What is DBT therapy? Is DBT right for me?

October 8, 2026|Kim's Blog, Relationship Management|

Most people are aware of CBT (Cognitive Behavioural Therapy). But fewer are familiar with DBT (Dialectical Behaviour Therapy). This post supports psychoeducation – helping you understand more about how your mind works and exploring different types of therapy. It describes DBT therapy – its core concepts and some of its tools that you might use to improve your sense of personal control and self-esteem. What is DBT therapy? Is DBT right for me?

What is DBT?

DBT stands for Dialectical Behaviour Therapy.

“Dialectical” means exploring and comparing opposites and understanding that two things can be true at the same time. It helps people move from extremes to balance. For example, you might say “my childhood was awful” or “my childhood was wonderful” whereas the reality is probably closer to “my childhood had both difficult and pleasant aspects”.

Like CBT, DBT offers a way to step out of distorted thinking patterns – such as having a black and white view of the world. It helps you start to appreciate the grey areas.

DBT adopts a skills-based approach to help you change your relationship with uncomfortable thoughts. It helps you balance acceptance and change. DBT provides healthy coping mechanisms and helps you build a life worth living.

Origins of DBT and who finds it helpful

Dialectics Behaviour Therapy (DBT) is a third wave CBT (Cognitive Behaviour Therapy) talking therapy approach.

Cognitive Behavioural Therapy (CBT) is a structured, goal-focused type of talk therapy that helps you understand and change the connection between your thoughts, feelings, and behaviours. As there is a lot of evidence of its effectiveness, CBT is supported by the NHS.

DBT was originally created in 1993 by Marsha M Linehan, a US psychotherapist, to help those with personality disorders (particularly BPD – Borderline Personality Disorder which is now referred to as emotionally unstable personality disorder (EUPD)).

DBT has a philosophy of acceptance and is non-judgmental. DBT offers ways to challenge unhelpful thoughts, adopt healthier ways to think and behave and develop new skills to help you change and find new ways of dealing with distress. Whereas CBT is thought focused, DBT is more emotion focused.

DBT therapists may be more directive than other therapist types – they may provide more guidance. And there is a focus on helping clients learn new skills.

By helping you to understand yourself as a person and make sense of why you might do certain things – it can also help to reduce self-harm, depression (and suicidal thoughts), drug and alcohol and eating issues. Dialectical behaviour therapy (DBT) | Treatments | Mind

What’s involved in DBT therapy?

There are five principles and some core skills in DBT:

Dialectics – moving from opposites to a more balanced view

Mindfulness – to be fully present in the moment, aware of where we are and what we’re doing, and not overly reactive or overwhelmed by what’s happening around us

Distress tolerance – manage emotional pain and high stress without making the situation worse or reacting impulsively

Emotion regulation – monitor, manage and respond to your emotional state in a healthy way instead of letting intense feelings control your actions (see Emotional Regulation – A key element of Emotional Intelligence (EQ) and How to manage your emotions so they don’t manage you)

Interpersonal effectiveness – social and communication skills that help you meet your needs, handle conflict and build healthy relationships

Many DBT practitioners use a variety of therapy interventions: one-to-one sessions to track behaviours and assess progress, skills training groups and phone coaching. DBT therapists will provide interventions that:

Reduce life-threatening behaviours
Reduce therapy-interfering behaviours (from both the client and the therapist)
Address quality-of-life interfering behaviours
Increase behavioural skills

DBT therapists will validate clients – promoting self-acceptance – before attempting to help a client change their behaviour. A DBT therapist will help a client to slow down and pace themselves. DBT therapists may use behavioural chain analysis to look at the target behaviour, prompting or triggering events, vulnerability factors, links and consequences.

DBT encourages you to avoid the extremes of rational, logical mind and emotional mind. It helps you blend them together to use your wise mind (the 90 second rule to respond rather than react may help here: Confidence – Radiators and Drains and the 90 second rule)

Rational Mind
Emotional Mind
Wise Mind

Some DBT tools and skills to help you

Typically, you work with your therapist on these activities. Like all new activities and skills, it may take time to learn, practice and master them. Naturally, people differ in which techniques they find most helpful for them.

Monitor your moods

Find a way to monitor your moods. Perhaps in a diary or journal.

Develop a scale of 1 (bad day) through to 10 (great day) – and note words that you might use to describe in between days (how would you describe a “not so bad” day at 3? Or a “better day” at 8?)

You might also start to note down what happens to prompt days at either end of the scale. Note down what you are feeling and thinking and doing at different points on the scale.

