbt Skills Suitable for You? Signs and Help Options

Dialectical Behavior Therapy (DBT) is a comprehensive therapeutic approach that has transformed the landscape of mental health treatment since its development in the late 1980s. Originally created by psychologist Marsha Linehan to help individuals with borderline personality disorder who experienced chronic suicidal thoughts, DBT has grown significantly over the past 30 years, with research proliferating along with interest by clinicians and the public. This evidence-based treatment combines cognitive-behavioral techniques with mindfulness practices to help individuals develop critical life skills for managing emotions, improving relationships, and building a life worth living.

If you're struggling with intense emotions, unstable relationships, or self-destructive behaviors, you may be wondering whether DBT skills could help you. This comprehensive guide will help you understand what DBT is, assess whether it's suitable for your needs, recognize the signs that indicate you could benefit from this approach, and explore the various help options available to you.

What Is Dialectical Behavior Therapy?

At its core, DBT is a form of cognitive-behavioral therapy (CBT), yet DBT developed as a result of failures of traditional CBT for women with chronic suicidal behaviors and borderline personality disorder. The term "dialectical" refers to the synthesis of opposites—specifically, the balance between acceptance and change. This philosophical foundation recognizes that people need to accept themselves as they are while simultaneously working to change problematic behaviors and thought patterns.

The Theoretical Foundation of DBT

The evolution of DBT led to three theoretical underpinnings that inform the treatment: behavioral science, acceptance, and dialectical philosophy. DBT blends cognitive-behavioral approaches with practices embodied by the dialectical thinking of Zen, in which the dialectical balance of acceptance and changes and relationship between normal and abnormal psychology and behavior is emphasized.

DBT follows a biosocial model that conceives borderline personality disorder as a disorder of the emotion regulation system that activates a behavioral pattern of instability as a coping mechanism. This model suggests that emotional dysregulation results from a combination of biological vulnerability to emotional sensitivity and an invalidating environment during development.

The Structure of Standard DBT

The standard DBT has multicomponent including weekly individual therapy, weekly group skills training, as-needed between-session telephone coaching and weekly therapist consultation team meetings. This comprehensive structure ensures that individuals receive support across multiple dimensions:

• Individual Therapy: One-on-one sessions focus on motivation, addressing life-threatening behaviors, and applying DBT skills to specific challenges in your life.
• Group Skills Training: Weekly sessions where you learn and practice the four core skill modules with others facing similar challenges.
• Phone Coaching: Between-session support to help you apply skills in real-time crisis situations.
• Consultation Team: Therapists meet regularly to ensure they're providing the best possible treatment and maintaining their own well-being.

Understanding the Four Core DBT Skills Modules

The heart of DBT lies in its four skills modules, each designed to address specific challenges related to emotional regulation and interpersonal functioning. DBT's four skills map directly onto the dialectical model, with mindfulness and distress tolerance being acceptance-oriented skill modules, while emotion regulation and interpersonal effectiveness are change-oriented skills.

Mindfulness: The Foundation of DBT

Mindfulness is the foundation skill for DBT, teaching you to observe your thoughts and feelings non-judgmentally, setting the stage for emotion regulation, distress tolerance and interpersonal effectiveness. Mindfulness skills are the foundation of all Dialectical Behavioral Therapy skills training.

Mindfulness is the practice of being fully present in the moment without judging yourself or your feelings, involving developing an awareness of your thoughts, emotions, and sensations while learning to accept them without reacting impulsively.

DBT mindfulness skills are organized into two categories:

• "What" Skills (what you do to be mindful):
  • Observe: Notice your experience without trying to change it
  • Describe: Put words to your experience without judgment
  • Participate: Fully engage in the present moment
• "How" Skills (how you practice mindfulness):
  • Non-judgmentally: Let go of evaluating experiences as good or bad
  • One-mindfully: Focus on one thing at a time
  • Effectively: Do what works in each situation

Research found that clinical application of mindfulness as taught in DBT leads to increases in self-reported mindfulness—especially non-judgemental awareness along with psychological measures that suggests an increase in mindfulness, and studies demonstrated that an increase in mindfulness had a positive effect on some clinical symptoms such as symptoms of Borderline Personality Disorder.

