How Does Dialectical Behavioral Therapy Work?

Dialectical Behavioral Therapy, or DBT, helps people manage painful emotions that can lead to self-destructive behaviors. Even though DBT was initially created as a treatment for borderline personality disorder, research shows that this particular form of therapy can also help treat:

  • Depression
  • Bipolar disorder
  • Post-traumatic stress disorder
  • Eating disorders
  • Substance use disorders and addiction

If you’re living with any of these conditions, DBT can teach you how to better regulate your emotions during challenging times. Dialectical behavioral therapy can also show you how to endure distressing moments without turning to harmful habits that can interfere with your wellbeing. Learning these techniques can help you communicate your needs better and improve your relationships with others. Let’s explore what DBT is and how the treatment works.

What Is Dialectical Behavioral Therapy?

Dialectical behavioral therapy is a treatment method that combines talk and behavioral therapy. As you discuss the negative emotions you feel with your therapist, you can learn strategies, techniques, and skills that can help you cope with stress, regulate distressing emotions, live in the moment, and improve interpersonal relationships.

As the name suggests, dialectical behavioral therapy is based on a philosophical idea called “dialectics.” The dictionary defines dialectics as the art of investigating or discussing the truth of opinions. That’s basically what happens in DBT. You discuss and explore the truth about the negative emotions you may be feeling in a particular moment. But DBT is also more substantial than that.

According to dialectics, everything is composed of opposites. Change happens when those opposites have a “dialogue” with each other. In DBT, you’ll learn that more often than not, truth and reality can be reached when opposing thoughts and feelings come together. If you’re battling depression, for example, you might think you’re either completely independent or absolutely helpless. Those two identities contradict each other. But the reality of who you are is somewhere in between independent and helpless. Recognizing that you are capable even if you’re not fully independent can help you combat feelings of despair.

DBT can help you learn to accept yourself by resolving the contradictions you inherently believe in. As you start to regulate your emotions and build your self-confidence, you’ll likely start to see positive changes in your life as well.

How Does DBT Therapy Work?

Dialectical behavioral therapy works by balancing opposites. Through this therapy, you’ll learn to balance two opposing perspectives at the same time. This can help you avoid harmful black-and-white thinking which can distort your self-image. In DBT, your therapist will help you develop a “both-and” mindset instead of an “either-or” outlook in a variety of ways. Here’s how.

  • Support-oriented identity building. With this method, a DBT therapist helps you identify your strengths and develop them so that you can feel better about yourself and your life.
  • Cognitive-based positive thinking. Working with a DBT therapist can also help you pinpoint thoughts, beliefs, and assumptions that make your life harder. Thoughts such as “I have to be perfect,” “I’m a terrible person,” and “I make everything worse” can trigger the distressing emotions you’re trying to overcome. DBT therapists can help you reframe these thoughts into beliefs such as “I don’t have to be perfect,” “Everyone messes up” and “I can learn from my mistakes.” These statements can help you regulate your emotions, which in turn, can help make life more bearable.
  • Collaborative skill building. Your DBT therapist might also encourage you to work on relationship challenges. They may ask to complete relationship-based homework assignments, role play new ways of interacting with others, and teach you how to calm yourself when others make you upset.

Most times, these methods are incorporated into individual or group DBT sessions.

  • Individual DBT sessions. During your weekly individual sessions, your therapist might focus on problem-solving behaviors you could have called upon for issues you encountered the previous week. Sometimes, DBT therapists use individual sessions to talk about quality of life issues. At other times, they may want to talk about decreasing current and post-traumatic stress reactions. These sessions may vary in topic, but they will be tailored to your specific needs and will focus on either building your identity, changing your thinking, or successfully engaging with others.
  • Group DBT sessions. Typically, group sessions focus on one of DBT’s 4 behavior-changing strategies:
    1. Mindfulness
    2. Distress tolerance and/or reality acceptance skills
    3. Emotional regulation
    4. Interpersonal effectiveness

Let’s explore these strategies individually.

DBT’s Behavior-Changing Strategies

Even though DBT is a subsect of cognitive behavioral therapy, which is known for its holistic approach to treatment, dialectical behavioral therapy focuses on 4 main behavior-changing strategies. As you engage in DBT, you’ll develop 4 specific skills that can help you effectively change your behavior. These strategies include:

1. Mindfulness

This is one of the most important DBT strategies because mindfulness helps you pay attention to what’s happening in your body, what you feel and think, and what’s happening around you. Mindfulness can also help you slow down and focus on using healthy coping skills when you’re distressed or feeling emotional pain. Additionally, being mindful can help you avoid automatic negative thinking that can lead to self-destructive behavior.

2. Distress Tolerance

Learning distress tolerance skills can help prepare you for intense emotions. This practice empowers you to cope with your reality in a more positive way. As you learn to endure stressful situations, you’ll feel less compelled to escape and more equipped to address stress in a healthy, productive, problem-solving way.

3. Emotional regulation

Learning to regulate your emotions allows you to manage powerful feelings more effectively. This DBT strategy can help you identify, name, and change your emotions. Being able to recognize and deal with intense emotions in a healthy way can help make you less vulnerable to psychological distress.

4. Interpersonal effectiveness

Not knowing how to effectively communicate with others can lower your self-esteem. Interpersonal effectiveness skills can help you better communicate with other people, strengthen your relationships, and maintain your self-respect and boundaries. Learning these skills can help combat anxiety and feelings of hopelessness and worthlessness. These skills can also help you deal with challenging people in a way that minimizes distress.

DBT: Effective Therapy Worth Investing In

At StoneRidge Centers, we pride ourselves on helping individuals reach a more balanced form of mental health. You don’t have to live in a constant state of psychological and emotional distress. Our comprehensive, evidence-based treatment programs can help you overcome mental health challenges. DBT can help you manage painful emotions in a healthy way. Invest in your mental health and contact us today if you’re ready to:

  • Stop self-destructive habits
  • Build and maintain healthier relationships
  • Minimize psychological and emotional distress
  • Improve your overall health and well being

Our team is ready, willing, and available to help you obtain optimal mental health.

Innovative, Evidence-Based Therapies

Because mental health and addiction concerns are so often interconnected, we utilize research-based approaches with evidence-based outcomes that promote overall healing and recovery.

Transcranial Magnetic Stimulation (TMS)

This low-impact magnetic stimulation activates neurons inside the brain, relieving symptoms associated with depression and anxiety.

qEEG/Brain Mapping

Using brain scanning and readings, we create a map of our patients’ brains, helping us develop more targeted and effective treatments.


This process assists patients in visualizing their own brain functionality through continuous EEG readings.

Spravato Therapy

We use carefully monitored doses of Spravato to help patients struggling with complex mental health disorders, including severe depression.

Cognitive Behavioral Therapy (CBT)

Patients use this practice to help reframe intrusive or negative thought patterns and develop coping techniques for long-term recovery.

Dialectical Behavior Therapy (DBT)

This practice helps patients learn to regulate emotions, communicate more effectively, and process their own thoughts and feelings..

Eye Movement Desensitization (EMDR)

Licensed and trained therapists guide patients through this technique for managing stress and anxiety on an ongoing basis.

Individual Therapy

Patients experience one-on-one therapy sessions with a licensed therapist to provide a safe and private place to recover and heal.

Group/Family Therapy

Patients can practice the skills and techniques they have learned in treatment with others in a safe, therapist-guided space.

Contact StoneRidge Centers

5940 E. Copper Hill Dr. Ste B & E, Prescott Valley, AZ. 86314

We exercise progressive, leading brain science in our treatment approach for patients in our community and across the country who are struggling with mental health and addiction challenges.