TIPP technique for distress tolerance

A well-known DBT technique is TIPP – it helps if you rate your level of emotional distress (on a scale of 1 – 10) before the exercise and afterwards. You are encouraged to work through the stages for each situation causing distress

Temperature – Reduce your facial temperature to trigger the mammalian dive reflex, which slows a racing heart

Intense exercise – A short burst of fast movement to burn off extra adrenaline and physical energy caused by anger, anxiety or panic

Paced breathing – Slow and deepen your breath to signal to your nervous system that you are safe (breathing exercises are shown here: Grounding tools (support for emotional regulation) – Kim Tasso)

Progressive muscle relaxation – Tense and release different muscle groups noticing the physical sensations – move from your toes, up your body and to your face

TIPP: DBT Skills, Worksheets, Videos, Exercises

ACCEPT technique for distress tolerance

Helping you to regain control of yourself and your reactions to situations. It is a skill that needs to be learned and practiced.

Activities – Take action. Even a small step that takes your mind away from the distress. This might be as simple as going for a short walk. Or entering a different room or making a hot drink

Contribute – Notice other people and offer to help them in some way. Interacting and supporting someone else will reduce focus on ourselves and help diminish our negative state

Comparison – Consider people who may be enduring greater issues than you do. Show compassion to others to help remove our focus from self-destructive processes

Emotions – Think about a different state or emotion than you are experiencing. You don’t necessarily have to think positive thoughts. Consider a time when you felt something different and focus on that thought – remember what it felt like

Push – When feeling an extreme emotion, gently push against that state and build energy that motivates you to take back control

Thoughts – Try to move from what you are feeling to what you might think about. Engage your brain – watch an instructional video or TV documentary. Or tackle a puzzle or crossword

Other techniques are described here:

Grounding tools (support for emotional regulation) – Kim Tasso

How to manage your emotions so they don’t manage you

PLEASED technique to help with emotional regulation

Self-care skills reduce emotional vulnerability and promote well-being

Physical Health – Attend to your physical health – go to check-ups. Treat illness when it arises. Rest when you need it. Take some exercise.

List resources and barriers – List people who can help you and other sources of comfort and help. List things and activities that help improve your mood. Consider what presents a barrier to your self-care and find ways to overcome them

Eat balanced meals – Plan and eat regular balanced meals with healthy ingredients. Drink plenty of water to remain hydrated. Eat slowly and mindfully. Don’t eat too much or too little. Consider how to have a nutritious and balanced diet as part of your lifestyle

Avoid drugs and alcohol – Whilst these may provide temporary relief or numbness, it is likely that you will require more of these substances and that can create other issues. If you are concerned about inappropriate use then seek help.

Sleep between 7 and 10 hours – Sleep is important for our physical health and it regulates our energy levels and moods. Adjust your sleep routine if necessary

Exercise – Aim for 20 to 60 minutes exercise a few times each week. Try to move during the day – avoid long periods of just sitting or immobility.

Daily – All PLEASED skills need to become daily habits. Record your progress on your phone, a card or in a journal.

There are further tools to help with emotional regulation:

Emotional Regulation – A key element of Emotional Intelligence (EQ)

Grounding tools (support for emotional regulation) – Kim Tasso

How to manage your emotions so they don’t manage you

Stop letting everything affect you by Daniel Chidiac (Overthinking

Behaviour change exercise

Changing the way you feel, think and behave is hard. It requires time and practice. DBT offers a series of prompt questions to help you manage behaviour change

What behaviour do you want to change?
What small steps have you or could you take now to start your change process?
How have you or how might you reinforce this behaviour change?
What results have you seen so far?
What results have others seen in you and commented on?
What adjustments or enhancements might you make to the change process as you move forward?

Change process – Emotions when reacting to change

FAST technique to help with interpersonal effectiveness

Dialectics are central to healthy relationships. You need to be balanced about considering yourself and the other person (people). This approach helps you find balance based on the nature of the relationship and the situation.

Fair – Take a non-judgemental stance with yourself and others. Avoid extremes (use your wise mind) in interactions with others. We treat others with respect because it builds our sense of self-worth.

Apologies not always needed – Avoid unnecessary apologetic behaviour. You are entitled to your own viewpoint and opinion. You are allowed to disagree. Avoid apologies for things over which you have no control. Unnecessary apologies erode self-respect

Stick to values – Remember your goals, priorities and values. Choose behaviours and interactions that build your self-respect. Know which of your values are non-negotiable. Learn to adopt productive conflict resolution techniques

Truth and accountability – Be honest and accountable with yourself and others. Take responsibility for yourself

As a practising therapist, I recently attended some excellent training with Martin J Smith of ITC Consultancy. ITC Consultancy – “taking control of life, work and relationships”