Distress Tolerance: Surviving Crisis Without Making Things Worse

Distress Tolerance skills are a set of Dialectical Behavioral Therapy skills that are strategies to help you get though difficult feelings and situations, and tolerate the things that you can't immediately change. DBT emphasizes learning to bear pain skillfully because pain and distress are part of life and cannot be entirely avoided, and tolerance is necessary during any behavior change because impulsive behavior would interfere.

The distress tolerance module includes both crisis survival - dealing with high stress situations without making things worse - and reality acceptance skills, for coming to terms with things that have happened and aspects of the client's present experience that they wish were different, with these skills focusing on acceptance of what is happening in the present, with the view that this is the first step in changing what is in our control.

Key distress tolerance techniques include:

• TIPP Skills: Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation to quickly reduce emotional arousal
• ACCEPTS: Activities, Contributing, Comparisons, Emotions, Pushing away, Thoughts, and Sensations to distract from distress
• Self-Soothing: Using your five senses to comfort yourself in healthy ways
• IMPROVE: Imagery, Meaning, Prayer, Relaxation, One thing in the moment, Vacation, and Encouragement
• Radical Acceptance: Completely accepting reality as it is, even when it's painful
• Willingness vs. Willfulness: Choosing to participate in life rather than refusing to tolerate the moment

Emotion Regulation: Understanding and Managing Your Feelings

Emotion Regulation is the Dialectical Behavioral Therapy module that teaches how emotions work, providing skills to help manage emotions instead of being managed by them, reduce vulnerability to negative emotions, and build positive emotional experiences.

Learning Emotion Regulation Skills help you to address emotional vulnerability and manage your emotional reactions in healthy ways and offers you specific techniques to help manage emotions, with one of the goals being able to identify and label your feelings and change the feelings that you want to change.

Core emotion regulation skills include:

• Understanding Emotions: Learning how emotions function and why they occur
• Identifying and Labeling Emotions: Recognizing and naming what you're feeling
• Reducing Emotional Vulnerability: Taking care of your physical health through the PLEASE skills (treating Physical illness, balanced Eating, avoiding mood-altering substances, balanced Sleep, and Exercise)
• Increasing Positive Emotions: Building experiences that create positive feelings
• Building Mastery: Engaging in activities that make you feel competent and confident
• Opposite Action: Acting opposite to your emotional urge when the emotion doesn't fit the facts
• Checking the Facts: Examining whether your emotional response matches the actual situation
• Problem Solving: Addressing situations that trigger unwanted emotions

Interpersonal Effectiveness: Building Healthy Relationships

Interpersonal effectiveness skills help you communicate your needs, maintain self-respect, and build satisfying relationships. These skills are particularly valuable for people who struggle with assertiveness, setting boundaries, or maintaining relationships while managing intense emotions.

Key interpersonal effectiveness skills include:

• DEAR MAN: A structured approach for making requests and setting boundaries (Describe, Express, Assert, Reinforce, stay Mindful, Appear confident, Negotiate)
• GIVE: Skills for maintaining relationships (be Gentle, act Interested, Validate, use an Easy manner)
• FAST: Skills for maintaining self-respect (be Fair, no Apologies, Stick to values, be Truthful)
• Balancing Priorities: Knowing when to prioritize objectives, relationships, or self-respect
• Building Relationships: Finding and nurturing positive connections
• Ending Destructive Relationships: Recognizing when to let go of harmful connections

Who Can Benefit from DBT Skills?

While DBT was originally developed for borderline personality disorder, the vast majority of research demonstrates that it is effective at treating the behaviors that it targets across a wide range of conditions and populations.

Borderline Personality Disorder

Dialectical Behavior Therapy is a program that has provided encouraging results for treatment of borderline personality disorder. DBT is specifically identified as having persuasive data from randomized, controlled trials showing its efficacy for BPD treatment.

