Dialectical Behavioral Therapy (DBT)

Highest Standards, Nationally Recognized:

What is Dialectical Behavioral Therapy?

DBT is a form of cognitive behavioral therapy (CBT) developed by Dr. Marsha M. Linehan to help people struggling with intense emotions, impulsive behavior and unstable relationships. It was originally used to treat borderline personality disorder, but has since been adapted to address numerous mental health conditions.

DBT enhances the ability to work through difficult situations by combining the principles of CBT with mindfulness techniques and dialectical philosophy, which emphasizes the interconnectedness and paradoxical nature of opposing ideas. DBT embraces the fact that two seemingly contradictory concepts can be equally true without canceling each other out, helping individuals strike a balance between learning how to accept themselves as they are and acknowledging the need for change.

It helps shift one’s mindset from choosing between acceptance or change, to recognizing that both acceptance and change are necessary for growth.

How Does Dialectical Behavior Therapy Work?

One of the core theories of DBT is that some people are more prone to react intensely in emotional situations and take longer than others to calm down. They tend to have extreme mood swings and see the world in black and white. They find it hard to cope with such intense emotional surges, which can cause problems in their daily lives and relationships.

DBT provides a way to deal with these issues in a strategic way. During treatment, clients are taught how to cope with negative emotions, thoughts and behaviors to improve things like mindfulness, emotional regulation, interpersonal relationships and distress tolerance. Together, these skill areas are the four main pillars of DBT.

Four Pillars of Dialectical Behavior Therapy


Acceptance is the acknowledgment of reality as it is, rather than trying to fight or deny painful events and emotions. This doesn’t mean approving or endorsing what happened, but by accepting things as they are, clients can begin to develop effective solutions for moving forward and making change possible.

  • Mindfulness: Mindfulness is the cornerstone of DBT and emphasizes being present in the moment. This helps clients learn to understand, accept and observe their emotions without judgment and focus on the here and now in a calm, collected way. Mindfulness helps individuals develop a more balanced sense of self, which can help with intense emotions and reactivity.
  • Distress tolerance: Distress tolerance focuses on tolerating and minimizing the distress felt when faced with negative emotions. It teaches clients how to accept the current situation and cope with negative situations using healthier behaviors.


Once a client has become familiar with the idea of acceptance, they will pair it with change. DBT teaches people that they are OK as they are, but helps them build the skills needed to shift their thinking, emotions and behavior in a more positive direction.

  • Emotional regulation: Emotional regulation teaches clients how to navigate difficult or powerful emotions more effectively. By learning how to cope with intense feelings, clients become less vulnerable to negative moods and have more positive experiences.
  • Interpersonal effectiveness: Interpersonal effectiveness helps clients understand their relationships with others and handle conflict appropriately. It teaches them how to get what they want from others while sticking to their values, maintaining relationships and fostering the independence they need to move forward in the world.

What Should Dialectical Behavioral Therapy Accomplish?

DBT should be effective in helping clients to maintain control of their overwhelming emotions and learn to manage them more effectively. It also helps them to learn to handle distress in healthier ways. DBT emphasizes learning to tolerate emotional pain and better cope with negative situations. These skills help our clients to live happier and healthier lives.

Many different types of people are taught DBT skills: from those who are stressed out with work, to those struggling with parenthood, to adolescents who harm themselves in dealing with their stress. All walks of life are able to benefit from these skills. Dialectical behavioral therapy skills are positive life skills from which anyone can benefit.

What to Expect During DBT at Avalon Malibu

At Avalon Malibu, our therapists reinforce positive, adaptive behaviors as they occur. The emphasis is on teaching clients to manage emotional trauma rather than taking them out of the present crisis. Together, therapists and clients work to improve basic social skills by learning distress tolerance, reality acceptance, emotional regulation, and mindfulness.

Using DBT, we also focus on reducing destructive behaviors by teaching our clients clear and healthy ways to adapt and cope with their challenges and feelings of frustration or lack of power. Another focus is mindfulness — research has shown that problem-solving occurs when attention is fully focused on the present moment. There are two areas affected by stress: short-term memory and the ability to process information quickly.

Mindfulness in DBT includes meditation practices, where the client observes the experience of the present moment without judgment or impulsive action. These observations have been shown to reduce stress and increase concentration when practiced consistently. As a result, clients learn to recognize emotions in themselves and others, tolerate difficult emotions, and engage others more effectively for healthier relationships.

Dialectical Behavioral Therapy Group Work

Sometimes people have suffered painful childhood experiences that they cannot cope with. They find it hard to sleep without nightmares, or they feel angry or sad much of the time. They may abuse substances to get by. In relationships, they often feel misunderstood, hurt, angry or afraid that others don’t or won’t like them.

Group DBT sessions usually discuss how to apply the information learned during treatment to the client’s personal problems. These sessions teach clients a set of skills that work in coping with a range of difficult situations. The group is set up differently than ordinary group sessions and often resembles a classroom, with handouts, lectures, people taking notes, and discussions. Because of this, DBT is not like traditional group therapy.

A facilitator leads the groups in a focused and safe environment in which to learn and grow. Clients bring what they have learned in group to their individual DBT sessions, where discussion centers around how to personally apply the skills and information.

At Avalon Malibu, we’ve seen firsthand the difference that DBT can make in the lives of our clients. By teaching individuals how to apply the principles of DBT to their everyday lives, our experienced clinicians can help you or someone you love learn how to manage difficult emotions or situations and move toward a healthier way of being. If you’re struggling with mental health concerns, substance abuse or trauma, call us today at 888-958-7511 to learn more about our programs and find out if they’re right for you.

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