Combining effect measures for suicide and parasuicidal behavior revealed a net benefit in favor of DBT, and DBT demonstrates efficacy in stabilizing and controlling self-destructive behavior and improving patient compliance.

Suicidal and Self-Harming Behaviors

Dialectical behavior therapy is an effective intervention for chronically suicidal and self-injurious adolescents that incorporates caregivers in treatment to address emotion dysregulation due to chronic invalidation. DBT has strong evidence in support of its effectiveness in reducing suicide attempts, anger, impulsivity, and substance abuse.

Results have demonstrated reductions in a number of outcomes associated with BPD including self-harm, suicidal behaviours, and hospital admissions.

Post-Traumatic Stress Disorder (PTSD)

Based on the results of meta-analysis, DBT-PTSD and DBT PE were effective in reducing PTSD symptom severity and comorbid depressive symptoms. Specialized adaptations of DBT have been developed specifically to address trauma, combining DBT skills with exposure-based treatments for individuals with both PTSD and emotion regulation difficulties.

Substance Use Disorders

DBT has been adapted to treat substance use disorders, particularly for individuals who also struggle with emotional dysregulation. The skills help people manage cravings, tolerate distress without using substances, and build a life worth living that doesn't revolve around substance use.

Eating Disorders

The therapeutic benefits of DBT are supported by empirical evidence and research which support its effectiveness in reducing self-injurious behaviors, self-harm attempts, suicidal thoughts, as well as behaviors associated with depression or bulimia nervosa. DBT skills help individuals manage the emotional triggers for disordered eating behaviors and develop healthier coping strategies.

Depression and Anxiety

During the first six months of treatment, self-reported symptoms of depression, emotional and behavioral dysregulation, and psychological inflexibility significantly decreased. DBT skills can be particularly helpful for individuals whose depression or anxiety is characterized by emotional intensity and difficulty regulating emotions.

Adolescents with Emotional Dysregulation

Dialectical Behavioral Therapy emerges as a promising strategy, originating in 1993 as an outpatient program for individuals with borderline personality disorder, and has evolved into an evidence-based intervention for treating emotion dysregulation and maladaptive behaviors, providing structured techniques and coping mechanisms that equip adolescents with essential skills to navigate their emotions and cultivate resilience.

Signs That DBT Skills May Be Right for You

Determining whether DBT is suitable for you involves honest self-reflection about your emotional experiences, behavioral patterns, and relationship dynamics. Here are comprehensive signs that suggest DBT skills could be beneficial:

Emotional Intensity and Dysregulation

• You experience emotions that feel overwhelming and difficult to control
• Your emotions shift rapidly and unpredictably
• You feel emotions more intensely than others seem to
• Small events trigger disproportionately strong emotional reactions
• Once upset, it takes you a long time to calm down
• You feel like you're on an emotional rollercoaster
• You struggle to identify exactly what you're feeling
• Your emotions feel like they control you rather than the other way around

Relationship Difficulties

• Your relationships often feel unstable or tumultuous
• You experience intense fear of abandonment or rejection
• You have difficulty maintaining long-term relationships
• You struggle with setting and maintaining healthy boundaries
• You find it hard to ask for what you need
• You often feel misunderstood by others
• You tend to idealize people initially, then become disappointed
• Conflicts in relationships feel catastrophic
• You have difficulty balancing your needs with others' needs

Self-Destructive or Impulsive Behaviors

• You engage in self-harm behaviors
• You have thoughts of suicide or have made suicide attempts
• You turn to substance use to cope with emotions
• You engage in binge eating or other disordered eating patterns
• You make impulsive decisions that you later regret
• You engage in risky sexual behavior
• You spend money impulsively
• You sabotage your own success or relationships
• You act on urges without thinking through consequences

Difficulty with Distress and Crisis

• You have difficulty coping with stressful situations
• Minor setbacks feel like major crises
• You feel like you can't tolerate uncomfortable emotions
• You avoid situations that might be emotionally challenging
• You feel overwhelmed by everyday problems
• You have difficulty problem-solving when upset
• You turn to unhealthy coping mechanisms during stress

Sense of Self and Identity

• You struggle with feelings of emptiness or boredom
• You're not sure who you really are
• Your sense of self changes depending on who you're with
• You feel disconnected from yourself or your life
• You have difficulty identifying your values and goals
• You feel like you're just going through the motions

Cognitive Patterns

• You tend to think in black-and-white terms
• You have difficulty seeing nuance or middle ground
• You experience intrusive, distressing thoughts
• You struggle with rumination or obsessive thinking
• You have difficulty staying focused on the present moment
• You're highly self-critical

History of Invalidation

• You grew up in an environment where your emotions were dismissed or criticized
• You were told you were "too sensitive" or "overreacting"
• Your emotional experiences were minimized or ignored
• You learned to distrust your own perceptions and feelings
• You have difficulty validating your own experiences

The Benefits of Learning DBT Skills

DBT skills offer numerous benefits that can lead to profound improvements in quality of life. Understanding these potential benefits can help you decide whether pursuing DBT is right for you.

Enhanced Emotional Regulation and Stability

One of the primary benefits of DBT is learning to regulate emotions more effectively. You'll develop the ability to:

• Identify and understand your emotions more clearly
• Reduce the intensity of overwhelming emotions
• Decrease emotional reactivity to triggering situations
• Experience more emotional stability day-to-day
• Respond to emotions skillfully rather than being controlled by them
• Build resilience against future emotional challenges

Improved Interpersonal Relationships

Participants found DBT gave them control over their lives and the ability to manage setbacks and difficult situations, and contributed to healthier and more meaningful relationships with others. DBT skills help you:

• Communicate your needs more effectively
• Set and maintain healthy boundaries
• Navigate conflicts more successfully
• Build and maintain satisfying relationships
• Balance your needs with others' needs
• Reduce relationship-related distress
• Develop more secure attachment patterns

Reduction in Self-Destructive Behaviors

DBT is particularly effective at reducing harmful behaviors. Benefits include:

• Decreased self-harm behaviors
• Reduced suicidal thoughts and attempts
• Better management of substance use
• Decreased impulsive decision-making
• Improved ability to resist urges to engage in problematic behaviors
• Development of healthier coping strategies

Enhanced Coping Strategies for Stress and Crisis

DBT provides practical tools for managing difficult situations:

• Ability to tolerate distress without making situations worse
• Skills for getting through crises safely
• Techniques for self-soothing in healthy ways
• Capacity to accept difficult realities
• Improved problem-solving abilities
• Greater confidence in handling challenging situations

Greater Self-Awareness and Mindfulness

The mindfulness component of DBT brings significant benefits:

• Increased awareness of thoughts, emotions, and physical sensations
• Ability to stay present rather than ruminating about the past or worrying about the future
• Reduced reactivity to thoughts and emotions
• Greater acceptance of yourself and your experiences
• Improved focus and concentration
• Enhanced ability to observe without judgment

Building a Life Worth Living

Perhaps the most profound benefit of DBT is the focus on creating a meaningful life:

• Clarification of personal values and goals
• Increased engagement in activities that bring joy and meaning
• Greater sense of purpose and direction
• Improved quality of life overall
• Enhanced self-respect and self-compassion
• Development of a stronger sense of identity

Long-Term Benefits

Participants found DBT had a positive impact on their lives in the years after the programme and enabled further development. Research shows that the benefits of DBT can be lasting, with skills continuing to serve individuals long after formal treatment ends.

Help Options for Learning DBT Skills

If you've determined that DBT skills might be beneficial for you, there are multiple pathways to access this treatment. The right option depends on your specific needs, resources, and circumstances.

Comprehensive DBT Programs

The gold standard for DBT treatment is a comprehensive program that includes all four components: individual therapy, group skills training, phone coaching, and therapist consultation team. This intensive approach is typically recommended for individuals with more severe symptoms, particularly those struggling with suicidal thoughts, self-harm, or borderline personality disorder.

What to expect:

• Weekly individual therapy sessions (typically 50-60 minutes)
• Weekly group skills training (typically 2-2.5 hours)
• Access to phone coaching between sessions
• Commitment to the full program (usually one year)
• Homework assignments to practice skills
• Daily diary cards to track emotions, urges, and skill use

Benefits: Most comprehensive support, individualized treatment, real-time crisis support, peer learning in groups

Considerations: Significant time commitment, higher cost, may not be available in all areas

Individual DBT Therapy

Working one-on-one with a DBT-trained therapist can provide personalized support and guidance. While this may not include all components of comprehensive DBT, a skilled therapist can teach you DBT skills and help you apply them to your specific challenges.

What to look for in a DBT therapist:

• Formal training in DBT (intensive training workshops or certification)
• Experience treating your specific concerns
• Participation in a DBT consultation team
• Adherence to the DBT model
• Good therapeutic fit and rapport

Benefits: Personalized attention, flexible scheduling, can address individual concerns in depth

Considerations: May not include group skills training or phone coaching, effectiveness depends heavily on therapist's DBT expertise

DBT Skills Groups

DBT skills groups focus specifically on teaching the four skills modules without the individual therapy component. This option can be beneficial for people who want to learn DBT skills but may not need the full comprehensive program.

What to expect:

• Weekly group sessions (typically 2-2.5 hours)
• Structured curriculum covering all four skills modules
• Homework assignments and skills practice
• Peer support and shared learning
• Duration of 6 months to one year

Benefits: Learn from others' experiences, more affordable than individual therapy, structured skills training, peer support

Considerations: Less individualized attention, requires commitment to group attendance, may not address crisis situations

Online DBT Programs and Teletherapy

The digital age has made DBT more accessible through online platforms. Studies aim to examine the efficacy of TF-DBT compared to standard DBT and to compare the efficacy of TF-DBT and S-DBT delivered in online versus face-to-face formats, with research exploring the effectiveness of online delivery.

Options include:

• Virtual individual therapy sessions
• Online DBT skills groups
• Self-paced online courses
• DBT apps and digital tools
• Video-based skills training

Benefits: Accessible from anywhere, flexible scheduling, often more affordable, can be combined with in-person treatment

Considerations: Requires reliable internet access, may lack personal connection, self-paced options require strong self-motivation

DBT Books and Workbooks

For those who prefer self-study or want to supplement therapy, numerous books and workbooks focus on DBT skills. While not a replacement for professional treatment for serious mental health concerns, these resources can be valuable learning tools.

Recommended types of resources:

• Comprehensive DBT skills workbooks with exercises
• Books explaining DBT concepts and applications
• Specialized workbooks for specific issues (e.g., emotion regulation, relationships)
• Mindfulness practice guides
• DBT worksheets and handouts

Benefits: Affordable, self-paced learning, can review material as needed, good supplement to therapy

Considerations: Requires self-discipline, no personalized guidance, may be insufficient for severe symptoms, no crisis support

Online Resources and Websites

Various websites offer free DBT skills training materials, worksheets, videos, and educational content. These can be excellent resources for learning about DBT and practicing skills.

What to look for:

• Evidence-based information from credible sources
• Comprehensive coverage of all four skills modules
• Practical exercises and worksheets
• Video demonstrations of skills
• Clear explanations suitable for self-study

Benefits: Free or low-cost, accessible anytime, variety of learning formats, can explore before committing to treatment

Considerations: Quality varies, no personalized support, requires self-motivation, not suitable as sole treatment for serious concerns

Intensive Outpatient Programs (IOPs) and Partial Hospitalization Programs (PHPs)

For individuals who need more support than weekly therapy but don't require inpatient hospitalization, intensive programs incorporating DBT can be beneficial.

What to expect:

• Multiple sessions per week (IOPs: typically 9-20 hours/week; PHPs: typically 20-30 hours/week)
• Combination of individual therapy, group skills training, and other therapeutic activities
• More intensive support during crisis periods
• Structured environment for learning and practicing skills

Benefits: Intensive support, faster skill acquisition, structured environment, step-down from inpatient care or step-up from outpatient

Considerations: Significant time commitment, may interfere with work or school, higher cost, not available everywhere

DBT-Informed Treatment

Some therapists incorporate DBT skills and principles into their practice without offering a full DBT program. This "DBT-informed" approach can be helpful, particularly when combined with other therapeutic modalities.

Benefits: Flexibility to integrate DBT with other approaches, may be more readily available, can be tailored to individual needs

Considerations: Not adherent DBT, effectiveness may vary, may not include all DBT components

How to Find DBT Treatment

Finding quality DBT treatment requires some research and effort. Here are strategies to help you locate appropriate resources:

Professional Directories and Organizations

• Behavioral Tech: The organization founded by Marsha Linehan maintains a directory of DBT programs and clinicians who have completed intensive training
• Psychology Today: Search for therapists who list DBT as a specialty
• Your insurance provider: Contact your insurance company for a list of in-network DBT providers
• Local mental health organizations: Community mental health centers often offer DBT programs
• University counseling centers: Many universities offer DBT, sometimes at reduced cost

Questions to Ask Potential Providers

When evaluating DBT treatment options, consider asking:

• What is your training in DBT? (Look for intensive training workshops or certification)
• Do you participate in a DBT consultation team?
• What components of DBT do you offer? (individual therapy, skills group, phone coaching)
• How long is the treatment program?
• What is your experience treating my specific concerns?
• What does a typical session look like?
• What are the costs and do you accept insurance?
• What is your approach to crisis situations?
• How do you measure progress?

Financial Considerations

DBT treatment can be expensive, but there are options to make it more affordable:

• Insurance coverage: Many insurance plans cover DBT as mental health treatment; verify coverage and any requirements
• Sliding scale fees: Some providers offer reduced rates based on income
• Community mental health centers: Often provide DBT at lower cost
• Training clinics: University programs may offer DBT provided by supervised trainees at reduced rates
• Online options: Generally more affordable than in-person treatment
• Self-help resources: Books, workbooks, and free online materials can supplement or prepare for formal treatment

What to Expect When Starting DBT

Understanding what to expect can help you prepare for and commit to DBT treatment.

The Commitment Phase

DBT typically begins with a commitment phase where you and your therapist discuss:

• Your goals for treatment
• The structure and expectations of DBT
• Your commitment to the process
• Target behaviors to address
• Ground rules and agreements

The Learning Curve

Learning DBT skills takes time and practice. Be prepared for:

• Initial difficulty applying skills in real-life situations
• The need for repeated practice
• Homework assignments between sessions
• Tracking your emotions, urges, and skill use
• Gradual improvement rather than immediate change

The Treatment Hierarchy

DBT follows a specific hierarchy of treatment targets:

1. Life-threatening behaviors (suicide attempts, self-harm)
2. Therapy-interfering behaviors (missing sessions, not doing homework)
3. Quality-of-life interfering behaviors (substance use, relationship problems)
4. Skills acquisition and strengthening
5. Post-traumatic stress (in some DBT programs)
6. Self-respect and achieving individual goals

This hierarchy ensures that the most critical issues are addressed first.

The Role of Homework

DBT requires active participation outside of sessions:

• Completing diary cards daily
• Practicing skills in real-life situations
• Completing worksheets and exercises
• Reading assigned materials
• Applying skills between sessions

The more you practice, the more effective the treatment will be.

Overcoming Barriers to DBT Treatment

Several common barriers can prevent people from accessing or benefiting from DBT. Understanding these obstacles can help you address them proactively.

Availability and Access

Challenge: DBT programs may not be available in your area, particularly in rural locations.

Solutions:

• Consider online DBT options
• Look for DBT-informed therapists who incorporate skills
• Use self-help resources while waiting for a program opening
• Consider traveling to a nearby city for intensive programs
• Advocate for DBT services in your community

Cost and Insurance

Challenge: DBT can be expensive, and not all insurance plans provide adequate coverage.

Solutions:

• Verify insurance coverage and appeal denials if necessary
• Seek sliding scale providers
• Look into community mental health centers
• Consider group-only options which are typically less expensive
• Use free or low-cost online resources
• Investigate whether your employer offers an Employee Assistance Program (EAP)

Time Commitment

Challenge: Comprehensive DBT requires significant time investment (individual therapy, group, homework).

Solutions:

• Prioritize treatment as an investment in your future
• Discuss scheduling flexibility with providers
• Consider evening or weekend groups
• Start with skills group only if full program isn't feasible
• Use online options for greater scheduling flexibility

Skepticism or Resistance

Challenge: You may feel skeptical about whether DBT will help or resistant to the commitment required.

Solutions:

• Educate yourself about DBT's evidence base
• Start with a trial period to see if it's a good fit
• Discuss concerns openly with your therapist
• Connect with others who have benefited from DBT
• Remember that ambivalence is normal and can be worked through
• Focus on your goals and what you want to change

Shame or Stigma

Challenge: You may feel ashamed about needing help or worry about stigma associated with mental health treatment.

Solutions:

• Recognize that seeking help is a sign of strength, not weakness
• Remember that mental health challenges are common and treatable
• Focus on your well-being rather than others' opinions
• Connect with supportive people who understand
• Practice self-compassion
• Consider online options if privacy is a concern

Maximizing Your Success with DBT

To get the most benefit from DBT skills training, consider these strategies:

Commit Fully to the Process

• Attend all scheduled sessions
• Complete homework assignments
• Practice skills daily, even when you don't feel like it
• Be honest with your therapist about challenges
• Give the treatment adequate time to work (at least several months)

Practice Skills Consistently

• Use skills even when you're not in crisis
• Practice new skills repeatedly until they become automatic
• Keep skills materials accessible for quick reference
• Track which skills work best for you
• Be patient with yourself as you learn

Build a Support System

• Share what you're learning with trusted friends or family
• Connect with others in your skills group
• Consider involving loved ones in your treatment when appropriate
• Seek out supportive communities (online or in-person)
• Educate important people in your life about DBT

Be Patient and Compassionate with Yourself

• Recognize that change takes time
• Expect setbacks and view them as learning opportunities
• Celebrate small victories
• Practice self-validation
• Remember that struggling doesn't mean failure

Apply Skills to Real Life

• Look for opportunities to practice skills in daily situations
• Start with easier situations before tackling more challenging ones
• Reflect on what works and what doesn't
• Adjust your approach based on experience
• Generalize skills across different contexts

When DBT Might Not Be the Right Fit

While DBT is highly effective for many people, it's not the right choice for everyone. Consider whether DBT might not be suitable if:

• You're not willing or able to commit to the time requirements
• You're in active crisis requiring inpatient stabilization
• You have severe cognitive impairments that prevent learning new skills
• You're dealing primarily with issues better addressed by other treatments (e.g., specific phobias, OCD)
• You're not experiencing significant emotion dysregulation
• You prefer a less structured, more exploratory therapeutic approach

If DBT doesn't seem like the right fit, discuss alternatives with a mental health professional. Other evidence-based treatments might be more appropriate for your specific needs.

Complementary Approaches to DBT

DBT can be effectively combined with other treatments and self-care practices:

Medication

While DBT is a psychotherapy, medication can be a helpful adjunct for managing specific symptoms like depression, anxiety, or mood instability. Work with a psychiatrist to determine if medication might support your DBT treatment.

Other Therapeutic Approaches

• Trauma-focused therapies: EMDR or prolonged exposure for PTSD
• Family therapy: To address relationship dynamics
• Couples therapy: To improve romantic relationships
• Occupational therapy: For practical life skills

Lifestyle Factors

• Regular exercise: Supports emotional regulation and stress management
• Adequate sleep: Essential for emotional stability
• Balanced nutrition: Impacts mood and energy
• Stress reduction: Yoga, meditation, or other relaxation practices
• Social connection: Maintaining supportive relationships
• Meaningful activities: Engaging in hobbies and interests

The Future of DBT: Emerging Developments

DBT continues to evolve with ongoing research and adaptation. DBT research has grown significantly since the 1990s, with the United States leading in publication volume, citation impact, and academic collaboration. Recent developments include:

• Adaptations for specific populations: DBT protocols tailored for adolescents, older adults, and specific cultural groups
• Shortened formats: Brief DBT interventions for those who can't commit to year-long programs
• Technology integration: Apps, virtual reality, and digital tools to support skill practice
• Expanded applications: DBT principles applied to new conditions and settings
• Trauma-focused DBT: Trauma-Focused DBT is based on the principles, treatment modes, and functions of DBT, with the goal to condense and accelerate the core therapeutic processes of DBT and expand therapeutic strategies for addressing BPD symptoms beyond Stage I of DBT

Taking the Next Step

If you've recognized yourself in the signs and symptoms described in this article, taking action is the next important step. Here's how to move forward:

Assess Your Readiness

Consider these questions:

• Am I willing to commit time and effort to learning new skills?
• Do I believe that change is possible for me?
• Am I ready to practice skills even when it's difficult?
• Can I be honest with myself and my therapist about my struggles?
• Am I willing to tolerate discomfort as I learn and grow?

If you answered yes to most of these questions, you're likely ready to begin DBT.

Start Your Search

1. Research DBT providers in your area or online
2. Contact your insurance company to understand coverage
3. Reach out to potential providers to ask questions
4. Schedule initial consultations with therapists or programs
5. Choose the option that best fits your needs and circumstances

Prepare for Treatment

• Educate yourself about DBT through books or online resources
• Identify your primary goals for treatment
• Consider what support you'll need from others
• Arrange your schedule to accommodate therapy commitments
• Prepare to be an active participant in your treatment

If You're in Crisis

If you're experiencing suicidal thoughts or are in immediate danger, don't wait to start a DBT program. Seek immediate help:

• Call 988 (Suicide and Crisis Lifeline) in the United States
• Text "HELLO" to 741741 (Crisis Text Line)
• Go to your nearest emergency room
• Call 911 or your local emergency number
• Reach out to a trusted friend, family member, or mental health professional

Crisis support can help stabilize you so that you can then engage in DBT treatment.

Conclusion: Building a Life Worth Living

Determining whether DBT skills are suitable for you involves honest self-reflection about your emotional experiences, behavioral patterns, and relationship dynamics. If you struggle with intense emotions, unstable relationships, self-destructive behaviors, or difficulty tolerating distress, DBT may offer the tools and support you need to create meaningful change in your life.

The vast majority of research demonstrates that DBT is effective at treating the behaviors that it targets, though DBT has been established as a gold-standard treatment for certain populations and behaviors, there is much more research needed to answer critical questions and improve its efficacy. The evidence supporting DBT continues to grow, with applications expanding beyond its original focus on borderline personality disorder.

The journey through DBT is not always easy. It requires commitment, practice, and patience. You'll be asked to learn new ways of thinking and behaving, to tolerate discomfort, and to persist even when change feels slow. However, for many people, DBT provides the foundation for profound transformation—helping them move from a life of emotional chaos and suffering to one of greater stability, meaning, and fulfillment.

Whether you choose comprehensive DBT, skills groups, individual therapy, or self-study resources, the key is to take that first step. Reach out to a mental health professional, explore available resources, and begin the process of learning skills that can change your life. Remember that seeking help is not a sign of weakness but rather an act of courage and self-compassion.

DBT's ultimate goal is to help you build "a life worth living"—a life where you can manage your emotions effectively, maintain satisfying relationships, cope with stress skillfully, and pursue your values and goals. If you're struggling with the challenges described in this article, DBT skills may be exactly what you need to create the life you deserve.

For more information about DBT and mental health resources, visit the National Alliance on Mental Illness (NAMI), the Substance Abuse and Mental Health Services Administration (SAMHSA), or Psychology Today's therapist directory. These organizations provide valuable information, support, and connections to qualified mental health professionals who can help you on your journey toward healing and growth.